Which instruction would be most effective in preventing pooling of blood in the lower extremities for a 38-week primagravida?

The most effective instruction for preventing pooling of blood in the lower extremities in a 38-week primagravida is to encourage movement, specifically moving about every hour. During pregnancy, particularly in the later stages, the growing uterus can compress blood vessels in the pelvis, leading to venous stasis and pooling of blood in the legs. Regular movement helps to stimulate circulation, promoting venous return to the heart and reducing the risk of complications such as edema or even deep vein thrombosis.

While wearing support stockings can certainly aid in maintaining good venous return and may help prevent pooling, the most proactive method is encouraging the individual to engage in movement. Movement helps to pump blood back to the heart through the muscles of the legs, enhancing venous circulation.

Reducing salt in the diet is generally more related to managing water retention and hypertension than specifically preventing venous pooling. Avoiding constrictive clothing can help mitigate discomfort and restrict blood flow, but it does not actively promote circulation like movement does. Therefore, the focus on regular movement is the most direct and effective approach to prevent the pooling of blood in the lower extremities in this scenario.