A nurse is reinforcing discharge teaching to a client who has valvular heart disease. Which of the following should the nurse include in the teaching?

Valvular heart disease disrupts laminar blood flow, creating localized turbulence that triggers platelet activation and thrombus formation along abnormal leaflet surfaces. Structural valve damage or prosthetic replacements markedly elevate the risk of systemic thromboembolism and ischemic stroke. Long-term maintenance of antithrombotic therapy prevents clot propagation, requiring strict medication compliance to mitigate cardiovascular morbidity. A. Comply with compression therapy.: External compression garments manage peripheral venous stasis and lower extremity edema associated with chronic venous insufficiency. Valvular heart disease involves central cardiac structures, and compression stockings do not alter intracardiac mechanics or valve function. This intervention addresses peripheral vascular disease instead. B. Monitor for gradual onset of symptoms.: Valvular decompensation often manifests as sudden, acute dyspnea, chest pain, or syncope as ventricular compliance fails. Instructing a patient to expect only gradual changes can dangerously delay recognition of acute pulmonary congestion. Patients must report any abrupt symptomatic shifts immediately. C. Monitor wounds on lower extremities.: Dermal ulcerations and slow-healing stasis wounds occur typically in patients suffering from advanced peripheral arterial or venous insufficiency. While end-stage heart failure causes peripheral edema, tracking skin ulcers is not the specific primary focus of valvular discharge instructions. It lacks direct relevance to valvular integrity. D. Take antiplatelet medications as ordered.: Prescribed antiplatelet or anticoagulant regimens suppress the coagulation cascade activated by turbulent blood flow across damaged endocardial structures. Consistent adherence is vital to reduce the risk of thromboembolic events, especially with mechanical or tissue valve replacements. This directly addresses a major life-threatening complication.