A client is recovering from a transurethral prostatectomy. Which activity should the practical nurse (PN) reinforce with the client to limit until after the first postoperative visit?

Choice A reason: Placing the client in the left lateral recumbent position with the right leg supported in proper alignment is not the best choice for reducing swelling and promoting comfort in a client with a fractured right tibia and fibula. While supporting the leg in proper alignment is important, the left lateral recumbent position does not provide optimal elevation of the affected limb. Elevation is crucial to reduce swelling and promote venous return, which can help decrease edema and discomfort.
Choice B reason: Placing the client in the dorsal recumbent position with the right leg elevated on two pillows is the most appropriate choice. This position allows the right leg to be elevated above the level of the heart, which helps reduce swelling by promoting venous return and lymphatic drainage. Elevation also decreases the hydrostatic pressure in the lower extremity, which can help minimize edema and improve comfort. This position ensures that the leg is properly supported and aligned, which is essential for optimal healing.
Choice C reason: Placing the client in the supine position with a footboard and a trochanter roll to the right leg is not the best choice for reducing swelling. While using a footboard and a trochanter roll can help maintain proper alignment and prevent external rotation of the leg, it does not provide the necessary elevation to reduce swelling. Elevation is a key component in managing edema and promoting comfort in clients with fractures.
Choice D reason: Placing the client in the right lateral position with a pillow between the legs is not an appropriate choice for reducing swelling in a client with a fractured right tibia and fibula. The right lateral position does not allow for proper elevation of the affected limb, which is essential for reducing swelling and promoting venous return. Additionally, this position may place pressure on the injured leg, causing discomfort and potentially compromising the healing process.

Choice A reason: Maintaining the client in a recumbent position is not typically necessary on the first postoperative day following an appendectomy. While it is important to ensure the client is comfortable and to monitor for signs of complications, encouraging mobility as soon as it is safe is generally beneficial. Prolonged bed rest can lead to complications such as deep vein thrombosis (DVT) and respiratory issues. Therefore, this intervention is not the most appropriate for promoting recovery and ensuring the client's well-being.
Choice B reason: Applying moist heat for pain relief is generally not recommended in the immediate postoperative period following an appendectomy. The use of heat can increase blood flow to the surgical site and potentially exacerbate inflammation or swelling. Pain management should be approached with appropriate analgesics as prescribed by the healthcare provider. Additionally, it is crucial to monitor for signs of complications such as infection or hematoma, and moist heat may not be the safest method for addressing postoperative pain in this context.
Choice C reason: Restricting ambulation to the bathroom only may be overly restrictive and can hinder the client's recovery process. Encouraging early and safe ambulation is important to prevent complications like DVT, promote circulation, and support overall recovery. While it is essential to ensure that the client does not overexert themselves, completely restricting movement to only bathroom trips is not conducive to optimal postoperative care. Gradual, supervised ambulation should be encouraged as the client's condition permits.
Choice D reason: Documenting the first bowel movement is a crucial intervention following an appendectomy. It provides important information about the return of gastrointestinal function, which can be affected by both the surgery and anesthesia. Monitoring and recording bowel movements help ensure that the client is not experiencing postoperative ileus, a common complication characterized by a temporary cessation of bowel activity. Early detection of such issues allows for timely intervention and supports the client's overall recovery.