An older patient has a stage III pressure ulcer. Which treatment would the nurse expect the physician to order for the patient's wound?
1. Cadexomer
2. Silver sulfadiazine
3. Nanocrystalline silver
4. Topical antibiotic cream
2. Silver sulfadiazine
Explanation: 1. Cadexomer iodine dressings provide a slow-release form of iodine. These dressings have effective antibacterial action and do not harm granulation tissue. The patient's wound is not healing and would not have granulation tissue.
2. Silver sulfadiazine is the topical antimicrobial of choice for the non-healing ulcer.
3. Nanocrystalline silver dressings have been found to be effective against gram-negative, gram-positive, and anaerobic organisms.
4. Topical antibiotics are not recommended for pressure ulcers. Reasons include inadequate penetration if the wound is deep, development of antibiotic resistance, hypersensitivity reactions, and local irritation.
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