The nurse is assessing a patient's postoperative wound and finds it has separated from the suture line with extrusion of the intestine through the opening. How does the nurse document this finding?
Wound evisceration
Wound dehiscence
Wound infection
Wound tunneling
The Correct Answer is A
Wound evisceration refers to the protrusion of internal organs or tissues through an open wound. In this case, with the separation of the wound and extrusion of the intestine through the opening, it is a clear indication of wound evisceration. It is a surgical emergency that requires immediate medical attention.
Wound dehiscence, on the other hand, refers to the separation or opening of a previously closed surgical incision or wound. It does not involve the extrusion of internal organs or tissues.
Wound infection refers to the presence of infectious microorganisms in the wound, leading to inflammation and other signs of infection.
Wound tunneling refers to the formation of narrow channels or tunnels within the wound, often caused by improper wound healing or infection.
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Related Questions
Correct Answer is B
Explanation
A paralytic ileus is a type of bowel obstruction characterized by the impairment or absence of normal bowel motility. It occurs due to the temporary paralysis or dysfunction of the muscles that propel food and waste material through the intestines. After surgery, paralytic ileus can occur as a result of the handling of the intestines during the procedure, the effects of anesthesia, or the body's response to inflammation and trauma.
The absence of bowel sounds is a key indicator of paralytic ileus. Normally, bowel sounds are present and indicate the movement of contents through the intestines. However, in a paralytic ileus, the bowel sounds may be diminished or absent due to the lack of peristalsis (wave-like contractions that move food along the digestive tract).
Correct Answer is B
Explanation
Cushing's syndrome is a disorder characterized by excessive production or prolonged exposure to high levels of glucocorticoids, particularly cortisol. This can occur due to various reasons, such as the use of corticosteroid medications or overproduction of cortisol by the adrenal glands. Elevated glucocorticoid levels result in a variety of clinical manifestations associated with Cushing's syndrome, including weight gain, central obesity, muscle wasting, thinning of the skin, easy bruising, and impaired glucose metabolism.
It's important to note that Cushing's syndrome can have different underlying causes, such as adrenal tumors, pituitary tumors, or ectopic ACTH production. Regardless of the cause, the common feature in Cushing's syndrome is the excessive glucocorticoid levels, which contribute to the signs and symptoms of the condition.
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