Which statements by the client indicate a good understanding of foot care in peripheral vascular disease? (Select all that apply.)

Choice A rationale

While medication cost can be a barrier to adherence, it doesn't directly address the client's misconception about the disease itself. Focusing on this aspect may be premature and might not resolve the client's core belief that treatment is unnecessary without symptoms.

Choice B rationale

This statement provides accurate and crucial scientific information. Hypertension is often called the "silent killer" because it typically has no symptoms until it causes significant end-organ damage. Explaining this concept directly addresses the client's flawed reasoning about medication adherence.

Choice C rationale

This response is dismissive and inaccurate. Most people with hypertension do not experience severe morning headaches, and this statement might mislead the client into thinking their lack of symptoms is a sign of good health, thereby reinforcing their decision not to take medication.

Choice D rationale

This response uses scare tactics, which can be counterproductive. While kidney failure is a potential consequence of untreated hypertension, a more educational and less confrontational approach is generally more effective for promoting long-term adherence to a medical regimen.

Choice A rationale

A Braden Scale score of 9 indicates a high risk for pressure injury. Requesting a referral to a registered dietitian nutritionist is an evidence-based intervention because poor nutrition, particularly protein and calorie deficiency, is a significant risk factor for skin breakdown and impaired wound healing.

Choice B rationale

Keeping the head of the bed raised no more than 45 degrees is an evidence-based practice to prevent pressure injuries. This position reduces the risk of shear and friction forces on the sacrum, which can lead to tissue damage and pressure ulcer formation.

Choice C rationale

Performing perineal cleansing every 2 hours is not an evidence-based intervention for a Braden Scale score of 9. Frequent cleansing can cause excessive moisture, which macerates the skin and increases the risk of breakdown. Cleansing should be done as needed, not on a rigid schedule.

Choice D rationale

Daily skin assessment is a fundamental and evidence-based intervention for all clients at risk for pressure injuries. A Braden score of 9 signifies a high-risk client, and a daily head-to-toe skin assessment is crucial for early detection of erythema or other signs of skin breakdown.