When performing dressing changes in an older client, what should the nurse assess for?

Signs of infection

Skin color changes

Decreased pain levels

Changes in blood pressure

Answer and Explanation

The Correct Answer is A

A.   Signs of infection: Older adults may have compromised immune systems and are more susceptible to infections. During dressing changes, the nurse should assess for signs of infection such as increased redness, swelling, warmth, drainage, or foul odor, which could indicate an infection at the wound site.

B.   Skin color changes: While changes in skin color can be indicative of various skin conditions or circulation problems, assessing for signs of infection is more pertinent during dressing changes to prevent and manage complications.
C.   Decreased pain levels: Older adults may have altered pain perception due to age-related changes or comorbidities. However, assessing for signs of infection takes priority during dressing changes to ensure timely intervention if infection is present.

D. Changes in blood pressure: Changes in blood pressure may be relevant in certain clinical contexts but are not specifically related to performing dressing changes in older clients.

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Correct Answer is C

Explanation

A. Potassium: Potassium levels are not typically used to diagnose infection. Elevated potassium levels may indicate other health conditions such as kidney dysfunction.
B. BUN (Blood Urea Nitrogen): BUN levels assess kidney function and are not directly related to the presence of infection.
C. WBC count (White Blood Cell count): An elevation in the WBC count, specifically the neutrophil count (neutrophilia), is indicative of the body's response to infection or inflammation.
D. RBC count (Red Blood Cell count): RBC count is not typically used to diagnose infection.
Elevated RBC count may indicate conditions such as dehydration or polycythemia.

A. Utilizing a friend's computer keyboard. B. Talking directly to someone coughing. C. Standing next to a person with a varicella (chickenpox) infection. D. Walking past an individual coughing and sneezing.

Correct Answer is A

Explanation

A. Utilizing a friend's computer keyboard: Indirect transmission occurs when pathogens are transmitted via inanimate objects, such as keyboards, doorknobs, or utensils. If the friend's computer keyboard is contaminated with pathogens, the patient could contract an illness by touching it.
B. Talking directly to someone coughing: This is an example of direct transmission, where pathogens are transmitted through close contact with an infected person's respiratory secretions.
C. Standing next to a person with a varicella (chickenpox) infection: This is an example of direct transmission, as varicella is spread through respiratory droplets.
D. Walking past an individual coughing and sneezing: This is also an example of direct transmission, as respiratory droplets containing pathogens can land on the nurse and lead to infection if inhaled or touched.

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When performing dressing changes in an older client, what should the nurse assess for?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Correct Answer is A

Explanation

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