A nurse is caring for a client 8 hr postoperative following a total knee replacement. Which of the following actions should the nurse take?

Choice A rationale Cold therapy or cryotherapy is often used in the immediate postoperative period to reduce edema and pain through vasoconstriction. However, applying cool compresses only every 6 hours is not a standard or specific protocol for total knee replacement recovery compared to systematic hydration. While ice can be used, the duration and frequency are usually more consistent, and excessive cold can sometimes impair the localized surgical site circulation if not monitored. Choice B rationale Placing a pillow directly under the affected limb, specifically under the knee, is contraindicated after a total knee replacement. This position promotes knee flexion, which increases the risk of developing a flexion contracture. To ensure optimal surgical outcomes, the knee should be kept in an extended position when the patient is resting. Any elevation should support the entire length of the lower extremity or the calf, avoiding the popliteal space. Choice C rationale Promoting bed rest for 5 to 7 days is inappropriate and dangerous following orthopedic surgery. Early mobilization is a primary goal to prevent venous thromboembolism, such as deep vein thrombosis or pulmonary embolism. Most protocols require the patient to begin physical therapy and weight bearing activities within 24 hours of surgery. Prolonged immobility also increases the risk of pneumonia, skin breakdown, and loss of muscle strength in the non operative limb. Choice D rationale Encouraging increased fluid intake is vital for postoperative recovery. Adequate hydration helps maintain blood volume and blood pressure, supports renal function after anesthesia, and thins respiratory secretions to prevent atelectasis. Furthermore, hydration is essential in preventing constipation, which is a common side effect of opioid analgesics used for pain management. Normal adult fluid requirements are approximately 2000 to 3000 mL per day unless contraindicated by heart or kidney failure.