The nurse is caring for an immobile client who has bilateral lower-extremity edema related to chronic venous insufficiency. Which positioning intervention should the nurse implement to promote venous return from the client's legs?
Place the client supine with the legs elevated on pillows so the ankles are above heart level.
Encourage the client to dangle the legs off the side of the bed for 20 minutes every 4 hours.
Have the client sit in a chair with feet flat on the floor for 2 hours three times a day.
Position the client in high-Fowler's with the knees bent and a pillow under the thighs.
Elevating the legs on pillows so the heels rest higher than the level of the heart harnesses gravity to lower venous hydrostatic pressure, allowing pooled blood and interstitial fluid to drain toward the central circulation. This position is widely recommended to ease edema and reduce venous stasis. Keeping the legs dependent, sharply flexed, or unsupported below heart level increases venous pressure or impedes flow, so those positions do not facilitate venous return.
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