A client is prescribed antiembolic stockings. How should the nurse assess the skin on the client’s legs?
1. Defer the assessment because the stockings are in place.
2. Remove the stockings for this assessment.
3. Review the morning assessment, but don’t repeat it unless a problem occurs.
4. Assess the skin when the client removes the stockings at bedtime.
ANSWER
Correct Answer: 2
Rationale 1: The stockings are worn day and night, so the client will not remove them for sleep.
Rationale 2: The stockings should be removed to do this assessment.
Rationale 3: The nurse is responsible for assessing the skin under the stockings and should not assume that the morning nurse’s assessment is still accurate 12 hours later.
Rationale 4: The stockings are worn day and night, so the client will not remove them for sleep.
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