The nurse plans discharge teaching for a client newly diagnosed with polycythemia vera. Which actions will the nurse include in the teaching plan? Select all that apply.

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Polycythemia vera (PV) is a chronic disorder of the bone marrow in which too many red blood cells, white cells, and platelets are produced. Clients with PV are at risk of developing blood clots due to increased blood volume and viscosity. Clients are instructed to elevate the legs and feet when sitting, wear support stockings, and report signs of thrombosis (eg, swelling and tenderness in the legs). Adequate fluid intake during exercise and hot weather is important to reduce fluid loss and decrease viscosity (Options A, C, and E). (Option B) Increasing intake of iron-containing foods and supplements can further increase hemoglobin production and is not recommended. Clients with PV need periodic phlebotomy to remove excess blood. (Option D) Itching is a common and frustrating symptom of PV. Reducing water temperature, using starch baths, and patting the skin dry rather than rubbing vigorously are beneficial. Educational objective: Clients with polycythemia vera are at risk of developing thrombosis and should be taught preventive measures (eg, elevating the legs when sitting) and symptoms to report. They should take measures to prevent dehydration, and avoid iron-rich foods and hot showers/baths.

The Nurse Plans Discharge Teaching for a Client Newly Diagnosed