A nurse is providing teaching to a patient with chronic venous insufficiency. Which of the following should be included in the teaching plan? (Select all that apply.)

Walking is contraindicated and bed rest as much as possible is recommended

Dangle" legs on the side of the bed several times per day

Avoid sitting or standing for prolonged periods

Elevate legs above heart level for 20-30 minutes. 4-5 times per day

Use compression stockings to decrease swelling

Answer and Explanation

Correct Answer : C,D,E

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.

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Correct Answer is D

Explanation

A) "If I develop a fever, I will tell my doctor at the next scheduled office appointment."
. Clients with HIV should not wait for their next scheduled appointment to report any signs of infection or complications. Fever, as well as other symptoms such as cough, fatigue, or skin rashes, may indicate a potential infection or opportunistic infection that requires immediate medical attention. Early intervention can prevent complications. Therefore, the nurse should emphasize the importance of reporting any symptoms of illness immediately to the healthcare provider.

B) "I will avoid hugging my family, so that I don't give them the virus."
. HIV is not transmitted through casual contact such as hugging, shaking hands, or sharing meals. HIV is transmitted through blood, semen, vaginal fluids, breast milk, and through needle sharing or sexual contact. It is important for patients with HIV to understand that they can continue to engage in normal daily activities and maintain close relationships with family members and friends without the fear of spreading HIV through non-bodily fluid contact.

C) "I can still have my favorite sushi occasionally as long as I wear a mask to the restaurant."
. The need to wear a mask to prevent HIV transmission is a misconception. HIV is not transmitted through food, air, or casual social interactions. The concern regarding eating sushi comes from the risk of foodborne illness, particularly for individuals with compromised immune systems, such as those with HIV. Raw or undercooked food (like sushi) can expose individuals to bacterial, viral, or parasitic infections, which are more harmful to immunocompromised clients. Safe food handling practices and avoiding raw or undercooked foods are more important than wearing a mask.

D) "I will need to take the medications even when the virus is well-controlled."
. Adherence to antiretroviral therapy (ART) is essential for people living with HIV, even when the virus is well-controlled and their viral load is undetectable. Stopping or interrupting ART can lead to drug resistance and a return of the virus. Consistent medication use is the key to preventing the progression of HIV, reducing viral transmission, and maintaining long-term health. The patient should be educated about the importance of taking ART as prescribed for life, even when feeling well, to keep the virus suppressed and prevent complications

A. Obtaining a primary and secondary tubing set B. Ensuring another licensed personnel is available C. Obtaining 0.9% normal saline solution D. Checking ABO and Rh status of the donor and recipient

Correct Answer is B

Explanation

A) Obtaining a primary and secondary tubing set:
The primary tubing is used for the intravenous access, and the secondary tubing is attached for administering the blood product. This ensures that the blood transfusion will be delivered effectively, and it is a standard practice to use proper IV tubing for blood products to avoid contamination or complications.

B) Ensuring another licensed personnel is available:
. While it is required that two licensed healthcare professionals verify the blood product before starting the transfusion, this action itself is not contraindicated, it is required. Both individuals should independently check the patient's identification, blood type, and the matching of the blood product before administration. Therefore, the answer to the question should not be about ensuring availability of licensed personnel as this is actually a required safety measure, not contraindicated. The actual contraindications involve actions like using inappropriate fluids for transfusion or mismatching blood.

C) Obtaining 0.9% normal saline solution:
This is appropriate and necessary when preparing for a blood transfusion. Normal saline (0.9%) is the only compatible solution that should be used to flush the IV line before and after the transfusion or to prime the blood tubing. Other solutions, such as lactated Ringer's, can cause clotting when mixed with blood, making saline the only appropriate choice.

D) Checking ABO and Rh status of the donor and recipient:
This is essential and mandatory before administering a blood transfusion. It is critical to ensure that the ABO blood group and Rh factor of the donor and recipient are compatible to prevent hemolytic reactions. This compatibility check must be done every time before administering a transfusion, and it is an integral part of ensuring patient safety.

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A nurse is providing teaching to a patient with chronic venous insufficiency. Which of the following should be included in the teaching plan? (Select all that apply.)

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Explanation

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