The nurse observes the skin over a client's greater trochanter, as seen in the picture with pressure sores.
What actions should the nurse implement?
Instruct the unlicensed assistive personnel to frequently offer oral fluids.
Prepare to implement a pressure redistribution mattress.
Explain to the client that the wound needs debridement.
Obtain hemoglobin of the side to check for anemia and sensitivity.
The Correct Answer is B
Pressure redistribution is an important part of preventing and treating pressure sores1.
Choice A is not the answer because offering oral fluids does not directly address the issue of pressure sores.
Choice C is not the answer because debridement is a surgical procedure that removes dead tissue from a wound and may not be necessary in this case.
Choice D is not the answer because checking for anemia and sensitivity does not directly address the issue of pressure
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Pressure redistribution is an important part of preventing and treating pressure sores1.
Choice A is not the answer because offering oral fluids does not directly address the issue of pressure sores.
Choice C is not the answer because debridement is a surgical procedure that removes dead tissue from a wound and may not be necessary in this case.
Choice D is not the answer because checking for anemia and sensitivity does not directly address the issue of pressure
Correct Answer is A
Explanation
Guided imagery involves creating a specific imagined reality for yourself.
These techniques can be self-taught or guided by a professional.
The more you’re able to use your imagination and engage your senses, the greater the benefits 1.
Choice B is not the answer because motivational phrases may not be as effective as positive external places in reducing chronic pain through guided imagery.
Choice C is not the answer because tranquil sounds may not be as effective as positive external places in reducing chronic pain through guided imagery.
Choice D is not the answer because emotional reflection may not be as effective as positive external places in reducing chronic pain through guided imagery.
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