A nurse is performing a dressing change for a client who has a sacral wound using negative pressure wound therapy. Which of the following actions should the nurse take first?

Determine the client's pain level.

Irrigate the wound with 0.9% sodium chloride irrigation.

Apply skin preparation to wound edges.

Don sterile gloves.

Answer and Explanation

The Correct Answer is A

A. Assessing the client's pain level is the first step to ensure appropriate pain management during the procedure.

B. Irrigating the wound comes after assessing the client's pain level and preparing the wound for the dressing change.

C. Applying skin preparation to wound edges is part of the preparation process but should come after assessing the client's pain level.

D. Donning sterile gloves is necessary for the procedure but should come after assessing the client's pain level.

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Correct Answer is D

Explanation

A. Irregular uterine contractions at 38 weeks of gestation may not be a concern unless they become regular and more intense.

B. A client scheduled for a nonstress test (NST) at 39 weeks of gestation can typically wait until after attending to more urgent matters.

C. A client scheduled for an induction of labor at 40 weeks of gestation is not necessarily a priority unless there are urgent concerns.

D. Decreased fetal movement, especially for 2 days at 36 weeks of gestation, requires immediate assessment to ensure fetal well-being.

A. A client who has a history of MRSA will need antibiotics. B. A client who has a history of MRSA can develop immunity to the infection. C. A client who has a history of MRSA requires a protective environment. D. A client who has a history of MRSA can still transmit the infection.

Correct Answer is D

Explanation

A. Not all clients with a history of MRSA will require antibiotics. Treatment depends on the presence of active infection, colonization, and other clinical factors.
B. There is no evidence to suggest that individuals can develop immunity to MRSA. MRSA remains a significant pathogen, and individuals with a history of MRSA remain susceptible to reinfection or colonization.
C. A protective environment is not typically required for clients with a history of MRSA. Standard precautions, including hand hygiene and appropriate use of personal protective equipment, are sufficient to prevent transmission.

D. Clients with a history of MRSA can still carry the bacteria on their skin or in their nasal passages and may transmit the infection to others, especially in healthcare settings. Therefore, it is important to adhere to infection control practices to prevent transmission.

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A nurse is performing a dressing change for a client who has a sacral wound using negative pressure wound therapy. Which of the following actions should the nurse take first?