A nurse is contributing to the plan of care for a client who has AIDS and has malnutrition. Which of the following actions should the nurse include in the plan of care?

Choice A Reason:
Preparing the sterile dressing supplies 30 min before the dressing change is correct. While it's crucial to have all supplies ready before starting the procedure, preparing them 30 minutes in advance might not align with the principles of maintaining sterility. It's generally best to prepare sterile supplies just before the procedure to minimize the risk of contamination.
Choice B Reason:
Don sterile gloves before removing the dressing is incorrect. Sterile gloves should indeed be worn during the dressing change, but they should be put on after removing the old dressing. This ensures that the clean gloves don't touch potentially contaminated surfaces during the removal of the old dressing.
Choice C Reason:
Disinfect the wound bed with alcohol before applying tape is incorrect. Using alcohol to disinfect the wound bed is not recommended as it can cause tissue irritation and delay wound healing. Sterile saline or another wound cleansing solution prescribed for wound care would be more appropriate to clean the wound bed. Additionally, applying tape directly to the wound is generally avoided to prevent further damage to the fragile tissues of a pressure ulcer.
Choice D Reason:
Offering the client pain medication before the procedure is correct. Providing pain medication before the procedure ensures the client's comfort and helps manage any discomfort or pain associated with the dressing change, particularly when dealing with a stage III pressure ulcer, which can be quite sensitive.

Choice A Reason:

Discarding soiled wound care supplies in a trash receptacle outside the client's room is generally a good practice for infection control. However, this action alone might not be sufficient for managing an infectious wound. Proper disposal is essential, but placing the client in isolation is more critical to prevent the spread of infection.

Choice B Reason:

Administering antibiotic therapy before culturing the wound might interfere with accurate culture results. It's generally preferred to obtain wound cultures before starting antibiotic therapy to identify the specific pathogens causing the infection and determine the most effective treatment.

Choice C Reason:

Placing the client in a private room with a private bathroom is correct. Isolating the client in a private room with a private bathroom helps minimize the spread of potential pathogens present in the wound drainage. This measure helps contain the infection and prevents exposure to others.

Choice D Reason:

Instructing visitors to perform hand hygiene for only 5 seconds after leaving the client's room isn't thorough enough for proper infection control. Proper hand hygiene typically involves washing hands with soap and water or using alcohol-based hand sanitizer for at least 20 seconds to effectively reduce the spread of infection.