A nurse is providing discharge education to a client who is going home with a cast on his leg. What teaching point would be appropriate for the nurse to emphasize in the teaching session?

Choice A reason: Removing the drain is not an appropriate action for the nurse to take, as it may cause bleeding, infection, or hematoma at the surgical site. The drain is placed to prevent the accumulation of fluid and blood in the hip joint, and it should be removed only by the surgeon when the drainage is minimal and the wound is healing.

Choice B reason: Continuing to assess and monitor intake and output every shift is an appropriate action for the nurse to take, as it helps to evaluate the fluid balance and the renal function of the client. The nurse should record the amount, color, and consistency of the drainage, and compare it with the previous measurements. The nurse should also monitor the vital signs, the hemoglobin and hematocrit levels, and the signs of dehydration or fluid overload.

Choice C reason: Elevating the affected leg and placing the client in Trendelenburg position is not an appropriate action for the nurse to take, as it may cause hip dislocation, hypotension, or respiratory distress. The nurse should keep the affected leg slightly abducted and aligned with the body, and avoid flexing the hip more than 90 degrees. The nurse should also maintain the client in a semi-Fowler's or supine position, and avoid turning the client to the affected side.

Choice D reason: Notifying the surgeon and making aware of this finding is not an appropriate action for the nurse to take, as it is not an urgent or abnormal situation. The nurse should report the drainage to the surgeon only if it exceeds the expected amount, which is usually less than 200 mL in the first 24 hours after surgery, or if it changes in color, consistency, or odor.

Choice E reason: None of the above is not a correct choice, as there is one option that matches the most appropriate action for the nurse to take.

Choice A reason: Including an average daily intake of 300 mg of calcium is not a sufficient measure to prevent osteoporosis, as it is below the recommended dietary allowance (RDA) for calcium, which is 1000 mg for adults aged 19-50 years, and 1200 mg for adults aged 51 years and older. Calcium is an essential mineral for bone health, as it helps to build and maintain the bone density and strength.

Choice B reason: Walking 20-30 minutes three days a week is not an optimal measure to prevent osteoporosis, as it is below the recommended physical activity guidelines, which suggest at least 150 minutes of moderate-intensity aerobic exercise per week, and at least two sessions of muscle-strengthening activities per week. Physical activity is beneficial for bone health, as it stimulates the bone formation and reduces the bone loss.

Choice C reason: Engaging in isometric exercise 20-30 minutes weekly is not an effective measure to prevent osteoporosis, as it is not the best type of exercise for bone health, and it is not performed frequently enough. Isometric exercise is a form of exercise that involves contracting the muscles without moving the joints, such as holding a plank or a wall sit. Isometric exercise does not provide enough mechanical stress or load to the bones, which is needed to stimulate the bone remodeling and growth.

Choice D reason: Including adequate intake of vitamin E is not a relevant measure to prevent osteoporosis, as it is not a major nutrient for bone health, and it has no direct effect on the bone metabolism. Vitamin E is an antioxidant that helps to protect the cells from oxidative stress and inflammation, which may have some indirect benefits for the bone health, but it is not a key factor. Vitamin E is also not a common deficiency, and it can be obtained from various foods, such as vegetable oils, nuts, seeds, and green leafy vegetables.