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 A
Explanation
Choice A rationale
Taking prescribed cortisone accurately is the most important instruction for a client diagnosed with Addison’s disease. Cortisone is a type of glucocorticoid replacement therapy that helps to manage the symptoms of Addison’s disease and prevent adrenal crisis, a life-threatening condition characterized by acute insufficiency of adrenal hormones.
Choice B rationale
Using a walker when weakness occurs may be helpful for some clients with Addison’s disease, as muscle weakness is a common symptom. However, it is not the most important instruction. The primary treatment for Addison’s disease is hormone replacement therapy, which should help to alleviate symptoms such as muscle weakness.
Choice C rationale
Avoiding extreme environmental temperatures can be beneficial for individuals with Addison’s disease, as they may have difficulty regulating body temperature due to cortisol deficiency.
However, this is not the most important instruction. The cornerstone of managing Addison’s disease is hormone replacement therapy.
Choice D rationale
Increasing daily intake of sodium in the diet can be beneficial for some individuals with Addison’s disease, particularly during periods of gastrointestinal illness or intense physical activity. However, this is not the most important instruction. The primary treatment for Addison’s disease is hormone replacement therapy.
Correct Answer is A
Explanation
Choice A rationale
An ABO incompatibility reaction can occur if a patient receives the wrong type of blood during a blood transfusion. Symptoms of an ABO incompatibility reaction include lower back pain and hypotension, which are serious and should be reported immediately to the healthcare provider.
Choice B rationale
A delayed painful rash with urticaria is not typically a symptom of an ABO incompatibility reaction. While it could indicate an allergic reaction, it is not as immediate or potentially life-threatening as the symptoms in Choice A1.
Choice C rationale
Acute rhinitis and nasal stuffiness are more commonly associated with respiratory infections, not ABO incompatibility reactions. These symptoms are not typically a direct result of a blood transfusion.
Choice D rationale
Arthritic joint changes and chronic pain are not associated with ABO incompatibility reactions. These symptoms are more likely related to long-term conditions like arthritis.
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