A nurse is teaching a client about the use of ice for treatment of a soft-tissue injury. Which of the following instructions should be included? (Select All that Apply.)

Choice A Reason: Night sweats

Night sweats are not typically associated with liver disease. They are more commonly linked to conditions such as infections, hormonal imbalances, or certain cancers1. While liver disease can cause a variety of symptoms, night sweats are not a primary manifestation.

Choice B Reason: Acanthosis nigricans

Acanthosis nigricans is characterized by dark, velvety patches of skin, usually in body folds and creases. It is often associated with insulin resistance, obesity, and certain endocrine disorders. It is not a common manifestation of liver disease.

Choice C Reason: Hemosiderin staining

Hemosiderin staining refers to the deposition of iron in the skin, which can cause a brownish discoloration. This condition is more commonly associated with chronic venous insufficiency or hemochromatosis, a genetic disorder that causes iron overload. It is not a typical symptom of liver disease.

Choice D Reason: Pruritus

Pruritus, or itching, is a common symptom of liver disease. It is often caused by the accumulation of bile salts in the skin due to impaired bile flow, a condition known as cholestasis. This symptom can be particularly distressing for patients and is a significant indicator of liver dysfunction.

Choice A Reason: Alternate the use of ice and heat

Alternating the use of ice and heat is not typically recommended for the initial treatment of a soft-tissue injury. Ice is generally used during the first 24-48 hours to reduce swelling and inflammation. Heat can be applied later to help relax muscles and improve blood flow, but it should not be used immediately after an injury as it can increase swelling.

Choice B Reason: Apply ice pack intermittently

Applying the ice pack intermittently is important to prevent skin damage and frostbite. It is generally recommended to apply ice for 15-20 minutes at a time, followed by a break of at least 20 minutes before reapplying. This helps to reduce swelling and pain without causing harm to the skin and underlying tissues.

Choice C Reason: Do not place ice pack directly on the skin

Placing an ice pack directly on the skin can cause frostbite and damage to the skin and tissues. It is important to wrap the ice pack in a thin cloth or towel before applying it to the injured area. This provides a barrier that protects the skin while still allowing the cold to penetrate and reduce swelling.

Choice D Reason: Leave ice pack on for no more than 20 minutes at a time

Leaving the ice pack on for no more than 20 minutes at a time is crucial to prevent frostbite and skin damage. Prolonged exposure to cold can cause harm, so it is important to limit the duration of each application and take breaks in between.