A nurse is teaching a patent who is taking warfarin for deep venous thrombosis. Which statement by the patient indicates a need for further teaching?

A. Perform doppler evaluation once daily: While Doppler evaluation is valuable for assessing blood flow and detecting vascular abnormalities, performing it only once daily may not provide adequate monitoring, especially during the critical early postoperative period. More frequent assessments are necessary to ensure optimal graft function and to promptly identify any complications.

B. Assess for compartment syndrome every 2 hours: While assessing for compartment syndrome is important, performing assessments every 2 hours may not be necessary unless specific risk factors or clinical indications are present. Continuous monitoring for signs and symptoms of compartment syndrome is essential, but the frequency of assessment should be based on the patient's condition and the surgeon's orders.

C. Assess pulse of affected extremity every 15 minutes until stable: After popliteal bypass graft surgery, assessing the pulse of the affected extremity every 15 minutes until stable is crucial. Frequent pulse checks help monitor graft patency and perfusion to detect early signs of graft failure or ischemia. This high-frequency assessment allows for prompt identification of vascular compromise and timely intervention to prevent graft thrombosis or occlusion. Once the pulse is stable and adequate perfusion is confirmed, the frequency of pulse checks can be adjusted according to the patient's condition and clinical guidelines.

D. Palpate the affected leg for pain every shift: Palpating the affected leg for pain every shift is an important component of postoperative assessment. However, relying solely on pain assessment once per shift may not provide timely detection of complications or changes in the patient's condition, especially during the immediate postoperative period when close monitoring is necessary. Frequent and ongoing assessment of pain, along with other vital signs and clinical indicators, is essential for comprehensive postoperative care.

A. Diarrhea: Diarrhea is not a common side effect of metoprolol, a beta-blocker medication commonly used to treat hypertension. While gastrointestinal side effects such as nausea or constipation may occur, diarrhea is not typically associated with metoprolol use.

B. Insomnia: Insomnia, or difficulty falling or staying asleep, is a potential side effect of metoprolol. Beta-blockers like metoprolol may interfere with sleep patterns in some individuals, leading to insomnia. It is important for the nurse to assess the patient for changes in sleep patterns while taking metoprolol.

C. Urinary retention: Urinary retention, or the inability to completely empty the bladder, is not a common side effect of metoprolol. In fact, beta-blockers like metoprolol are more likely to cause urinary frequency or urgency rather than retention.

D. Gum changes: Gum changes, such as gingival hyperplasia, are not typically associated with metoprolol use. This side effect is more commonly associated with certain other medications, such as calcium channel blockers or anticonvulsants.