For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client:

A) Wear sterile gloves to remove the dressing: For a wet-to-dry dressing change, clean gloves are typically used when removing the dressing, as the procedure does not require a sterile technique unless the wound is being directly cleaned or treated with sterile instruments. Wearing sterile gloves for removal is unnecessary and could increase the risk of contamination when handling non-sterile dressing material.

B) Remove the tape by pulling from the center of the dressing: Tape should be removed by pulling it gently from the edges rather than from the center. Pulling from the center may cause unnecessary trauma to the surrounding skin or disrupt the wound's healing process. Gently pulling from the edges helps reduce the risk of skin irritation and minimizes discomfort for the patient.

C) Moisten dressing before removal: The dressing should be moistened before application, not before removal. Wetting the dressing before removing it may actually cause further trauma to the wound, and it might be difficult to remove the wet-to-dry dressing cleanly. The dressing should be removed first, and then a new dressing should be moistened if needed.

D) Clean the wound from the center to the outer edges: When cleaning a wound, the nurse should always clean from the center of the wound to the outer edges in a circular motion. This helps prevent the spread of bacteria from the outer contaminated areas into the clean tissue. By cleaning from the center outward, the nurse reduces the risk of introducing new bacteria into the wound site.

A) pH 7.36 (7.35 to 7.45), PaCO2 38 mm Hg (35 to 45 mmHg), HCO3 25 mEq/L (22 to 26 mEq/L): This is a normal set of arterial blood gas (ABG) values, with a pH within normal range, a normal PaCO2, and a normal HCO3. It does not suggest metabolic alkalosis.

B) pH 7.48 (7.35 to 7.45), PaCO2 32 mm Hg (35 to 45 mm Hg), HCO3 24 mEq/L (22 to 26 mEq/L): Although the pH is elevated, indicating alkalosis, the PaCO2 is slightly low, and the bicarbonate (HCO3) is within the normal range. This set of values does not indicate metabolic alkalosis, but could indicate respiratory alkalosis or compensated alkalosis.

C) pH 7.46 (7.35 to 7.45), PaCO2 36 mm Hg (35 to 45 mm Hg), HCO3 29 mEq/L (22 to 26 mEq/L): This is consistent with metabolic alkalosis. The elevated pH (alkalosis) combined with an increased bicarbonate level (HCO3 > 26 mEq/L) and a normal PaCO2 suggests metabolic alkalosis, as the kidneys retain bicarbonate to compensate for the condition.

D) pH 7.26 (7.35 to 7.45), PaCO2 35 mm Hg (35 to 45 mm Hg), HCO3 18 mEq/L (22 to 26 mEq/L): This set of values indicates acidosis, not alkalosis. The pH is low, indicating acidosis, and the bicarbonate (HCO3) is also low, which suggests metabolic acidosis. The PaCO2 is normal, which further supports a metabolic origin of the acidosis.