A nurse is caring for a client with active tuberculosis. Which of the following intervention are appropriate for this client?

A) Walking is contraindicated and bed rest as much as possible is recommended:
. Walking is actually highly recommended for patients with chronic venous insufficiency (CVI). Gentle, regular physical activity, such as walking, helps improve circulation and reduce the risk of blood pooling in the lower extremities. Bed rest is not typically recommended unless the patient has severe symptoms like ulcers or active infection. In fact, staying active can promote better venous return and prevent worsening of CVI.

B) Dangle legs on the side of the bed several times per day:
. Dangling the legs can exacerbate venous stasis (blood pooling in the veins), which worsens symptoms of chronic venous insufficiency. Instead of dangling the legs, patients should focus on elevating the legs to reduce swelling and improve venous return. Dangle the legs only if advised by a healthcare provider for specific reasons, such as short periods of time to encourage blood flow after immobility.

C) Avoid sitting or standing for prolonged periods:
. One of the key recommendations for managing chronic venous insufficiency is to avoid prolonged sitting or standing. Remaining in one position for too long can cause blood to pool in the lower extremities, leading to increased swelling, pain, and discomfort. It’s important to encourage frequent position changes and movement, such as standing up or walking around if sitting, or sitting down to rest if standing for prolonged periods.

D) Elevate legs above heart level for 20-30 minutes, 4-5 times per day:
. Elevating the legs above heart level is a key intervention for patients with chronic venous insufficiency. This helps reduce swelling by promoting venous return and decreasing the pressure in the veins. Elevating the legs for 20-30 minutes, several times a day (4-5 times) can help alleviate symptoms and prevent further complications, such as ulcers and skin changes.

E) Use compression stockings to decrease swelling:
. Compression stockings are a cornerstone of managing chronic venous insufficiency. They help improve venous return, prevent blood from pooling in the lower legs, and reduce swelling. The stockings should be properly fitted and worn throughout the day (except when sleeping) to provide continuous support and minimize the risk of complications associated with CVI, such as venous ulcers.

A) Nitrofurantoin (Macrobid): While nitrofurantoin is commonly prescribed for urinary tract infections (UTIs), it does not typically cause a red-orange discoloration of the urine. Nitrofurantoin may cause other side effects, such as gastrointestinal upset or pulmonary issues, but urine discoloration is not a common or expected side effect.

B) Sulfamethoxazole-trimethoprim (SMX TMP, Bactrim): Sulfamethoxazole-trimethoprim is another common medication for UTIs, but it does not cause urine to turn red-orange. Some individuals may experience allergic reactions, rash, or gastrointestinal side effects, but urine discoloration is not typically associated with this medication.

C) This is expected with a UTI not related to medications: While it’s true that UTIs can cause changes in urine color due to blood or infection, the red-orange discoloration specifically linked to a UTI is often caused by medications, not the infection itself. Therefore, this statement is not accurate in explaining the cause of the urine color change.

D) Phenazopyridine (Pyridium): This is the correct answer. Phenazopyridine is a medication commonly used to alleviate urinary tract pain and discomfort. One of its well-known side effects is causing urine to turn a red-orange color. This discoloration is harmless and typically resolves once the medication is discontinued. However, patients should be informed about this effect to avoid unnecessary concern.