A nurse is reviewing the medical history of a client who is scheduled for surgery.
Which of the following findings places the client at risk for an incisional hematoma?

The client has peripheral vascular disease.

The client has urinary incontinence.

The client takes anticoagulant medications.

The client is underweight.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Peripheral vascular disease does not directly place the client at a higher risk for an incisional hematoma. While it is a vascular condition, the use of anticoagulant medications is a more significant risk factor for bleeding complications.

Choice B rationale:

Urinary incontinence is not directly related to an increased risk of incisional hematoma. Incontinence is a separate issue and does not influence surgical outcomes in the context of hematoma formation.

Choice C rationale:

Taking anticoagulant medications is a significant risk factor for incisional hematoma. Anticoagulants reduce the blood's ability to clot, which can lead to excessive bleeding at the surgical site and the formation of hematomas.

Choice D rationale:

Being underweight is not a primary risk factor for incisional hematoma. While poor nutrition and overall health can influence wound healing, anticoagulant use is a more direct concern for hematoma formation in surgical patients.

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Correct Answer is C

Explanation

Choice A rationale:

The "Region" in the PQRST mnemonic refers to the location of the pain. It helps identify where the pain is occurring in the body. While this information is important, it does not address the quality or nature of the pain, which is what the nurse is asking the client to describe.

Choice B rationale:

"Severity" in the PQRST mnemonic relates to how intense the pain is. It helps in assessing the degree of pain the client is experiencing, but it does not address the quality or nature of the pain, which is what the nurse is inquiring about.

Choice C rationale:

"Quality" in the PQRST mnemonic pertains to the description of the pain itself. It helps the nurse understand the characteristics of the pain, such as whether it is sharp, dull, burning, throbbing, etc. This information is essential for a more accurate assessment of the pain's underlying cause, making it the correct choice in this scenario.

Choice D rationale:

"Precipitating cause" in the PQRST mnemonic is concerned with what factors or actions might trigger the pain. While this information is valuable, it does not directly address the nature or quality of the pain, which is what the nurse is trying to assess.

A. Hold the tip of the syringe at least 1.3 cm (0.5 in) above the wound while irrigating. B. Chill the irrigant prior to the procedure. C. Flush the wound from the most contaminated area to the cleanest area. D. Irrigate the wound until the solution that is draining is clear.

Correct Answer is D

Explanation

Choice A rationale:

Holding the tip of the syringe at least 1.3 cm (0.5 in) above the wound while irrigating is not the best practice for wound irrigation. It's crucial to maintain a close distance to the wound to ensure that the irrigation solution effectively cleans the area.

Choice B rationale:

Chilling the irrigant prior to the procedure is not necessary and could be uncomfortable for the patient. Room temperature or slightly warmed sterile saline solution is typically used for wound irrigation to prevent temperature-related discomfort.

Choice C rationale:

Flushing the wound from the most contaminated area to the cleanest area is an incorrect approach for wound irrigation. The wound should be irrigated from the cleanest to the most contaminatedto prevent contamination of previously clean areas and ensures thorough cleaning of the wound.

Choice D rationale:

Irrigating the wound until the solution that is draining is clear is a common practice for wound irrigation. It indicates that the wound is free of contaminants, debris, and infectious material.

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A nurse is reviewing the medical history of a client who is scheduled for surgery.Which of the following findings places the client at risk for an incisional hematoma?

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A nurse is reviewing the medical history of a client who is scheduled for surgery.
Which of the following findings places the client at risk for an incisional hematoma?