A postoperative home care client has developed thrombophlebitis in her right leg.
What category of medications will probably be prescribed for this cardiovascular complication?

Choice A rationale:
Circular turns involve wrapping the bandage around the limb in a continuous circle, with each layer overlapping the previous one. While this technique is effective for securing dressings on cylindrical body parts like the arm or thigh, it's not ideal for joints like the ankle. Circular turns can constrict movement and potentially impair circulation, especially if applied too tightly. Additionally, they don't provide adequate compression for wounds that require it.
Choice B rationale:
Figure-of-eight turns create a cross-over pattern around the joint, resembling the number 8. This technique offers better flexibility and movement compared to circular turns, but it's still not the most appropriate for the ankle. The cross-over pattern can create uneven pressure points and potentially lead to discomfort or even skin irritation. Moreover, it might not provide sufficient compression for wound management.
Choice C rationale:
Spiral turns involve wrapping the bandage diagonally, ascending or descending the limb, with each layer overlapping the previous one by about half its width. This technique is considered the most suitable for bandaging joints like the ankle for several reasons:
Conforms to Joint Contours: Spiral turns naturally mold to the shape of the ankle, providing even pressure distribution and avoiding constriction points. This ensures comfort and maintains proper blood flow.
Allows for Movement: The diagonal pattern accommodates the natural flexion and extension of the ankle joint, allowing for greater mobility without compromising bandage integrity.
Provides Effective Compression: Spiral turns can be applied with varying degrees of compression to suit the needs of the wound and surrounding tissue. This can help control bleeding, reduce swelling, and promote healing.
Easy to Apply and Adjust: Spiral turns are relatively straightforward to apply and can be easily adjusted if needed, making them adaptable to different wound sizes and patient needs.
Choice D rationale:
Recurrent bandaging involves wrapping the bandage back and forth over the same area multiple times, creating a thicker layer. This technique is primarily used for stumps or areas requiring significant padding and absorption. It's not typically used for bandaging joints like the ankle, as it can create excessive bulk and potentially restrict movement.

Skin breakdown:

Prolonged exposure to urine, especially in the presence of incontinence briefs, can irritate and macerate the skin, leading to breakdown.

Factors contributing to skin breakdown:

Moisture from urine:

Creates a warm, moist environment ideal for bacterial growth.

Disrupts the skin's natural barrier function, making it more susceptible to damage.

Friction from incontinence briefs:

Can rub against the skin, causing irritation and further damage.

Chemical irritants in urine:

Ammonia and other substances in urine can further irritate and damage the skin.

Signs of skin breakdown:

Redness, warmth, tenderness, or swelling of the skin.

Blisters, erosions, or ulcers.

Pain or discomfort.

Prevention of skin breakdown:

Frequent changing of incontinence briefs (as soon as they become wet or soiled).

Thorough cleansing of the skin with mild soap and water after each change.

Application of a skin barrier cream or ointment to protect the skin.

Use of breathable incontinence briefs that allow air to circulate.

Monitoring of the skin for signs of breakdown and seeking prompt medical attention if any occur. Urinary tract infections (UTIs):

Bacteria from the skin can enter the urinary tract through the urethra, leading to infection.

Factors increasing UTI risk in those with incontinence:

Incomplete bladder emptying:

Residual urine in the bladder provides a breeding ground for bacteria.

Use of incontinence briefs:

Can trap moisture and bacteria near the urethra.

Difficulty with personal hygiene:

May lead to the spread of bacteria from the skin to the urinary tract.

Signs of a UTI:

Frequent urination.

Pain or burning during urination.

Urgency to urinate.

Blood in the urine.

Cloudy or foul-smelling urine.

Prevention of UTIs:

Maintaining good personal hygiene.

Drinking plenty of fluids to help flush bacteria from the urinary tract.

Promptly emptying the bladder when the urge to urinate is felt.

Seeking medical attention if any signs of a UTI occur.