After teaching a home caregiver how to mange a pressure ulcer, the nurse realizes further education is needed when the caregiver says:
A. "I will be sure to reposition her frequently and keep her off of the pressure ulcer."
B. "I will wash the pressure ulcer with saline and report any changes in the drainage."
C. "I know that a thick, black covering will protect the pressure ulcer from getting worse."
D. "I will let you know if the pressure ulcer starts to smell rotten."
C
C. Black tissue in a pressure ulcer is eschar, a necrotic tissue that covers a section of the ulcer and prevents effective assessment.
A. This statement indicates the caregiver understands the factors
that cause pressure ulcers.
B. This statement indicates that the caregiver understands how to cleanse and assess the pressure ulcer.
D. This statement indicates that the caregiver understands a warning sign of infection of the pressure ulcer.
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The nurse debriding a burn wound explains that the purpose of debridement is to:
a. increase the effectiveness of the skin graft. b. prevent infection and promote healing. c. promote suppuration of the wound. d. promote movement in the affected area.
When assessing a wound in the remodeling phase of healing, the nurse would expect to find:
A) scar tissue formation. B) acute inflammation. C) a fibrin clot. D) granulation tissue.
As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?
a. Two b. Three c. Four d. Five
Which patient has more extracellular fluid?
A) Adult woman B) Adolescent man C) Female school-age child D) Newborn