The nurse is reviewing the medication list of a patient with impaired wound healing. Which medication would be of concern to the nurse?
A) NPH insulin
B) Prednisone
C) Cefazolin
D) Vitamin C
B) Prednisone
Explanation: A) While diabetes mellitus may impair wound healing, the use of insulin does not have a negative effect on healing.
B) Corticosteroids, such as prednisone, promote the breakdown of carbohydrates, fats, and proteins, impairing the anabolic processes needed for cell growth and proliferation during wound healing. Corticosteroids also exert an anti-inflammatory action that may impede the inflammatory phase of wound healing. Negative effects of corticosteroids include reduced phagocytosis, reduction in fibroblast proliferation and collagen synthesis, and decreased angiogenesis. These actions lead to prolonged wound hypoxia, increased susceptibility to wound infection, reduced granulation tissue formation, decreased wound tensile strength and stability, increased incidence of wound dehiscence, and reduced wound contraction.
C) Cefazolin, a cephalosporin antibiotic, does not negatively affect wound healing and may help wound healing when infection is present.
D) Vitamin C has a positive effect on wound healing and a deficiency can effect wound healing in all phases.
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