The nurse assesses several preoperative patients for potential postoperative referrals to the wound care team. Which patient assessment does the nurse use to identify the patient who is least likely to have delayed postoperative wound healing?
a. Eight weeks postpartum from live vaginal birth in for tubal ligation
b. Older than 70 years, coronary artery dis-ease, and hypertension
c. Six-week course of chemotherapy for a cancerous tumor
d. Chronic obstructive lung disease on long-term prednisone therapy
A
The patient with the lowest risk of delayed wound healing is the patient scheduled for a tubal ligation because she is likely to be 40 years old or younger, decreasing the risk for chronic disease. She is likely to have generally good health as evidenced by a live vaginal birth. The older patient with coronary artery disease and hypertension has atherosclerotic lesions in the heart aggravated by high blood pressure. The patient is likely to have atherosclerotic lesions in other vessels be-cause atherosclerosis is a nonselective disease; thus the patient is at risk for delayed healing be-cause of the potential for impaired tissue perfusion. Radiation therapy increases the risk of post-radiation scarring and fibrosis which increases the risk of delayed healing. The patient taking prednisone is at high risk for delayed healing because glucocorticoids suppress inflammation and the immune system.
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