The nurse is caring for a newborn requiring a life-saving blood transfusion. The parents are practicing Jehovah’s Witnesses and refuse the transfusion. Who would the nurse consult for assistance in this situation?

Choice A reason: This statement reflects denial, which is a common initial reaction in the grief process. The client is not accepting the reality of their prognosis and believes the doctor is exaggerating. Denial serves as a defense mechanism to protect the individual from the emotional impact of the diagnosis. It is a way for the client to cope with the overwhelming news by rejecting its truth.

Choice B reason: This statement reflects anger, another stage in the grief process. The client is expressing disbelief and frustration towards the doctor’s competence. Anger often follows denial and is directed towards others as a way to cope with the emotional pain. It is not indicative of denial but rather a progression in the grieving process.

Choice C reason: This statement reflects acceptance of the physical symptoms and the reality of the client’s condition. The client acknowledges their lack of energy and the impact of the illness on their daily life. This is not a sign of denial but rather an acceptance of their current state.

Choice D reason: This statement reflects acceptance and gratitude towards the doctor. The client recognizes the efforts made by the healthcare team and accepts that their time is limited. This is a sign of acceptance, the final stage in the grief process, where the individual comes to terms with their situation.

Choice A reason: Cover

Covering a wound with slough is not an appropriate intervention. Slough is a type of necrotic tissue that can impede the healing process by providing a medium for bacterial growth and preventing the formation of healthy granulation tissue. Simply covering the wound without addressing the slough can lead to infection and delayed healing.

Choice B reason: Clean

Cleaning the wound is a necessary step in wound care, but it is not sufficient on its own to address the presence of slough. While cleaning can help reduce the bacterial load and remove some debris, it does not effectively remove the slough itself. Slough often requires more targeted interventions such as debridement to be effectively managed.

Choice C reason: Debride

Debridement is the most appropriate intervention for a wound with slough. Debridement involves the removal of necrotic tissue, including slough, to promote a clean wound bed and facilitate the healing process. There are several methods of debridement, including autolytic, enzymatic, mechanical, and surgical, each with its own indications and benefits. Removing the slough allows for better assessment of the wound and promotes the formation of healthy granulation tissue.

Choice D reason: Leave Alone

Leaving a wound with slough alone is not advisable. Slough can harbor bacteria and impede the healing process, leading to chronic wounds and potential infection. Without intervention, the wound is unlikely to progress through the normal stages of healing.