A nurse is teaching a group of parents about expected development of gross motor skills during infancy. The nurse should teach that the following developmental tasks are expected to occur in what order? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Rationale:

A. Encourage the client to elevate their legs while in bed: Elevating the affected leg helps reduce venous pressure, decreasing edema and discomfort associated with DVT. Elevation also promotes venous return, which can limit further clot propagation. This intervention provides symptom relief without increasing the risk of embolization.

B. Place an immobilizer on the affected leg: Immobilizers restrict movement and are used for musculoskeletal injuries, not for DVT management. Immobilization can worsen venous stasis by reducing circulation in the lower extremity. Instead, clients with DVT benefit from gentle mobility once anticoagulation is initiated, unless contraindicated, to prevent worsening clot burden.

C. Implement bleeding precautions: The client has diagnostic confirmation of DVT and will require anticoagulation, which increases bleeding risk. Bleeding precautions help prevent complications such as hematuria, bruising, or gastrointestinal bleeding. Monitoring for signs of bleeding and avoiding trauma are essential once therapy begins.

D. Apply intermittent pneumatic compression devices to the unaffected leg: IPC devices should not be applied to the affected limb due to the risk of dislodging the thrombus. However, using them on the unaffected leg promotes venous return and helps prevent additional clot formation.

E. Instruct the client to expect dark stools: Dark stools can indicate gastrointestinal bleeding, which is not an expected effect of DVT treatment. While anticoagulants can increase bleeding risk, the nurse should teach the client to report black or tarry stools immediately.

Rationale:

A. The client takes a hot bubble bath every day: Frequent hot bubble baths can irritate the skin and mucous membranes, potentially increasing the risk of infections. Daily bathing is acceptable, but water should be warm rather than hot, and bubble baths should be limited.

B. The client washes her perineum first when bathing: Proper hygiene involves washing from front to back to prevent transferring bacteria from the rectal area to the urethra or vagina. Washing the perineum first without this technique increases the risk of urinary tract infections.

C. The client brushes her teeth twice daily: Brushing teeth twice daily is an appropriate and effective oral hygiene practice. It helps prevent dental plaque, cavities, and gum disease, indicating correct understanding of personal hygiene.

D. The client wipes back to front when toileting: Wiping back to front can transfer fecal bacteria to the urethra and genital area, increasing the risk of urinary tract infections. The correct technique is front to back.