Final answer:
Massaging calves in a client with CHF is not recommended without medical consultation due to risks of dislodging clots or worsening edema. The patient’s symptoms can be attributed to the impaired function of the skeletal muscle pump due to prolonged standing and lack of physical activity, contributing to fluid accumulation in the legs.
Step-by-step explanation:
Massaging the calves may not be recommended for a client with congestive heart failure (CHF) without prior medical evaluation. In individuals with CHF, the heart’s reduced ability to pump blood effectively can lead to fluid accumulation in the extremities, such as the ankles and feet, leading to swelling known as peripheral edema. A massage could potentially dislodge blood clots or exacerbate the condition by moving fluid around.
Regarding the patient's signs and symptoms, the skeletal muscle pump plays a crucial role in venous blood return from the lower limbs to the heart. Standing still for extended periods, as a cashier job often requires, can impede the skeletal muscle pump's effectiveness. Lack of physical activity further diminishes its function. This can contribute to venous pooling and the swelling observed in the patient's feet and ankles (peripheral edema). The fatigue and 'spaced out' feeling may also be related to poor circulation and the reduced oxygen delivery to tissues that can occur in CHF.