The nurse is planning care for a patient with a large leg wound. Which of the following would increase the patient's risk for developing a wound infection?
1. arthritis of weight bearing joints
2. biventricular pacemaker inserted two years prior
3. smoking cessation 45 years ago
4. diagnosis of peripheral vascular disease
4
Rationale: One variable that needs to be present for a wound infection to occur is that of a susceptible host. The patient who is a susceptible host has some degree of local or systemic impairment of resistance to bacterial invasion. Local impairment may be the result of dead, foreign material or hematomas directly in the wound or some interference in blood supply to the area as a result of vascular disease. Systemic impairment of the patient's resistance may include diabetes, acute or chronic use of steroids, renal disease, malnutrition, cardiovascular disease, extremes of age, obesity, cancer, or the use of immunosuppressive therapies. The patient has a diagnosis of peripheral vascular disease which would increase the risk for developing a wound infection. The other choices would have no effect on the development of a wound infection.
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