A nurse is caring for a client who has pulmonary edema and a new prescription for furosemide 40 mg IV twice daily. Which of the following client findings indicates the prescription is appropriate?

Choice A reason: Removing weights during repositioning disrupts skeletal traction’s constant pull, risking fracture misalignment or delayed healing. Traction maintains bone stability via weights and pulleys, essential for immobilization. Lifting the client without weights negates this, potentially shifting the fracture site. This action contradicts traction principles, compromising treatment efficacy and patient outcomes, making it unsafe and incorrect.

Choice B reason: Cleansing pin sites with hydrogen peroxide damages healthy tissue and delays healing by disrupting granulation, despite its antiseptic properties. Sterile saline or chlorhexidine is preferred, preserving skin integrity around traction pins. This outdated practice increases infection risk ironically, as tissue breakdown invites pathogens. It’s not aligned with current evidence-based care, rendering it inappropriate.

Choice C reason: Inspecting pin sites daily for redness, swelling, or pus detects infection early, a common traction complication like osteomyelitis. Chemotherapy or immobility heightens this risk, and prompt identification allows intervention, protecting bone health. This action aligns with standards, ensuring the fracture heals without secondary issues. It’s a proactive, essential step in traction management.

Choice D reason: Checking ropes every 8 hours ensures traction equipment integrity, preventing sudden weight drops that could misalign the fracture. While important, it’s secondary to infection monitoring, as fraying is less immediate than sepsis risk. Daily pin checks address a more urgent threat to healing. This action, though useful, isn’t the top priority here.

Choice A reason: Thrombocytopenia from chemotherapy reduces platelets, impairing clotting and increasing bleeding risk. A soft-bristled toothbrush minimizes gum trauma, preventing hemorrhage in oral tissues, a common bleeding site. This instruction protects the client from excessive blood loss, aligns with bleeding precautions, and promotes safety during daily hygiene. It’s a practical, evidence-based measure to reduce mucosal injury, critical in managing low platelet counts effectively.

Choice B reason: Administering a rectal suppository risks rectal mucosal tearing in thrombocytopenia, where low platelets hinder clot formation, potentially causing significant bleeding. Chemotherapy-induced bone marrow suppression heightens this danger, making invasive procedures contraindicated. Safer alternatives, like oral medications, avoid this hazard. This action contradicts standard care, increasing harm in a client already prone to hemorrhage.

Choice C reason: A low-residue diet reduces bowel bulk, easing digestion, but doesn’t address thrombocytopenia’s bleeding risk, the primary concern here. It’s used in conditions like diverticulitis, not for platelet issues. Chemotherapy-related bleeding stems from vessel integrity, not diet, so this action lacks relevance. It fails to mitigate the client’s key vulnerability, making it inappropriate.

Choice D reason: Encouraging a safety razor in thrombocytopenia heightens bleeding risk, as even minor skin nicks won’t clot properly with low platelets from chemotherapy. Electric razors are recommended instead, minimizing cuts. This advice endangers the client, opposing bleeding precautions critical for safety. It ignores the condition’s pathophysiology, where external trauma must be avoided to prevent uncontrolled bleeding.