A nurse is teaching a patent who is taking warfarin for deep venous thrombosis. Which statement by the patient indicates a need for further teaching?

A. Perform doppler evaluation once daily: While Doppler evaluation is valuable for assessing blood flow and detecting vascular abnormalities, performing it only once daily may not provide adequate monitoring, especially during the critical early postoperative period. More frequent assessments are necessary to ensure optimal graft function and to promptly identify any complications.

B. Assess for compartment syndrome every 2 hours: While assessing for compartment syndrome is important, performing assessments every 2 hours may not be necessary unless specific risk factors or clinical indications are present. Continuous monitoring for signs and symptoms of compartment syndrome is essential, but the frequency of assessment should be based on the patient's condition and the surgeon's orders.

C. Assess pulse of affected extremity every 15 minutes until stable: After popliteal bypass graft surgery, assessing the pulse of the affected extremity every 15 minutes until stable is crucial. Frequent pulse checks help monitor graft patency and perfusion to detect early signs of graft failure or ischemia. This high-frequency assessment allows for prompt identification of vascular compromise and timely intervention to prevent graft thrombosis or occlusion. Once the pulse is stable and adequate perfusion is confirmed, the frequency of pulse checks can be adjusted according to the patient's condition and clinical guidelines.

D. Palpate the affected leg for pain every shift: Palpating the affected leg for pain every shift is an important component of postoperative assessment. However, relying solely on pain assessment once per shift may not provide timely detection of complications or changes in the patient's condition, especially during the immediate postoperative period when close monitoring is necessary. Frequent and ongoing assessment of pain, along with other vital signs and clinical indicators, is essential for comprehensive postoperative care.

A. Assess nutritional status with height, weight, blood urea nitrogen, transferrin, hemoglobin, and hematocrit level: This option focuses on assessing the patient's nutritional status, which is important for planning appropriate interventions. However, in a patient presenting with severe diarrhea and vomiting, the priority is to address immediate physiological needs and stabilize the patient's condition before conducting comprehensive assessments. While assessing nutritional status is important for long-term management, it is not the first action the nurse should take in this acute situation.

B. Consult with a dietitian to determine the patient's nutritional needs: Consulting with a dietitian is an important step in addressing the patient's nutritional needs, especially in cases of prolonged diarrhea and vomiting. However, in this scenario, the patient is experiencing severe symptoms that require immediate attention. Before consulting with a dietitian, the nurse should address the patient's acute symptoms and initiate interventions to manage fluid and electrolyte imbalances.

C. Encourage the patient to prepare simple meals or to obtain assistance with meal preparation if possible: This option addresses the immediate need to provide nutritional support to the patient. Encouraging the patient to consume simple, easily digestible meals or to seek assistance with meal preparation helps ensure that the patient receives adequate nutrition despite experiencing symptoms of diarrhea and vomiting. Providing practical advice on meal preparation empowers the patient to take control of their nutritional intake, which can be beneficial in managing symptoms and promoting recovery.

D. Encourage the patient to eat meals with visitors or others when possible: While social support and companionship can have a positive impact on the patient's overall well-being, including their nutritional intake, this option is not the first priority in this scenario. The patient's severe symptoms of diarrhea and vomiting require immediate attention to address fluid and electrolyte imbalances and prevent complications such as dehydration. Once the patient's condition stabilizes, encouraging social interaction during meals can be beneficial for promoting nutritional intake and emotional support.