A nurse is developing a plan of care for a client who has cellulitis of the leg.
Which of the following interventions should the nurse include in the plan?

Choice A rationale

While pain management is crucial postoperatively, teaching the client how to use a PCA pump does not directly prevent common postoperative complications like pneumonia, deep vein thrombosis, or wound infections. These complications are more directly addressed by respiratory exercises and early mobilization.

Choice B rationale

Instructing the client on coughing and deep breathing exercises is essential for preventing postoperative pulmonary complications such as atelectasis and pneumonia. These exercises help to expand the lungs, mobilize secretions, and improve oxygenation, reducing the risk of infection and respiratory distress.

Choice C rationale

Explaining the importance of early ambulation is vital in preventing several postoperative complications. Mobilization improves circulation, reducing the risk of deep vein thrombosis and pulmonary embolism. It also helps to promote bowel function and prevent constipation, as well as aiding in lung expansion and preventing atelectasis.

Choice D rationale

Discussing the use of incentive spirometry is important for preventing postoperative respiratory complications. Incentive spirometry encourages deep and sustained inhalation, which helps to expand the alveoli, improve lung volume, and prevent atelectasis and pneumonia.

Choice A rationale

Gradually decreasing the dose of diphenhydramine once tolerance to sedation is reached is not a recommended strategy. Tolerance to the antihistamine effects, including sedation, may develop over time, but abruptly or gradually changing the dose without provider guidance is not advisable and could lead to a return of pruritus.

Choice B rationale

Taking diphenhydramine with meals may slightly delay its absorption but is unlikely to significantly reduce daytime sedation. While taking some medications with food can affect their pharmacokinetics, the primary cause of daytime sedation with diphenhydramine is its antihistaminic effect on the central nervous system, which is not directly mitigated by food intake.

Choice C rationale

Distributing the doses of diphenhydramine evenly throughout the day is likely to worsen daytime sedation. Diphenhydramine is a first-generation antihistamine known for its sedating properties due to its ability to cross the blood-brain barrier and block histamine receptors in the central nervous system. Evenly spaced doses would maintain a more consistent level of the drug in the system, leading to continued sedation.

Choice D rationale

Taking most of the daily dose of diphenhydramine at bedtime can help minimize daytime sedation. By concentrating the medication administration closer to the client's sleep period, the sedative effects are more likely to occur during sleep, and the residual sedation during the day may be reduced. This allows for symptom relief while minimizing interference with daytime activities. .