A nurse is caring for a client with a chronic wound and is discussing smoking cessation. The client does not understand how smoking may impact wound healing. Which of the following would be the best nurse response?
Smoking causes you to cough frequently and the wound might get infected by sputum.
Nicotine causes vasoconstriction so your wound might not get enough blood flow to heal.
Nicotine causes tar to build up in the wound and it will impair healing.
Smoking is bad and you should stop right away.
The Correct Answer is B
A. Smoking causes you to cough frequently, and the wound might get infected by sputum.
While smoking can indeed contribute to respiratory issues like coughing, linking this directly to wound infection by sputum is not the most accurate explanation of how smoking affects wound healing. The primary concern with smoking and wound healing lies in its effects on circulation and tissue oxygenation rather than the risk of infection due to coughing.
B. Nicotine causes vasoconstriction, so your wound might not get enough blood flow to heal.
This is the best response among the options provided. Nicotine, a major component of cigarette smoke, is known to constrict blood vessels (vasoconstriction). This constriction reduces blood flow to the wound site, leading to decreased delivery of oxygen and nutrients necessary for proper wound healing. It addresses the direct physiological impact of smoking on wound healing and provides a clear explanation for the client.
C. Nicotine causes tar to build up in the wound, and it will impair healing.
While nicotine and other components of tobacco smoke can have detrimental effects on healing, particularly through vasoconstriction, the explanation about tar building up in the wound is not entirely accurate. Tar is more associated with lung damage from smoking rather than direct buildup in external wounds. Therefore, this response is less specific and may confuse the client about the actual mechanism of how smoking affects wound healing.
D. Smoking is bad, and you should stop right away.
While this response emphasizes the importance of smoking cessation, it lacks specificity in explaining how smoking impacts wound healing. Providing specific information about vasoconstriction due to nicotine, as mentioned in option B, would be more helpful in helping the client understand the direct effects of smoking on their chronic wound and why cessation is crucial.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Stage III pressure injury
Stage III pressure injuries involve full-thickness skin loss, extending into the subcutaneous tissue but not through the fascia. These wounds typically present as deep craters and may involve undermining or tunneling. Non-blanchable erythema alone without visible skin loss is not characteristic of a Stage III pressure injury.
B. Stage IV pressure injury
Stage IV pressure injuries are the most severe and involve full-thickness tissue loss with exposed bone, tendon, or muscle. These wounds often have extensive tissue damage and can be difficult to manage. Again, non-blanchable erythema without visible skin loss is not indicative of a Stage IV pressure injury.
C. Stage II pressure injury
Stage II pressure injuries involve partial-thickness skin loss with damage to the epidermis and possibly the dermis. These wounds often present as shallow open ulcers or blisters and may have characteristics such as intact or ruptured blisters. While Stage II injuries can present with erythema, non-blanchable erythema specifically indicates a Stage I injury.
D. Stage I pressure injury
Stage I pressure injuries are the earliest stage and involve non-blanchable erythema of intact skin. The skin may be warmer or cooler than surrounding tissue and may have changes in sensation. There is no visible skin loss at this stage, but the area is at risk for further injury if pressure is not relieved. Therefore, non-blanchable erythema on the heels most likely indicates a Stage I pressure injury.
Correct Answer is B
Explanation
A. Melanoma:
Melanoma is a type of skin cancer that arises from melanocytes, the cells that produce pigment (melanin) in the skin. Melanoma lesions are typically irregularly shaped, often asymmetrical, with varying shades of color (brown, black, tan, red, blue). They may have an uneven border and can evolve over time. Melanomas can be raised but are not typically described as indurated (firm) and shiny. They are also more commonly associated with changes in color, size, and shape.
B. Keloid:
A keloid is an abnormal overgrowth of scar tissue that extends beyond the boundaries of the original wound or incision site. Keloids are characterized by their raised appearance, firm or indurated texture, and shiny surface compared to the surrounding skin. They may also be darker than the surrounding skin due to increased collagen deposition. Keloids can develop months after an injury or surgery and are more common in individuals with darker skin tones, such as African Americans.
C. Nevus:
A nevus, commonly known as a mole or birthmark, is a benign growth of melanocytes or other skin cells. Nevus lesions can vary in appearance but are often flat or slightly raised, with a uniform color (brown, black, tan, or flesh-colored). They are usually not described as indurated or shiny. Nevus lesions can be present at birth (congenital nevus) or develop later in life (acquired nevus).
D. Angioma:
Angiomas are benign tumors that originate from blood vessels or lymphatic vessels. They can present as red or purplish raised lesions on the skin. Angiomas are typically not described as indurated or shiny. Common types of angiomas include cherry angiomas (small, red papules) and spider angiomas (red, spider-like lesions with central vessels).
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