The wound care nurse visits a patient in the long-term care unit. The nurse is monitoring a patient with a Stage III pressure ulcer. The wound seems to be healing, and healthy tissue is observed
How should the nurse document this ulcer in the patient's medical record?
a. Stage I pressure ulcer
b. Healing Stage II pressure ulcer
c. Healing Stage III pressure ulcer
d. Stage III pressure ulcer
ANS: C
When a pressure ulcer has been staged and is beginning to heal, the ulcer keeps the same stage and is labeled with the words "healing stage" or healing Stage III pressure ulcer. Once an ulcer has been staged, the stage endures even as the ulcer heals. This ulcer was labeled a Stage III, and it cannot return to a previous stage such as Stage I or II. This ulcer is healing, so it is no longer labeled a Stage III.
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The nurse is concerned that the patient will pull out the endotracheal tube. As part of the nursing management, the nurse obtains an order for:
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The nurse recognizes that the greatest risk to the fetus in a post-date pregnancy is
a. birth trauma due to cephalopelvic disproportion b. hypoglycemia due to depleted glycogen stores c. hypoxia due to uteroplacental insufficiency d. respiratory distress due to cesarean section
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research report? A) introduction B) methods C) results D) conclusions