What should a nurse instruct a client who has nasal packing inserted for epistaxis?

Instructing a client with nasal packing inserted for epistaxis to avoid rigorous aerobic exercise is crucial for several reasons. First, engaging in vigorous physical activity can increase blood flow and blood pressure, which may worsen bleeding and compromise the effectiveness of the nasal packing meant to control the hemorrhage. The packed nasal cavities need time to stabilize and heal, and excessive physical exertion can disrupt this process.

Moreover, vigorous activity can also lead to increased pressure in the nasal area, which might dislodge the packing material, leading to re-bleeding. Therefore, advising the patient to rest and avoid intense exercise helps to maintain the integrity of the nasal packing and reduces the risk of complications.

Other options like using aspirin may increase the risk of bleeding due to its anticoagulant properties, and suggesting the removal of packing, in case of swallowing difficulties, might precipitate further bleeding or interfere with the healing process. Omitting a dose of ramipril, while it is important to manage antihypertensive medications, does not directly pertain to the immediate management of nasal packing and is less critical in the situation of controlling a nasal bleed.