The nurse is caring for a patient diagnosed with acquired immunodeficiency syndrome (AIDS) whose most recent laboratory values reveal a CD4 level less than 200. Which assessment findings require immediate intervention?

A. Encourage the patient and family to manage the patient's activity level and activities of daily living effectively: While managing activity levels and daily living tasks is important for overall health and well-being, this action alone may not directly address feelings of isolation experienced by the patient. Encouraging social support and addressing emotional needs are also vital aspects of care for someone with HIV.

B. Encourage the patient to express feelings of isolation and loneliness, with the assurance that these feelings are not unique or abnormal: Patients with HIV often experience feelings of isolation and loneliness due to stigma, fear of rejection, or loss of social support. Encouraging the patient to openly express these feelings can help them feel validated and understood. Assuring them that such feelings are common among individuals with HIV can help reduce their sense of isolation and promote emotional well-being.

C. Encourage the patient and family to be active partners in the management of immunodeficiency: While involving the patient and family in the management of HIV is essential, this action primarily focuses on medical management rather than addressing the psychosocial aspect of isolation. Collaborative care is important, but addressing emotional needs should also be prioritized.

D. Make sure that the patient and family know how to adjust dosages of the medications used in treatment: While medication adherence is crucial in managing HIV, ensuring proper dosage adjustments is primarily a clinical aspect of care. While important, this action alone may not directly address the patient's feelings of isolation.

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.