The nurse assesses a client after a total hip arthroplasty. The client’s surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is appropriate?

Choice A reason: The maximum daily dose of acetaminophen for adults is typically 4000 mg to avoid hepatotoxicity. A statement indicating 5000 mg suggests a misunderstanding, as exceeding 4000 mg increases the risk of liver damage due to the accumulation of toxic metabolites like N-acetyl-p-benzoquinone imine, which depletes glutathione.
Choice B reason: Regular liver function tests are recommended for clients on long-term acetaminophen to monitor for hepatotoxicity, as the drug is metabolized by the liver. This statement shows correct understanding, as it acknowledges the need to assess liver enzymes like ALT and AST for potential damage.
Choice C reason: Checking other medications for acetaminophen content is crucial to prevent unintentional overdose, which can lead to acute liver failure. This statement reflects proper understanding, as combination drugs (e.g., cold remedies) often contain acetaminophen, contributing to cumulative toxicity if not monitored.
Choice D reason: Using topical patches or creams for osteoarthritis pain is a valid adjunctive therapy. These deliver localized relief (e.g., NSAIDs or capsaicin) without systemic effects, complementing acetaminophen’s action. This statement indicates correct understanding of multimodal pain management strategies.

Choice A reason: Tobacco use accelerates bone loss by reducing osteoblast activity and blood flow to bones, increasing osteoporosis risk. Cutting down on smoking improves bone density by enhancing bone formation and reducing resorption, a key preventive measure for women.
Choice B reason: Limiting alcohol to two drinks daily is not specific enough, as even moderate alcohol can impair calcium absorption and osteoblast function, increasing osteoporosis risk. Guidelines recommend minimal alcohol consumption, making this less accurate for prevention.
Choice C reason: Strengthening exercises (e.g., resistance training) stimulate osteoblast activity, increasing bone density and strength. This is critical for preventing osteoporosis, as mechanical stress on bones enhances mineralization, reducing fracture risk in women, especially postmenopausal.
Choice D reason: Calcium and vitamin D are essential for bone health. Calcium forms bone matrix, and vitamin D enhances its absorption. Adequate intake prevents bone resorption, maintaining bone density and reducing osteoporosis risk, making this a cornerstone of prevention.
Choice E reason: Weight-bearing exercises like walking stimulate bone formation by applying mechanical stress, increasing osteoblast activity. Walking 30 minutes three times weekly improves bone density and reduces fracture risk, making it an effective strategy for osteoporosis prevention in women.