The nurse is teaching a client diagnosed with Raynaud phenomenon about ways to prevent recurrent episodes. Which instructions should the nurse include? Select all that apply.

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11ecbb05_c927_2903_b433_81adebd74958_MD0009_00 Raynaud phenomenon is a vasospastic disorder resulting in an episodic vascular response related to cold temperatures or emotional stress. It most commonly affects women age 15-40. Vasospasms induce a characteristic color change in the appendages (eg, fingers, toes, ears, nose). When vasoconstriction occurs, the affected appendage initially turns white from decreased perfusion, followed by a bluish-purple appearance due to cyanosis. Clients usually report numbness and coldness during this stage. When blood flow is subsequently restored, the affected area becomes reddened and clients experience throbbing or aching pain, swelling, and tingling. Acute vasospasms are treated by immersing the hands in warm water. Client teaching regarding prevention of vasospasms includes: Wear gloves when handling cold objects (Option E).Dress in warm layers, particularly in cold weather.Avoid extremes and abrupt changes in temperature.Avoid vasoconstricting drugs (eg, cocaine, amphetamines, ergotamine, pseudoephedrine).Avoid excessive caffeine intake (Option A).Refrain from use of tobacco products (Option D).Implement stress management strategies (eg, yoga, tai chi) (Option C). Wear gloves when handling cold objects (Option E). Dress in warm layers, particularly in cold weather. Avoid extremes and abrupt changes in temperature. Avoid vasoconstricting drugs (eg, cocaine, amphetamines, ergotamine, pseudoephedrine). Avoid excessive caffeine intake (Option A). Refrain from use of tobacco products (Option D). Implement stress management strategies (eg, yoga, tai chi) (Option C). If conservative management is unsuccessful, clients may be prescribed calcium channel blockers to relax arteriole smooth muscle and prevent recurrent episodes. (Option B) Cold water will cause vasoconstriction and worsen the condition. Educational objective: Raynaud phenomenon is a vasospastic disorder triggered by exposure to cold or stress. Key elements of client teaching include management of acute attacks, avoidance of vasoconstrictive substances (eg, tobacco, cocaine, caffeine), stress reduction, and appropriate clothing (eg, gloves, warm layers).

The Nurse Is Teaching a Client Diagnosed with Raynaud Phenomenon