A nurse is caring for a client who is wearing antiembolic stockings. Which of the following interventions should the nurse include in the plan of care?

Massage the client's legs once every 8 hr while the stockings are in place

Fold the top of the stocking over neatly

Determine if the stockings are binding

Apply the stockings after the client is in a chair.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Massage the client's legs once every 8 hr while the stockings are in place: Massaging the legs of a client at risk for thromboembolism is discouraged, as it could dislodge a clot and lead to a pulmonary embolism. Mechanical methods like stockings are preferred for promoting circulation.

B. Fold the top of the stocking over neatly: Folding the stockings creates a tourniquet effect, restricting venous return and potentially increasing the risk of venous stasis or skin breakdown. Stockings should remain flat and unfolded.

C. Determine if the stockings are binding: It’s important to assess for tightness, especially at the toes and calves, to ensure proper circulation and prevent pressure injuries. Stockings should fit snugly but not impair blood flow.

D. Apply the stockings after the client is in a chair: Stockings are most effective when applied while the client is in a supine position, before blood pools in the lower extremities. Delayed application reduces their preventive benefit.

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Correct Answer is D

Explanation

Rationale:

A. Request a change in medication from the provider: Medication adjustments should be based on a full assessment of the child’s symptoms and patterns. Requesting a change prematurely may lead to ineffective or inappropriate treatment.

B. Refer the family to a chronic pain support group: Support groups are helpful for long-term coping and education, but they are not an immediate action. The nurse must first assess the current situation to guide any referrals.

C. Set up an appointment with the school nurse: While school involvement can support symptom management, especially for triggers or academic impact, it is not the initial step. The nurse must first gather complete data on the headaches.

D. Review the child's electronic pain diary: The pain diary provides detailed information about frequency, triggers, intensity, and patterns of the migraines. Reviewing it is the first step to making informed decisions about the child’s care plan.

A. Assess the client's peripheral pulses every 15 min. B. Elevate the head of the client's bed to 45. C. Change the client's dressing 4 hr following the procedure. D. Instruct the client to flex the right knee every 30 min.

Correct Answer is A

Explanation

Rationale:

A. Assess the client's peripheral pulses every 15 min: Frequent assessment of peripheral pulses is essential to monitor for signs of arterial obstruction, bleeding, or hematoma formation at the femoral site. This helps ensure adequate perfusion and detect complications early.

B. Elevate the head of the client's bed to 45°: After femoral catheterization, the head of the bed should be elevated no more than 30° to reduce pressure at the puncture site and prevent bleeding. A 45° angle may increase the risk of hemorrhage.

C. Change the client's dressing 4 hr following the procedure: The dressing should remain in place and be monitored for signs of bleeding or saturation. Routine dressing changes shortly after the procedure are not recommended unless soiled or ordered.

D. Instruct the client to flex the right knee every 30 min: Flexing the leg increases the risk of dislodging the clot or reopening the arterial puncture site. The affected leg should remain straight and immobilized for several hours post-procedure.

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A nurse is caring for a client who is wearing antiembolic stockings. Which of the following interventions should the nurse include in the plan of care?

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