A patient with a skin disorder is undergoing enzymatic debridement with an occlusive dressing. The nurse teaches the patient that an expected manifestation includes which of the following?
A) Increased body temperature
B) Foul odor
C) Increased drainage
D) Blister formation
Ans: B
Feedback: When enzymatic debridement is being used under an occlusive dressing, a foul odor is produced by the breakdown of cellular debris. This odor does not indicate that the wound is infected. The nurse should expect this reaction and help the patient understand the reason for the odor. When increased body temperature occurs, the nurse is aware of the potential for site infection. Increased drainage and blister formation and are not expected manifestations of enzymatic debridement.
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