A nurse is reinforcing teaching with a client who has peripheral vascular disease (PVD). The nurse should recognize that which of the following statements by the client indicates a need for further teaching?

Choice A rationale Avoiding crossing the legs at the knees is a correct recommendation for peripheral vascular disease (PVD). Crossing the legs compresses major veins, particularly the popliteal vein, which impedes venous return to the heart and increases venous stasis in the lower extremities. This increased pressure and stasis can exacerbate symptoms of PVD and increase the risk of deep vein thrombosis (DVT). Choice B rationale Wearing stockings with elastic tops is contraindicated and thus indicates a need for further teaching. The tight elastic band acts as a tourniquet, creating a circumferential constriction around the leg, which significantly obstructs venous and lymphatic return. This exacerbates venous stasis and pressure distal to the constriction, worsening edema and PVD symptoms. Stockings should be non-constricting. Choice C rationale Using a thermometer to check bath water temperature is a correct and crucial safety measure for clients with PVD, especially those with associated peripheral neuropathy. Impaired circulation and nerve damage can reduce tactile sensation, increasing the risk of thermal injury (burns) without the client perceiving the danger, leading to potential skin breakdown and infection in vulnerable limbs. Choice D rationale Avoiding going barefoot is a correct preventive measure. Clients with PVD are at high risk for trauma and skin breakdown on their feet due to poor circulation, which impairs tissue healing. Even minor cuts or abrasions from going barefoot can quickly lead to slow-healing ulcers and severe infections due to compromised blood flow and immune response.