The nurse is providing discharge teaching to an older patient hospitalized for treatment of venous leg ulcers. What instructions should the nurse include in the teaching plan? (Select all that apply.)
The patient should eat a diet high in protein and vitamins A and C.
The patient should keep their legs elevated when sitting or lying down.
The patient should maintain as much bed rest as possible.
The patient should inspect their ankles daily for areas of darkening skin.
The patient should apply intermittent cold compresses four times daily.
Correct Answer : A,B,D
Choice A rationale
A diet high in protein and vitamins A and C can help promote wound healing. Protein is essential for tissue repair, and vitamins A and C play crucial roles in wound healing and immune function.
Choice B rationale
Keeping legs elevated when sitting or lying down can help reduce swelling and improve blood circulation, which is beneficial for healing venous leg ulcers.
Choice C rationale
Maintaining as much bed rest as possible is not typically recommended for patients with venous leg ulcers. Physical activity and movement can help improve blood circulation, which is beneficial for healing venous leg ulcers.
Choice D rationale
Inspecting ankles daily for areas of darkening skin can help detect early signs of worsening venous leg ulcers. Early detection and treatment can prevent complications and promote healing.
Choice E rationale
Applying intermittent cold compresses four times daily is not typically recommended for venous leg ulcers. Cold compresses can constrict blood vessels and reduce blood flow to the area, which may hinder the healing process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While it’s important to keep the feet moisturized to prevent skin cracks, this statement does not indicate that the client understands how to prevent complications related to diabetes mellitus.
Choice B rationale
Using salt, herbs, and spices to enhance the flavor of foods can be a part of a healthy diet, which is crucial in managing diabetes. This statement indicates that the client understands the importance of dietary management in preventing complications related to diabetes mellitus.
Choice C rationale
While moderate alcohol consumption may be acceptable for some people with diabetes, it’s not a key factor in preventing complications related to diabetes mellitus.
Choice D rationale
While regular monitoring of blood glucose control through tests like the A1C is important, this statement alone does not indicate that the client understands how to prevent complications related to diabetes mellitus.
Correct Answer is B
Explanation
Choice A rationale
A superficial partial-thickness burn involves the destruction of the epidermis and possibly a portion of the dermis. The description provided does not match this type of burn.
Choice B rationale
A full-thickness burn involves total destruction of the epidermis and dermis, and in some cases, the underlying tissue, muscle, and bone. The description of the burn as severely swollen, with a wound bed that appears brown and yellow, and the patient reporting no pain, is consistent with a full-thickness burn.
Choice C rationale
A deep partial-thickness burn involves the destruction of the epidermis and upper layers of the dermis and injury to the deeper portions of the dermis. The description provided does not match this type of burn.
Choice D rationale
Deep full-thickness burns are a more severe form of full-thickness burns that extend beyond the dermis into deeper tissues. The description provided does not match this type of burn.
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