A nurse is caring for a patient who has sustained second-degree burns on his left leg. A skin graft has been used to cover the area of the burn. Nursing management of the skin graft site includes which of the following?
A) Assisting with AROM of the skin graft site to prevent contractures
B) Keeping the affected area mobilized as much as possible
C) Applying heat to the grafted area to decrease edema
D) Using lanolin to moisten the graft site on postoperative day 2
Ans: B
Feedback: The nurse should instruct the patient to keep the affected part immobilized as much as possible. When ambulation is permitted, the patient wears an elastic stocking to counterbalance venous pressure. There may be loss of feeling or sensation in the grafted area for a prolonged period; the application of heating pads and exposure to the sun must be avoided to prevent burns and further skin trauma. Lanolin is used inn donor site care, to keep the donor site soft and pliable.
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