A nurse is assisting in the care of a client who is scheduled for surgery.

Exhibits
The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for delayed wound healing. Select all that apply.

History of diabetes mellitus

Prealbumin level

Cholesterol level

Mini Nutritional Assessment screening tool score

History of malnutrition

History of hyperlipidemia

Answer and Explanation

Correct Answer : A,B,D,E

A. History of diabetes mellitus: Diabetes causes impaired blood flow and neuropathy, which delay wound healing by reducing oxygen and nutrient delivery to tissues and increasing infection risk.

B. Prealbumin level: A low prealbumin level reflects inadequate protein stores, which are critical for cellular repair, immune function, and the synthesis of collagen during wound healing.

C. Cholesterol level: While elevated cholesterol increases cardiovascular risk, it does not directly affect the biochemical processes involved in wound healing or tissue repair.

D. Mini Nutritional Assessment screening tool score: A low score indicates poor nutritional status, often linked with deficiencies in vitamins, minerals, and protein that are necessary for effective tissue repair and immune response.

E. History of malnutrition: Malnutrition results in diminished energy reserves and nutrient deficiencies, both of which weaken the body's capacity to regenerate tissue and fight infections, prolonging wound healing time.

F. History of hyperlipidemia: Hyperlipidemia contributes to atherosclerosis but is not directly associated with impaired wound healing or immune function necessary for tissue recovery.

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Correct Answer is A

Explanation

A. Syringe: A syringe is essential for irrigating a stage 4 pressure injury to cleanse the wound thoroughly without causing trauma to the tissue. Proper irrigation helps remove debris and bacteria, promoting healing. A syringe allows controlled, gentle flushing of the wound bed, which is important in managing deep, complex wounds like stage 4 pressure injuries.

B. Tongue depressor: A tongue depressor is generally used to examine the throat and oral cavity and is not suitable for wound care. It lacks the precision and safety needed for wound cleaning or dressing application, especially for deep pressure ulcers.

C. Adhesive tape: Adhesive tape is used to secure dressings but is not a primary supply for wound care itself. In managing a stage 4 pressure injury, the priority is proper wound cleaning and dressing materials rather than just securing them, so adhesive tape is secondary.

D. Cotton-tipped applicator: Cotton-tipped applicators are commonly avoided in wound care because they can leave fibers in the wound bed and potentially cause trauma or infection. They are not recommended for cleaning or applying medication to deep pressure ulcers, where more sterile, gentle methods are needed.

A. Hyponatremia B. Hyperkalemia C. Hypocalcemia D. Hypermagnesemia

Correct Answer is A

Explanation

A. Hyponatremia: Vomiting and diarrhea cause significant fluid loss, often leading to a decrease in sodium levels in the blood (hyponatremia) due to loss of electrolytes and dilution from fluid replacement or retained water.

B. Hyperkalemia: Vomiting and diarrhea usually cause potassium loss, resulting in hypokalemia rather than hyperkalemia, as potassium is lost through gastrointestinal fluids.

C. Hypocalcemia: Calcium levels are generally not directly affected by vomiting and diarrhea, so hypocalcemia is less likely in this scenario.

D. Hypermagnesemia: Magnesium is typically lost with gastrointestinal losses; therefore, hypermagnesemia is uncommon with vomiting and diarrhea.

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A nurse is assisting in the care of a client who is scheduled for surgery. Exhibits The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for delayed wound healing. Select all that apply.

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A nurse is assisting in the care of a client who is scheduled for surgery.

Exhibits
The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for delayed wound healing. Select all that apply.