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.)

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.