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While changing the dressing of a client who is immobile, the practical nurse (PN) observes a red and swollen wound with a moderate amount of yellow and green drainage and a foul odor.

Before reporting this finding to the healthcare provider, the PN should evaluate which of the client's laboratory values?

A.

C-reactive protein level

B.

Culture for sensitive organisms.

C.

Serum albumin.

D.

Serum blood glucose (BG) level.

Answer and Explanation

The Correct Answer is B

 

The correct answer is choice B: Culture for sensitive organisms.

  • Choice A rationale:
  •  C-reactive protein level - C-reactive protein (CRP) is a blood test marker for inflammation in the body. While it could indicate an infection, it is not specific enough to identify the type of infection or the causative organism.
  •  
  • Choice B rationale:
  •  Culture for sensitive organisms - When a wound has a moderate amount of yellow and green drainage and a foul odor, it is often a sign of a bacterial infection. A culture for sensitive organisms can help identify the specific bacteria causing the infection, which is crucial for determining the most effective treatment.
  •  
  • Choice C rationale:
  •  Serum albumin - Serum albumin levels can indicate a person’s nutritional status. Low levels can slow wound healing, but they do not directly indicate the presence of an infection.
  •  
  • Choice D rationale:
  •  Serum blood glucose (BG) level - High blood glucose levels can impair the immune response and slow wound healing, making a person more susceptible to infections. However, like CRP, it does not provide information about the specific organism causing the infection.


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Related Questions

Correct Answer is B

Explanation

Digoxin is a medication used to treat various heart conditions, such as abnormal heart rhythms and heart failure.It works by improving the strength and efficiency of the heart, or by controlling the rate and rhythm of the heartbeat.

One of the important things to monitor when giving digoxin to an infant is the pulse rate. Digoxin can lower the heart rate, which can be dangerous if it becomes too slow.Therefore, the pulse rate should be checked for one full minute before administering digoxin, and the medication should be held if the pulse rate is below 90 beats per minute (bpm) for an infant.

In this case, the infant’s heart rate is 120 bpm, which is within the normal range for a 2-month-old. Therefore, the correct action for the PN to take is to administer the medication and document the heart rate. This is optionbin the list of choices. Optionais incorrect because there is no need to hold the medication or recheck the heart rate in one hour. Optioncis incorrect because there is no need to alert the charge nurse unless there is a problem with the infant’s condition or the medication. Optiondis incorrect because holding the medication and documenting cardiac assessment is not appropriate for a normal heart rate.

Correct Answer is B

Explanation

Ask the client to describe what happened.

Calling the agency-based client advocate (Choice A) should not be the first action taken in this situation. While involving an advocate might be necessary at some point, it is more appropriate to address the client's concerns and gather information about the incident first.

Completing a client adverse incident report (Choice C) is an important step to document theevent and any potential issues, but it should not be the first action taken. Before completing the report, the nurse needs to understand the situation from the client's perspective.

Informing the charge nurse of the situation (Choice D) is a reasonable step, but it should not be the first action. It may be necessary to escalate the issue, but understanding the situation from the client's viewpoint should be prioritized.

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