A nurse is teaching a client who has venous insufficiency due to deep-vein thrombosis. Which of the following Instructions should the nurse include in the teaching?

A) Use petroleum jelly on a cotton ball to plug your ear when shampooing.
This technique helps prevent water from entering the ear during activities like showering. While it is useful for keeping the ear dry, it does not directly address preventing trauma or further hearing impairment post-surgery.

B) Clean dried blood in your ear canal with a cotton-tipped applicator.
Using cotton-tipped applicators can cause damage to the delicate ear canal and potentially disturb the surgical site. This action increases the risk of infection and trauma, potentially worsening hearing loss instead of preventing it.

C) Avoid blowing your nose for 1 month after surgery.
Refraining from nose blowing is essential because it prevents pressure changes that could disrupt the surgical repair. Such pressure changes can lead to complications like graft displacement, which can cause trauma and impair hearing.

D) Notify your provider if you have popping or crackling sensations in the affected ear.
Popping or crackling can be common as the ear heals and adjusts. These sensations typically do not indicate a problem unless accompanied by pain or other symptoms. Thus, while monitoring is important, it is not a primary preventative measure for trauma or hearing issues.

A) "You will be allowed to drive yourself home within 6 hours following the procedure."This statement is incorrect. After an esophagogastroduodenoscopy (EGD), the patient is typically sedated, and the sedation can affect their alertness, coordination, and judgment. It is generally recommended that patients arrange for someone else to drive them home. It is unsafe for the patient to drive themselves after sedation, even if they feel alert. The nurse should instruct the client to have someone accompany them to the procedure and drive them home afterward.

B) "You might experience a hoarse voice for several days following the procedure."This statement is correct. A hoarse voice is a common and expected side effect after an esophagogastroduodenoscopy, as the procedure involves passing a flexible tube (endoscope) through the mouth and throat. The endoscope may cause irritation to the vocal cords or the lining of the throat, leading to a hoarse voice that can last for a few days. This is a normal, transient effect and should be explained to the patient in advance so they are not alarmed.

C) "You can have a clear liquid diet for breakfast prior to the procedure."This statement is incorrect. For most procedures like EGD, patients are typically instructed to fast for at least 6 to 8 hours prior to the procedure to ensure the stomach is empty. Having food or liquids before the procedure may increase the risk of aspiration or interfere with the examination. The nurse should educate the client to follow fasting instructions and avoid consuming any food or liquids, including clear liquids, as per the healthcare provider's guidelines.

D) "You should not take any of your routine medications until after the procedure is complete."

This statement is generally incorrect. Many patients are instructed to continue taking routine medications, especially if they are vital for managing chronic conditions, unless otherwise directed by the healthcare provider. In some cases, medications such as anticoagulants, aspirin, or certain blood pressure medications may need to be withheld temporarily before the procedure. However, the nurse should clarify with the healthcare provider which medications the client should stop or continue taking before the procedure. The patient should not withhold medications on their own without proper guidance.