A nurse is caring for a client who has rheumatoid arthritis (RA). The nurse understands that this condition is caused by what type of hypersensitivity?

Choice A reason:

Applying a moist dressing to the wound provides a moist environment for wound healing and protects the wound from contamination and trauma. Moisture prevents dehydration and necrosis of the wound bed and promotes cell migration and growth.

Choice B reason:

Assessing the wound for signs of infection is important to detect and treat any infection that may impair wound healing or cause systemic complications. Signs of infection include increased redness, warmth, swelling, pain, drainage, odor, fever, or leukocytosis.

Choice C reason:

Debriding necrotic tissue from the wound is essential to remove any dead or devitalized tissue that may interfere with wound healing or serve as a source of infection. Debridement can be done by surgical, mechanical, enzymatic, or autolytic methods.

Choice D reason:

Elevating the affected leg above the heart level reduces edema and improves blood circulation to the wound. Edema can impair wound healing by causing tissue hypoxia, increasing bacterial growth, and delaying granulation tissue formation.

Choice E reason:

Massaging the wound edges gently is not recommended for chronic wounds, as it may cause trauma or bleeding to the wound bed or delay epithelialization. Massaging may be beneficial for preventing hypertrophic scars or contractures in healed wounds.

Choice A reason:

Gram-positive cocci are bacteria that have a spherical shape and stain purple with Gram stain due to their thick peptidoglycan cell wall. Streptococcus pyogenes is an example of gram-positive cocci that can cause infections such as pharyngitis, impetigo, cellulitis, necrotizing fasciitis, or rheumatic fever.

Choice B reason:

Gram-negative cocci are bacteria that have a spherical shape and stain pink with Gram stain due to their thin peptidoglycan cell wall and outer membrane. Neisseria gonorrhoeae and Neisseria meningitidis are examples of gram-negative cocci that can cause infections such as gonorrhea, meningitis, or septicemia.

Choice C reason:

Gram-positive bacilli are bacteria that have a rod-shaped shape and stain purple with Gram stain due to their thick peptidoglycan cell wall. Bacillus anthracis and Clostridium botulinum are examples of gram-positive bacilli that can cause infections such as anthrax, botulism, or tetanus.

Choice D reason:

Gram-negative bacilli are bacteria that have a rod-shaped shape and stain pink with Gram stain due to their thin peptidoglycan cell wall and outer membrane. Escherichia coli and Pseudomonas aeruginosa are examples of gram-negative bacilli that can cause infections such as urinary tract infection, wound infection, or sepsis.