An adult female client, who is an office worker, comes to the occupational health dinic with an edematous right leg twice the size of the left leg. The client reports that she is otherwise healthy, smokes 2 packs of cigarettes a day, and takes birth control pills on a regular basis. Which initial nursing action should the occupational health nurse take?

A. A first voided morning specimen is often used for detecting conditions such as urinary tract infections (UTIs) or pregnancy because it is more concentrated and may provide a clearer result. However, for diagnosing urethritis specifically, a clean catch or midstream specimen is generally preferred to minimize contamination and better identify pathogens.
B. A clean catch urine specimen is the most appropriate method for diagnosing urethritis. This method reduces the risk of contamination from bacteria that may be present in the initial or final part of the urine stream, providing a more accurate representation of the urine coming directly from the bladder.
C. Collecting any specimen after drinking fluids is not a standardized method for diagnosing urethritis. While adequate fluid intake is generally important for urine production and can help dilute the urine, the quality and accuracy of the specimen are more reliably ensured through specific collection techniques such as a clean catch.
D. A 24-hour urine collection is used for assessing the overall function of the kidneys and measuring substances that vary in concentration throughout the day, such as proteins or electrolytes. It is not typically used for diagnosing urethritis, which is usually evaluated with a clean catch specimen for a more immediate assessment of infection or inflammation.

A. Chips and pretzels are high in sodium, which can contribute to fluid retention and exacerbate symptoms of CVI. While reducing sodium intake can help manage fluid retention and swelling, it is not the most direct action for promoting circulation itself. It’s more of an adjunctive measure that can support overall management of CVI but does not directly improve venous circulation.
B. Mountain biking is an intense physical activity that may not be suitable for all clients with chronic venous insufficiency, especially if they have significant symptoms or mobility issues. High-impact exercises can potentially exacerbate symptoms or lead to injury. Low-impact activities are generally recommended to improve circulation and manage CVI.
C. Elevating the lower extremities is a highly effective measure for promoting circulation in clients with chronic venous insufficiency. It helps reduce venous pressure and promotes the return of blood to the heart, thereby alleviating swelling and discomfort. This action is directly beneficial in managing CVI.
D. Restricting fluid intake to water alone does not directly address the underlying issues of venous insufficiency. While managing overall fluid intake can be part of a comprehensive plan to prevent excessive fluid retention, it is not the most direct or effective action for promoting circulation compared to elevating the legs.