A client is receiving negative pressure wound therapy (NPWT) for a chronic wound on the lower leg. The nurse observes that the wound edges are approximated and granulation tissue is filling the wound bed. Which action should the nurse take?

Correct answer: C) Discontinue the NPWT and apply a moist dressing.

Rationale: The nurse should discontinue the NPWT and apply a moist dressing when the wound edges are approximated and granulation tissue is filling the wound bed. This indicates that the wound is healing well and does not need further NPWT. NPWT is a type of advanced wound therapy that uses a vacuum device to apply negative pressure to a wound, which helps to remove excess fluid, reduce edema, increase blood flow, and stimulate granulation tissue formation. NPWT should be discontinued when the wound has achieved sufficient granulation tissue or epithelialization, or when there are signs of infection or bleeding.

Incorrect options:

A) Increase the frequency of dressing changes. - This is not an appropriate action, as increasing the frequency of dressing changes can disrupt the wound healing process and cause trauma and pain to the client. Dressing changes for NPWT are usually done every 48 to 72 hours, depending on the type of dressing and the amount of drainage.

B) Decrease the amount of negative pressure applied. - This is not an appropriate action, as decreasing the amount of negative pressure applied can reduce the effectiveness of NPWT and delay wound healing. The amount of negative pressure applied should be determined by the provider based on the type and location of the wound, the amount of drainage, and the client's tolerance.

D) Continue the NPWT until the wound is completely closed. - This is not an appropriate action, as continuing the NPWT until the wound is completely closed can cause overgranulation or maceration of the wound and surrounding skin. NPWT should be discontinued when the wound has achieved sufficient granulation tissue or epithelialization, or when there are signs of infection or bleeding.

Correct answer: D) Hydrogel dressing

Rationale: The nurse should use a hydrogel dressing to promote autolytic debridement of the wound. Autolytic debridement is a natural process that uses the body's own enzymes and moisture to liquefy and remove necrotic tissue from a wound. Hydrogel dressings provide hydration and moisture to dry wounds and facilitate autolytic debridement.

Incorrect options:

A) Alginate dressing - This is not an appropriate dressing for autolytic debridement, as alginate dressings are used for wounds with moderate to heavy exudate that need absorption and hemostasis. Alginate dressings form a gel-like substance when in contact with wound fluid and help to maintain a moist environment for wound healing.

B) Foam dressing - This is not an appropriate dressing for autolytic debridement, as foam dressings are used for wounds with moderate to heavy exudate that need insulation and protection. Foam dressings have a soft and absorbent layer that cushions the wound and prevents maceration of the surrounding skin.

C) Gauze dressing - This is not an appropriate dressing for autolytic debridement, as gauze dressings are used for wounds with minimal to moderate exudate that need cleansing and packing. Gauze dressings can adhere to the wound surface and cause trauma and bleeding when removed.