The nurse delegates applying a binder over the patient's abdominal incision to nursing assistive personnel (NAP). Which does the nurse include in the NAP's instructions?

Question

a. Start the binder right under the axilla.
b. Place the patient in a semi-Fowler's posi-tion.
c. Secure the binder with metal fasteners.
d. Remove the old dressing and apply a binder.

Answer 1

C
The nurse instructs the NAP to secure the binder with metal fasteners, Velcro strips, or safety pins to keep the dressing in place. This prevents the binder from opening accidentally and in-creasing the risk of patient infection. If the NAP starts right under the axilla, the binder will en-case the thorax, potentially impairing the patient's ability to oxygenate, ventilate, cough, and deep breathe thereby increasing the risk of hypoxia, acidosis, atelectasis, and pneumonia. The NAP is instructed to place the patient in the supine position to apply the binder because in that position the patient may assist the NAP by rolling from side to side. This allows the NAP to place the fanfolded binder under the patient so it may be drawn around the abdomen. The nurse instructs the NAP to apply the binder after the sterile dressing change is completed to prevent patient infection and protect the wound.