A nurse is developing a plan of care for a client who has a stage 3 pressure ulcer. Which of the following interventions should the nurse include in the plan?

Apply a heat lamp twice a day.

Reposition the client at least every 2 hours.

Massage reddened areas with dressing changes.

Clean the wound with hydrogen peroxide solution.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Applying a heat lamp twice a day is not recommended for treating stage 3 pressure ulcers. Heat lamps can cause burns and further damage to the already compromised skin. The primary goal in treating pressure ulcers is to reduce pressure, keep the area clean, and promote healing. Heat lamps do not contribute to these goals and can potentially worsen the condition.

Choice B reason:

Repositioning the client at least every 2 hours is a crucial intervention for managing stage 3 pressure ulcers. Frequent repositioning helps to alleviate pressure on the affected area, improving blood flow and preventing further tissue damage. This practice is essential in preventing the progression of pressure ulcers and promoting healing. It is one of the most effective strategies in pressure ulcer management.

Choice C reason:

Massaging reddened areas with dressing changes is not advisable. Massaging can cause additional trauma to the skin and underlying tissues, potentially worsening the ulcer. Instead, gentle handling and appropriate wound care techniques should be used to avoid further damage. Massaging can also disrupt the healing process and increase the risk of infection.

Choice D reason:

Cleaning the wound with hydrogen peroxide solution is not recommended for stage 3 pressure ulcers. Hydrogen peroxide can damage healthy tissue and delay the healing process. It is better to use saline or other wound cleaning solutions that are gentle and effective in removing debris without harming the tissue. Proper wound cleaning is essential to prevent infection and promote healing.

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Correct Answer is C

Explanation

Choice A reason: You sound overwhelmed. Let’s talk about this some more. This response acknowledges the mother’s feelings and opens the door for further discussion. However, it does not directly address her specific concerns about physical activities. While it is empathetic, it lacks the focus needed to explore her worries about her son’s participation in school activities.

Choice B reason: I agree. His well-being is the most important. This response validates the mother’s concern but may inadvertently reinforce her fears without providing a balanced perspective. It does not encourage a discussion about the benefits of physical activity for children with diabetes or how to manage his condition safely during such activities.

Choice C reason: Tell me more about how you are feeling about your son’s activities. This response is the most appropriate as it invites the mother to express her specific concerns and feelings. It shows empathy and a willingness to understand her perspective, which can lead to a more productive conversation about managing her son’s diabetes while allowing him to participate in physical activities.

Choice D reason: You might want to use tutors to home-school him. This response suggests an alternative that may not be necessary or beneficial. Home-schooling might isolate the child and prevent him from enjoying social interactions and physical activities that are important for his overall development. It does not address the mother’s concerns directly and may not be the best solution.

A. Cardiac glycosides B. Thyroid hormones C. Anticoagulants D. NSAIDs

Correct Answer is B

Explanation

Choice A reason: Cardiac glycosides are primarily used to treat heart conditions such as heart failure and atrial fibrillation. They do not typically affect bone density or contribute to osteoporosis.

Choice B reason: Thyroid hormones can increase the risk of osteoporosis, especially if taken in excess. Over-replacement of thyroid hormone can accelerate bone loss, leading to decreased bone density and increased fracture risk.

Choice C reason: Anticoagulants are used to prevent blood clots but are not generally associated with an increased risk of osteoporosis. Their primary side effects are related to bleeding and bruising.

Choice D reason: NSAIDs (nonsteroidal anti-inflammatory drugs) are used to reduce inflammation and pain. They do not typically affect bone density or contribute to osteoporosis.

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