You are assessing a client in the clinic setting who has been taking oral contraceptives for several years, without side effects. Vital signs are stable and the client denies any pain or tenderness
On examination, you note a small erythematous area of approximately 2 cm on her right lower leg. She denies any traumatic injury and says this is a recent onset of a few days. Based on this information you would:
a. instruct the client to use warm compresses for several days and keep the leg elevated as much as possible.
b. have the client wear flats rather than heels to modify her gait and help alleviate this issue.
c. refer the client to the health care provider for additional diagnostic work up.
d. have the client take an over-the-counter (OTC) nonsteroidal antiinflammatory drug (NSAID) and return to the clinic if the problem persists.
ANS: C
Because the client has a history of taking oral contraceptives, the nurse must assess and evaluate findings relative to ACHES (warning signs of oral contraceptives). Thus, the client should be worked up for the possibility of a superficial or deep vein thrombosis (DVT). Warm compresses and elevation of the leg, wearing flats, and taking an OTC NSAID may lead to further problems if there is an underlying clot that is not addressed promptly.
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