A pregnant client complains of varicosities in the third trimester. Which of the following activities should she be advised to avoid?

A pregnant client with varicosities should avoid wearing knee-high stockings. The elastic band at the top of these stockings can act as a tourniquet, constricting circulation at the popliteal space behind the knee. This constriction impedes venous return from the lower leg, which increases venous pressure, worsens venous stasis, and can exacerbate the varicosities. Instead, graduated compression stockings or support pantyhose that extend above the area of varicosity are recommended to promote blood flow back to the heart.

A. While prolonged crossing of legs at the knees should be avoided, crossing at the ankles has a less significant impact on venous return.

B. Thromboembolic disease (TED) stockings are a therapeutic intervention that provides graduated compression to improve venous return and are recommended for varicosities.

C. Support pantyhose are also a recommended intervention as they provide compression to the entire leg, which helps prevent venous pooling and relieves discomfort.

1. Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K. R. (2020). Maternity & Women's Health Care (12th ed.). Elsevier. In the chapter on "Assessment and Health Promotion," the text advises pregnant women to avoid constrictive clothing and stockings that are too tight at the top or leave impressions in the skin, as this can impede venous return (specific guidance typically found in sections on self-management for common discomforts of pregnancy).

2. University of Rochester Medical Center. (n.d.). Common Discomforts of Pregnancy. Health Encyclopedia. The guidance for managing varicose veins includes avoiding tight clothing or knee-high stockings and wearing support hose. This content is part of the university's health education curriculum for patients and students.

3. Story, L. (Ed.). (2011). The Johns Hopkins Manual of Gynecology and Obstetrics (4th ed.). Lippincott Williams & Wilkins. In Chapter 8, "The Puerperium," while discussing postpartum care, the principles of managing venous stasis are outlined, which include avoiding constrictive clothing like tight knee-high stockings that can impair venous return (p. 121). These principles are directly applicable to antepartum care for varicosities.