A nurse is teaching a newly licensed nurse about preventing puncture injuries, Which of the following instructions should the nurse include?

Break needles on syringes before disposal

Use two hands to recap a needle after administering a medication

Dispose of used razors in wastebaskets.

Replace sharps containers when they are 3/4 full.

Answer and Explanation

The Correct Answer is D

A) "Break needles on syringes before disposal":
Breaking needles before disposal is not a safe practice because it increases the risk of injury to staff during disposal. Needles should be disposed of intact in designated sharps containers to prevent injury. Tampering with used needles or syringes could expose staff to bloodborne pathogens.

B) "Use two hands to recap a needle after administering a medication":
The use of two hands to recap a needle is a high-risk behavior and should be avoided. The proper procedure is to never recap a needle after use. If recapping is absolutely necessary, a one-handed technique using the cap or a mechanical device should be employed to reduce the risk of needlestick injuries. The best practice is to dispose of the needle immediately in a sharps container.

C) "Dispose of used razors in wastebaskets":
Used razors should never be disposed of in wastebaskets, as this poses a significant risk of injury to waste management personnel. Razors, like needles and other sharp objects, should be placed in a designated sharps container. These containers are puncture-resistant and provide a safe environment for the disposal of used sharp items.

D) "Replace sharps containers when they are 3/4 full":
Sharps containers should be replaced when they are 3/4 full to prevent overfilling, which increases the risk of needlestick injuries. Overfilled containers can also make it difficult to dispose of new sharps safely. It is essential to follow institutional guidelines for the proper disposal of sharps and ensure that containers are replaced in a timely manner to maintain a safe environment.

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Correct Answer is B

Explanation

A) Keep the head of the client’s bed elevated to 45 degrees:
Elevating the head of the bed to 45 degrees can actually increase the risk of pressure injuries, particularly in clients who are already at risk. This position can cause shearing forces and increase pressure on areas such as the sacrum, heels, and hips, making it more likely for pressure ulcers to develop.

B) Provide the client with a high-calorie diet:
A high-calorie diet is important for clients at risk of pressure injuries because adequate nutrition supports skin integrity and wound healing. Clients at risk for pressure injuries often have compromised nutritional status, and providing sufficient calories, protein, and other nutrients helps improve tissue regeneration and resilience. A high-calorie, high-protein diet helps prevent further breakdown of the skin and supports the healing process for any existing wounds.

C) Massage the client’s bony prominences:
Massaging bony prominences, such as the heels, elbows, and sacrum, is not recommended because it can cause tissue damage and increase the risk of pressure injury. Instead, the focus should be on minimizing pressure on these areas and using appropriate methods to redistribute pressure, such as repositioning the client or using pressure-relieving devices.

D) Reposition the client every 4 hours:
Repositioning the client every 4 hours may not be frequent enough for those at high risk for pressure injuries. For individuals who are immobile or at high risk, repositioning should typically occur at least every 2 hours to alleviate pressure on vulnerable areas of the body.

A. The client is underweight. B. The client takes anticoagulant medications. C. The client has urinary incontinence D. The client has peripheral vascular disease

Correct Answer is B

Explanation

A) The client is underweight:
Being underweight is not directly associated with an increased risk of incisional hematoma formation. However, underweight individuals may have a lower amount of subcutaneous fat, which could affect wound healing. While nutritional status plays a role in recovery after surgery, being underweight does not specifically increase the risk of hematoma formation at
the incision site.

B) The client takes anticoagulant medications:
Taking anticoagulant medications (e.g., warfarin, heparin, or newer anticoagulants like dabigatran) increases the risk of bleeding and the formation of an incisional hematoma. Anticoagulants work by reducing the blood's ability to clot, making it more difficult to stop bleeding after surgery. This increases the likelihood of blood accumulating in the tissue around the incision site, potentially forming a hematoma.

C) The client has urinary incontinence:
Urinary incontinence does not directly increase the risk of incisional hematoma formation. However, it can lead to other complications, such as skin irritation or infection, but it is not a primary risk factor for hematoma formation in the surgical wound. The main concern with urinary incontinence in the perioperative period is ensuring proper skin care to prevent moisture-associated skin damage.

D) The client has peripheral vascular disease:
Peripheral vascular disease (PVD) affects circulation in the extremities, which can impair wound healing due to decreased blood flow. While PVD can contribute to delayed healing and complications like infection, it is not the most significant factor for the formation of incisional hematomas.

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