The nurse is teaching a client with debilitating rheumatoid arthritis about home safety. Which statement should the nurse include?

Choice A reason: Primary intention is the correct answer, because it is the type of wound healing that occurs when the wound edges are approximated and closed with sutures, staples, or glue. Primary intention is the fastest and most effective way of wound healing, as it minimizes tissue loss, infection, and scarring.

Choice B reason: Secondary intention is not the correct answer, because it is the type of wound healing that occurs when the wound edges are not approximated and left open to heal by granulation, contraction, and epithelialization. Secondary intention is the slowest and least effective way of wound healing, as it results in more tissue loss, infection, and scarring.

Choice C reason: Tertiary intention is not the correct answer, because it is the type of wound healing that occurs when the wound edges are initially left open and then closed with sutures, staples, or glue after a period of time. Tertiary intention is a delayed form of primary intention, and it is used when the wound is contaminated, infected, or requires drainage.

Choice D reason: Binary intention is not the correct answer, because it is not a real term for wound healing. Binary intention is a madeup term that does not describe any specific process or outcome of wound healing.

Choice A reason: This is the highest risk client because surgery can cause trauma, blood loss, and infection, which can weaken the immune system and increase the susceptibility to complications. The immune system is the body's defense mechanism that protects against foreign invaders, such as bacteria, viruses, or fungi. Surgery can damage the skin and tissues, which are the first line of defense, and cause inflammation, which can impair the function of the white blood cells, which are the second line of defense. The nurse should monitor the client's vital signs, wound healing, and signs of infection and administer antibiotics, fluids, and pain medication as ordered.

Choice B reason: This is not the highest risk client, but it is a moderate risk client because extreme anxiety can cause stress, which can affect the immune system and increase the vulnerability to illness. Stress is the body's response to a perceived threat or challenge, which can activate the sympathetic nervous system and the hypothalamicpituitaryadrenal (HPA) axis. Stress can cause the release of hormones, such as cortisol and adrenaline, which can suppress the immune system and reduce the production and activity of the white blood cells. The nurse should assess the client's anxiety level and provide coping strategies, such as relaxation, breathing, or counseling.

Choice C reason: This is not the highest risk client, but it is a low risk client because awaiting surgery can cause anxiety, which can affect the immune system and increase the vulnerability to illness. However, the client's anxiety level may not be as high as the client with extreme anxiety, and the client's immune system may not be as compromised as the client who has just had surgery. The nurse should assess the client's anxiety level and provide education, reassurance, and support.

Choice D reason: This is not the highest risk client, but it is a low risk client because delivering a baby can cause blood loss, hormonal changes, and fatigue, which can affect the immune system and increase the risk of infection. However, the client's immune system may not be as compromised as the client who has just had surgery, and the client may have some protection from the antibodies that are passed from the mother to the baby through the placenta and breast milk. The nurse should monitor the client's vital signs, lochia, and signs of infection and provide hygiene, nutrition, and rest.