A nurse is assessing pressure ulcers on four clients to evaluate the effectiveness of a change in wound care procedure. Which of the following findings indicates wound healing?

Choice A reason: This client does not need an interdisciplinary conference because their condition is not complex or chronic. The nurse can manage the client's care by monitoring their vital signs, fluid intake and output, and hydration status. The nurse can also educate the client on how to prevent orthostatic hypotension by changing positions slowly and wearing compression stockings.

Choice B reason: This client does not need an interdisciplinary conference because their condition is well-controlled and self-managed. The nurse can manage the client's care by checking their blood glucose levels, administering insulin as prescribed, and providing dietary and lifestyle education. The nurse can also collaborate with the diabetes educator or the endocrinologist if needed.

Choice C reason: Although this client is at risk for pressure ulcers, their albumin level is within the normal range, indicating adequate nutritional status. Low albumin levels are often associated with poor wound healing and increased risk of skin breakdown, but in this case, nutrition does not appear to be a concern. Preventive measures, such as regular repositioning, skin assessments, and pressure-relieving devices, can be implemented by nursing staff without requiring an interdisciplinary meeting.

Choice D reason:This client is the most appropriate candidate for an interdisciplinary conference. The activated partial thromboplastin time (aPTT) is a critical lab value for monitoring heparin therapy, and a level of 34 seconds is below the therapeutic range. A subtherapeutic aPTT increases the risk of clot formation, indicating that the heparin dose may need to be adjusted. An interdisciplinary team, including the physician, pharmacist, nurse, and laboratory personnel, should collaborate to ensure safe and effective anticoagulation management. This conference would allow for a discussion on dosage adjustments, potential medication interactions, and continued monitoring to prevent complications such as deep vein thrombosis or pulmonary embolism.

Choice A reason: This is not the correct choice because witnessing the client signing the consent form is not a valid option. The client is a minor and cannot legally consent to their own treatment without the permission of their guardian, unless they are emancipated, married, or pregnant.

Choice B reason: This is not the correct choice because asking the adult neighbor to sign the consent form is not a valid option. The adult neighbor is not a legal guardian or a close relative of the client and has no authority to consent to the client's treatment.

Choice C reason: This is not the correct choice because obtaining consent from the hospital administrator is not a valid option. The hospital administrator is not a medical professional or a legal representative of the client and has no authority to consent to the client's treatment.

Choice D reason: This is the correct choice because attempting to notify the client's guardian to obtain consent is the best option. The client's guardian is the person who has the legal right and responsibility to make decisions for the client's health care. The nurse should try to contact the guardian by phone or other means and obtain verbal or written consent for the emergency surgery. If the guardian cannot be reached, the nurse should follow the facility's policy and procedure for obtaining consent in emergency situations.