A nurse is reinforcing discharge teaching with a client who had an above-the-knee amputation and has a prosthesis. Which of the following Instructions should the nurse include?

A. Elevates the client's legs before applying the stockings: Elevating the legs helps reduce venous pressure and promotes venous return, making it easier to apply the antiembolic stockings without causing constriction or discomfort. This step ensures the stockings fit smoothly and function effectively to prevent deep vein thrombosis.

B. Instructs the client to dorsiflex their feet while applying the stockings: While dorsiflexion exercises help stimulate circulation once the stockings are in place, instructing the client to dorsiflex during application is unnecessary and does not facilitate proper placement of the stockings.

C. Massages the client's legs before applying the stockings: Massaging the legs prior to applying stockings is contraindicated because it can dislodge a thrombus in clients at risk for deep vein thrombosis, potentially leading to a pulmonary embolism.

D. Folds the top of the stockings over after applying them: Folding the top of antiembolic stockings can create constriction, impair circulation, and reduce the stockings’ effectiveness. Stockings should be applied smoothly without wrinkles or folds to ensure uniform pressure and safety.

A. Document the client's respiratory rate in 1 hr: Measuring and recording vital signs, including respiratory rate, is within the scope of practice for an assistive personnel (AP). After the nurse administers a PRN pain medication, the AP can safely monitor and document routine parameters, providing the nurse with data to evaluate the client’s response.

B. Monitor the client for an allergic reaction for 30 min: Observing for adverse or allergic reactions requires nursing assessment skills, clinical judgment, and the ability to intervene immediately if a severe reaction occurs. This task is outside the AP’s scope of practice.

C. Check the client's response to the medication in 1 hr: Evaluating a client’s pain relief or therapeutic response involves subjective assessment and interpretation, which require nursing judgment. This responsibility cannot be delegated to an AP.

D. Evaluate the client for therapeutic effects in 30 min: Assessing the effectiveness of medication, such as pain relief or sedation, requires clinical judgment and decision-making to determine if further interventions are needed. This is a nursing responsibility and should not be assigned to an AP.