A nurse is caring for a client who has leukemia. Which of the following findings is the highest priority for the nurse to report to the provider?

Choice A: This is incorrect because Sims position is used for clients who have lower back pain, abdominal surgery, or enemas. It is not appropriate for clients who have a closed head injury.

Choice B: This is incorrect because modified Trendelenburg position is used for clients who have hypovolemic shock or poor venous return. It is not appropriate for clients who have a closed head injury.

Choice C: This is correct because semi-Fowler's position is used for clients who have increased intracranial pressure, respiratory distress, or head trauma. It elevates the head and chest to reduce cerebral edema and facilitate breathing.

Choice D: This is incorrect because prone position is used for clients who have acute respiratory distress syndrome, spinal cord injury, or pressure ulcers. It is not appropriate for clients who have a closed head injury.

Choice A reason: Applying moist heat to the incision while in bed is not an appropriate instruction, as it can increase the risk of infection, bleeding, or swelling at the site. The nurse should instruct the client to keep the incision dry and covered with a sterile dressing.

Choice B reason: Performing range of motion by adducting the hip is not an appropriate instruction, as it can cause dislocation or damage to the prosthesis. The nurse should instruct the client to avoid crossing their legs or turning their toes inward and to use an abduction pillow or wedge between their legs.

Choice C reason: Sitting in a straight-backed chair is an appropriate instruction, as it can prevent flexion contractures and promote circulation and healing in the hip joint. The nurse should instruct the client to use a raised toilet seat and a chair with armrests and avoid sitting for longer than 45 min at a time.

Choice D reason: Cleansing the surgical incision with hydrogen peroxide is not an appropriate instruction, as it can irritate or damage the tissue and delay wound healing. The nurse should instruct the client to use mild soap and water or saline solution to clean the incision and pat it dry gently.