A summer camp nurse is educating a group of adolescent girls on the importance of regular physical exercise. Which level of preventive care does this activity represent?

Rationale for Choice A:
Making assessments every 15 minutes for four hours does not directly address the immediate concern of blood loss and potential hemodynamic instability. While close monitoring is essential, it's not the primary action in this situation.
Excessive blood loss can rapidly lead to hypovolemic shock, which requires prompt intervention to prevent serious complications.
Relying solely on frequent assessments without active interventions could delay crucial treatment and compromise patient safety.
Rationale for Choice B:
Documenting the data, removing the old dressing, and applying a new dressing might be necessary at some point, but it's not the most urgent priority in this case.
Removing the dressing could disrupt clot formation and potentially worsen bleeding.
Applying a new dressing without addressing the underlying bleeding might not effectively control the blood loss. Rationale for Choice C:
Applying a well-secured additional pressure dressing is the most appropriate immediate action to help control bleeding and prevent further blood loss.
It provides direct compression to the surgical site, promoting hemostasis and reducing blood flow. This action prioritizes stabilizing the patient's condition and preventing further complications.

Reporting the findings to the healthcare provider is crucial for timely assessment, diagnosis, and management of potential complications, such as hemorrhage or hematoma.
It ensures collaboration with the healthcare team and facilitates appropriate interventions based on the patient's specific needs.
Rationale for Choice D:
Reassuring the family that this is a common problem might provide some comfort, but it doesn't address the patient's immediate needs or the potential severity of the situation.
It's essential to prioritize patient safety and provide interventions to control bleeding, even if bleeding is a known potential complication.
Transparency and clear communication with the family are important, but they should not replace necessary medical interventions.

Skin breakdown:

Prolonged exposure to urine, especially in the presence of incontinence briefs, can irritate and macerate the skin, leading to breakdown.

Factors contributing to skin breakdown:

Moisture from urine:

Creates a warm, moist environment ideal for bacterial growth.

Disrupts the skin's natural barrier function, making it more susceptible to damage.

Friction from incontinence briefs:

Can rub against the skin, causing irritation and further damage.

Chemical irritants in urine:

Ammonia and other substances in urine can further irritate and damage the skin.

Signs of skin breakdown:

Redness, warmth, tenderness, or swelling of the skin.

Blisters, erosions, or ulcers.

Pain or discomfort.

Prevention of skin breakdown:

Frequent changing of incontinence briefs (as soon as they become wet or soiled).

Thorough cleansing of the skin with mild soap and water after each change.

Application of a skin barrier cream or ointment to protect the skin.

Use of breathable incontinence briefs that allow air to circulate.

Monitoring of the skin for signs of breakdown and seeking prompt medical attention if any occur. Urinary tract infections (UTIs):

Bacteria from the skin can enter the urinary tract through the urethra, leading to infection.

Factors increasing UTI risk in those with incontinence:

Incomplete bladder emptying:

Residual urine in the bladder provides a breeding ground for bacteria.

Use of incontinence briefs:

Can trap moisture and bacteria near the urethra.

Difficulty with personal hygiene:

May lead to the spread of bacteria from the skin to the urinary tract.

Signs of a UTI:

Frequent urination.

Pain or burning during urination.

Urgency to urinate.

Blood in the urine.

Cloudy or foul-smelling urine.

Prevention of UTIs:

Maintaining good personal hygiene.

Drinking plenty of fluids to help flush bacteria from the urinary tract.

Promptly emptying the bladder when the urge to urinate is felt.

Seeking medical attention if any signs of a UTI occur.