The nurse provides discharge teaching to a client who had a total knee replacement 4 days ago. Which client statement indicates the need for additional teaching?

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The average hospital length of stay following total knee arthroplasty is 3-5 days. After the surgery, immediate initiation of physical therapy is a priority. An isometric quadriceps setting is initiated on the 1st postoperative day. The client should be fully weight bearing by discharge. Clients use an assistive device (eg, walker, crutches, cane, grab bar, hand rails) to help them sit, rise safely from a sitting to a standing position, and to negotiate steps (Option B). A knee immobilizer is used to maintain extension during ambulation and at rest for about 4 weeks. (Options A and C) Venous thromboembolism (eg, deep vein thrombosis [DVT], pulmonary embolism [PE]) following knee arthroplasty is a major preventable complication. Anticoagulation with oral anticoagulants (rivaroxaban) or enoxaparin (Lovenox) injections is therefore prescribed for at least 2 weeks after surgery. Ankle exercises, anti-embolic stockings, and frequent mobilization are prescribed as well. Clients are taught to recognize the warning signs and symptoms of DVT (eg, new swelling, tenderness, pain below the knee) or PE (eg, shortness of breath, pleuritic chest pain). (Option D) A raised toilet seat facilitates sitting on and rising from the toilet without over-bending the knee. Assistive devices, such as a long-handled shoehorn, shower chair, or grab bar, are also helpful for client safety at home. Educational objective: A client with total knee arthroplasty needs assistive devices (eg, walker, crutches) and a knee immobilizer to help ambulation; the client should be fully weight bearing by discharge. Prophylactic anticoagulation and recognition of postoperative complications (eg, DVT, PE) are also important.

The Nurse Provides Discharge Teaching to a Client Who Had