A nurse is reviewing the laboratory reports of a client who is undergoing nutritional screening due to a risk for chronic kidney disease. The nurse should identify that which of the following results indicates the need for further assessment?

Choice A reason: Applying ice packs for 15 minutes every hour is not an effective intervention for managing edema following knee replacement surgery because it can impair blood circulation and delay healing. Ice packs can also cause frostbite or nerve damage if applied for too long or too frequently. Ice packs should be used only for the first 24 to 48 hours after surgery and with a cloth barrier between the skin and the ice.

Choice B reason: Elevating the affected leg above the heart level is an effective intervention for managing edema following knee replacement surgery because it can reduce swelling and pain by facilitating venous return and lymphatic drainage. Elevation can also prevent blood clots and infection by improving blood flow and oxygen delivery to the wound site.

Choice C reason: Consuming nutrition-dense foods first is not a relevant intervention for managing edema following knee replacement surgery because it does not directly affect fluid balance or wound healing. Nutrition-dense foods are those that provide high amounts of nutrients per serving, such as eggs, cheese, nuts, beans, and meat. Nutrition-dense foods are important for overall health, but not specifically for edema management.

Choice D reason: Wearing compression stockings during the day is not a recommended intervention for managing edema following knee replacement surgery because it can interfere with wound healing and increase the risk of infection. Compression stockings can also cause skin irritation, blisters, or ulcers if worn incorrectly or too tightly. Compression stockings should be avoided until the wound is fully healed and only used under medical supervision.

Choice A reason: Telling the client to lie down after eating can increase the risk of aspiration pneumonia, as food or liquids can enter the lungs more easily when lying down.

Choice B reason: Instructing the client to tuck her chin when swallowing can help prevent aspiration pneumonia, as it closes off the airway and directs food or liquids into the esophagus.

Choice C reason: Placing the client in a Fowler's position to eat can help prevent aspiration pneumonia, as it elevates the head and chest and allows gravity to assist with swallowing.

Choice D reason: Encouraging the client to drink water before each meal can increase the risk of aspiration pneumonia, as it can thin out saliva and make it harder to control swallowing.