A nurse is assessing a client's wound in the stages of healing. Which of the following areas of the wound represents granulation tissue? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)
The Correct Answer is "{\"xRanges\":[333.4270782470703,393.4270782470703],\"yRanges\":[222.1666259765625,282.1666259765625]}"
Granulation tissue is a key component of the healing process for wounds and appears as new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process. It typically appears red or pink, indicating the presence of new blood vessels (capillaries). It has a moist, bumpy, or grainy texture. The tissue might look uneven or pebbled. It progressively covers the wound bed, starting from the edges and moving toward the center, eventually filling the wound cavity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Instruct the client to take a sitz bath three times a week. While sitz baths may provide symptom relief, they are not a primary intervention for treating a UTI.
B. Request a prescription for gabapentin. Gabapentin is used for neuropathic pain, not for treating UTIs.
C. Encourage the client to drink 2 oz of grapefruit juice each day. Grapefruit juice is not recommended for UTIs; cranberry juice is often suggested instead.
D. Increase the client's fluid intake to 3 L each day. Increasing fluid intake helps flush bacteria from the urinary tract and is a key intervention in managing UTIs.
Correct Answer is B
Explanation
A. Avoid using moisturizers on the client's skin. Moisturizers are important for maintaining skin integrity, especially in clients with incontinence, to prevent skin breakdown.
B. Place the client on a timed voiding schedule. This is correct. A timed voiding schedule can help manage incontinence by reducing the frequency of wetness and thereby preventing skin breakdown.
C. Place the client in high-Fowler's position while in bed. High-Fowler’s position is not typically indicated for preventing skin breakdown and can increase pressure on the sacral area.
D. Wash urine off the client's skin with hot water and soap. Washing with hot water and soap can be harsh and irritating to the skin. It is better to use mild soap and lukewarm water.
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