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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Macule: A macule is a flat, discolored area of skin that is smaller than 1 centimeter in diameter and does not contain fluid.
B. Vesicle: A vesicle is a raised, fluid-filled lesion smaller than 1 centimeter in diameter.
Examples include blisters caused by conditions such as herpes simplex virus or contact dermatitis.
C. Papule: A papule is a raised, solid lesion smaller than 1 centimeter in diameter that does not contain fluid. Examples include pimples or insect bites.
D. Wheal: A wheal is a raised, red area of skin that is often accompanied by itching. It is typically caused by an allergic reaction and may have irregular borders.
Correct Answer is D
Explanation
A. Antibiotic dosages below the minimum concentration are prescribed: This statement is inaccurate. MRSA infections typically require higher than normal doses of antibiotics due to their resistance. Prescribing below the minimum concentration would likely be ineffective.
B. Broad-spectrum antibiotics are used whenever possible: While broad-spectrum antibiotics may cover a wide range of bacteria, they are not always the best choice for treating MRSA.
Targeted antibiotics effective against MRSA are preferred to minimize the risk of further antibiotic resistance.
C. Antibiotics are prescribed only when a viral infection is present: MRSA is a bacterial infection, not viral. Antibiotics are indicated for bacterial infections like MRSA but not for viral infections.
D. Infections become resistant to high doses of antibiotics: This statement is accurate. MRSA is resistant to many common antibiotics, and overuse or inappropriate use of antibiotics can contribute to the development of antibiotic-resistant strains. High doses of antibiotics may not be effective against MRSA, as the bacteria have developed mechanisms to resist their action.
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