A client in her first trimester tells a midwife that she has developed tortuous veins in her lower extremities. Which of the following instructions given by the midwife is the least effective?
  1. “Don elastic support stockings immediately after you are on your feet in the morning.”
  2. “Eat fruits and vegetables high in Vitamin C.”
  3. “Exercise and have walk break at least twice a day.”
  4. “Lie on you back with your legs raised against the wall for 15 minutes twice a day.”
Explanation
Answer: A - The client should put on elastic support stockings before getting out of bed in the morning. Once she is on her feet, the blood has already started pooling in the lower extremities, and the stockings will be ineffective. To prevent the development or worsening of varicosities, the client should eat foods high in vitamin C, as it can be beneficial in reducing the size of the varicosities. Vitamin C is involved in the formation of collagen and endothelium of the blood vessels. Exercising stimulates venous return, alleviating the varicosities. Lying on the back with the legs raised against the wall for 15 minutes, twice a day, relieves varicosities.
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