Final answer:
The priority goal for a patient with heart failure and significant bilateral ankle and calf edema is to decrease venous congestion. This involves elevating the legs, using compression, promoting exercise, and managing salt intake to reduce swelling and prevent potential complications.
Step-by-step explanation:
The correct option : d
The priority goal for a client with heart failure and +4 bilateral edema is to decrease venous congestion. This is crucial because venous congestion leads to increased fluid retention in the tissues, resulting in swelling and potential tissue damage, particularly in the lower extremities. For this particular case, with edema of the right ankle extending to midcalf, the focus should be on measures that assist in reducing the edema and preventing its complications.
Heart failure can contribute to systolic edema due to compromised cardiac output, thus causing fluid to back up into the veins and capillaries, leading to increased pressurization and fluid leakage into the interstitial spaces and cells of the body. When this fluid accumulates in the soft tissues, particularly with gravity's effect on the lower limbs when sitting, it can manifest as severe edema, as seen in the client's case.
Interventions to help decrease venous congestion include elevating the legs to promote venous return, using compression to support the venous system and reduce edema, encouraging regular movement or exercise to activate the skeletal muscle pump, and considering a low-salt diet to decrease sodium and water retention. These actions can not only help to reduce the edema but also prevent potential complications such as skin breakdown or ulceration that can result from prolonged high pressure in tissue spaces.