A nurse is conducting a preoperative interview with a client who is scheduled for surgery.
The client states that he takes acetylsalicylic acid 81 mg. by mouth daily.
Prior to the client's upcoming surgery, the nurse should instruct the client to do which of the following?

Choice A rationale:
Elevating the head of the bed to a 45-degree angle is important for clients with obstructive sleep apnea (OSA) to help prevent airway obstruction during sleep. However, this should not be the nurse's immediate priority before leaving the client. Ensuring the client's positive airway pressure (PAP) device is properly applied is more crucial.
Choice C rationale:
While locking the side rails in place is generally essential for safety, it is not the most critical intervention for a client with OSA and urination issues. Ensuring proper use of the PAP device is a higher priority.
Choice D rationale:
Removing dentures or other oral appliances is important for preventing airway obstruction in clients with OSA, but it should not take precedence over ensuring the use of the PAP device. The nurse should address the immediate respiratory needs of the client.

Choice A rationale:

The nurse should not instruct the client to rest with the legs above heart level. While elevating the legs can be helpful for managing symptoms of peripheral artery disease (PAD), it is not a suitable choice for older adults, especially those with heart conditions. It can put additional strain on the heart and may not be appropriate for all clients. Elevation of the legs should be done with caution and under healthcare provider guidance.

Choice B rationale:

The nurse should not advise the client to wear antiembolic stockings during the day. Antiembolic stockings, also known as compression stockings, are primarily used for venous insufficiency and the prevention of deep vein thrombosis (DVT). They may not be effective or necessary for the management of PAD. It's important to tailor the instructions to the specific condition, and in the case of PAD, other strategies may be more appropriate.

Choice C rationale:

The correct answer is choice C. The nurse should instruct the client to adjust the thermostat so that the environment is warm. This is an important recommendation for clients with PAD because keeping the extremities warm can help improve circulation and reduce symptoms. Cold environments can exacerbate the vasoconstriction associated with PAD, leading to more discomfort. Maintaining a warm environment is a simple and effective measure for symptom management.

Choice D rationale:

The nurse should not recommend applying a heating pad on a low setting to help relieve leg pain. While heat can provide temporary relief for muscle pain, it may not be the best option for clients with PAD. Applying heat directly to the affected area can sometimes lead to burns or skin damage, especially in older adults who may have decreased sensation. Heat should be used cautiously, and other methods like keeping the environment warm are preferred.