Nokea
Match the following types of wound healing with their examples: Second intention
- A. A traumatic wound first left open to drain and then sutured closed
- B. An appendectomy incision sutured closed
- C. A pressure ulcer being packed with moist gauze
Correct Answer: C
Rationale: Second intention healing involves granulation tissue filling an open wound, as in a pressure ulcer packed with gauze.
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A patient has had emergency surgery because of a bowel obstruction. The wound becomes infected with Escherichia coli. This likely occurred because
- A. These bacteria are always present on the skin and easily enter a wound if sterile technique is not used.
- B. These bacteria grow in the absence of oxygen, which is the case in the bowel.
- C. These bacteria are present in the bowel, and with emergency surgery there is no time to perform special bowel preparations.
- D. The patient had poor nutritional intake because these bacteria grow in dying tissue.
Correct Answer: C
Rationale: E. coli, common in the bowel, likely contaminated the wound during emergency surgery due to lack of bowel prep time.
A patient is at risk for wound dehiscence as a result of nutritional issues and medical history. Which interventions should be included in the care plan?
- A. Assist the patient to splint the incision with a pillow when coughing.
- B. Enforce strict bedrest with bathroom privileges only.
- C. Administer stool softeners and antinausea medicine promptly.
- D. Obtain VS every 15 minutes.
Correct Answer: A,C
Rationale: Splinting the incision and preventing straining (via stool softeners/antinausea meds) reduce stress on the wound, preventing dehiscence.
The nurse realizes that the patient with a shoulder incision needs more teaching when the patient says
- A. I know the signs of infection and will report them to the physician if they occur.'
- B. If my fever goes above 100 degrees, I will notify my doctor.'
- C. I know how to change the dressing on my incision and have done it three times.'
- D. I will take these antibiotics until the doctor removes the staples.'
Correct Answer: D
Rationale: Antibiotics should be taken for the full prescribed course, not until staples are removed, indicating a need for further teaching.
You are calling a health-care provider to report a possible wound infection. What information will you include in your report?
- A. Most recent vital signs
- B. Amount and type of wound drainage
- C. Observed signs of infection
- D. Type and frequency of bowel movements
- E. Patient's rating of his or her pain
- F. Amount of activity the patient has had in the past 24 hours
- G. Laboratory results
Correct Answer: A,B,C,E,G
Rationale: Vital signs, drainage, infection signs, pain, and lab results are critical for assessing and managing a potential wound infection.
You are a nurse, and you are running behind schedule on a very busy workday. The UAP offers to change a patient's abdominal dressing for you. She is a first-semester nursing student. Which is the most appropriate response?
- A. That would be great. Don't forget to measure the open area in the middle of her incision for me.'
- B. I know you have been taught to do this in school, so you are not the same as the other UAPs. Go ahead and change the dressing.'
- C. Thanks, but could you help Mr. Wu walk in the hall instead? That way I can get that dressing changed.'
- D. You know you can't do that as a UAP. I would be in big trouble if I let you change that dressing!'
Correct Answer: C
Rationale: UAPs, including nursing students, are not permitted to perform complex tasks like dressing changes, which require nursing judgment. Delegating a simpler task is appropriate.