A nurse in an outpatient clinic is caring for a client. Which of the following findings indicates the client is experiencing a hearing deficit?

Rationale for Correct Choices

• Pain rating of 8/10 with no relief from pain medications: Increased or uncontrolled pain can indicate infection, inflammation, or ineffective wound healing. The lack of pain relief suggests the current wound vac therapy is not adequately addressing the underlying issue.
• Wound size increased from 2 cm × 2 cm to 3 cm × 2 cm: Wound enlargement indicates delayed or ineffective healing. Effective wound vac therapy should reduce wound size and promote closure; an increase in size signals treatment failure.
• Mild purulent drainage noted: Presence of purulent drainage suggests infection or poor wound healing. Effective negative-pressure therapy should promote a clean, granulating wound bed without signs of infection.

Rationale for Incorrect Choices

• Wound bed vascular with some approximation of the edges: This finding suggests that some healing is occurring. A vascular wound bed indicates good blood supply, which is necessary for tissue repair, and partial approximation of edges shows that some granulation tissue is forming and the wound is attempting to close.
• Respirations even and nonlabored, abdomen soft and nondistended, heart rate regular: These systemic findings suggest the client is stable overall. They indicate that there is no acute systemic compromise from the wound,

Rationale

A. Plan to meditate immediately after meals: Meditating immediately after eating may cause discomfort or drowsiness and can interfere with focus. It is recommended to meditate at a time when the client is alert and not experiencing postprandial fatigue, which supports effective stress reduction.

B. Tighten and relax muscles during relaxation therapy: Progressive muscle relaxation involves systematically tensing and then relaxing specific muscle groups to reduce physical tension and stress. This technique promotes awareness of muscle tightness and facilitates overall relaxation, making it an effective component of stress management.

C. Keep eyes open during relaxation therapy: Closing the eyes is typically recommended during meditation and relaxation exercises to minimize distractions and enhance focus. Keeping the eyes open can reduce the effectiveness of the therapy by increasing external stimuli and mental engagement.

D. Take short and shallow breaths when meditating: Effective meditation and relaxation techniques emphasize slow, deep, and controlled breathing. Short, shallow breaths can increase tension and limit oxygenation, reducing the calming effects of meditation. Deep breathing supports parasympathetic activation and stress reduction.