NUR 336 FINAL EXAM QUESTIONS AND
ANSWERS; 100% PASS GUARANTEED;
GRADED A+
13). Preventing pressure ulcers requires an aggressive program
of monitoring and
intervention. Use a risk assessment tool to determine a
patient's likelihood of developing
pressure ulcers.
14). Once a patient is identified as being at risk for developing
pressure ulcer, steps should
be taken to minimize their development.
15). Wound dressings are chosen to match the type of wound
tissue in the base of the
wound. For heavily draining wounds, calcium alginate is a good
choice.
16). Pack the wound with alginate dressing using either a cotton
tip applicator or a gloved
finger. Do not let the alginate extend over the border of the
wound.
After removing the initial surgical dressing as ordered, perform a
direct assessment. - correct answer- a. First, inspect the
,dressing, noting whether it's dry and clean or shows signs of
bleeding or profuse drainage.
b. If a suture line exists, inspect it next. Normally, it may have:
1. Clean, well-approximated edges, possibly with crusts from
wound drainage
2. Inflamed, swollen outer edges for the first 2 to 3 days only
3. And bruised-looking skin around the suture line
c. Now assess for any odor and describe the wound color, which
represents the
balance between necrotic tissue and new scar tissue.
1. Black wounds represent full-thickness tissue destruction as in
necrotic or desiccated tissue.
2. Yellow wounds represent the death of subcutaneous fat
tissue and muscle degeneration as in necrotic slough and
purulent drainage.
3. Red wounds represent increased red or pink granulation
tissue.
d. Then palpate the wound edges. Note areas of localized
tenderness or drainage.
If you detect any drainage, note its:
, 1. Color
2. Consistency
3. And amount, which can be expressed as the percentage of
the dressing saturated or the quantity of drainage (such as scant,
moderate, or copious)
e. If indicated, collect a specimen of the drainage
f. Also measure the length and width of the patient's wound
using a disposable measuring tape.
g. Then determine its diameter based on the length and width
measurements.
h. If the wound is oddly shaped, make a drawing or take a
photograph of it.
i. Rotate a swab along the wound's edges to determine if there
are tunnels or deeper areas in the wound.
j. Then, if appropriate, measure the wound's depth with a
sterile applicator swab, and convert that depth to centimeters.
ANSWERS; 100% PASS GUARANTEED;
GRADED A+
13). Preventing pressure ulcers requires an aggressive program
of monitoring and
intervention. Use a risk assessment tool to determine a
patient's likelihood of developing
pressure ulcers.
14). Once a patient is identified as being at risk for developing
pressure ulcer, steps should
be taken to minimize their development.
15). Wound dressings are chosen to match the type of wound
tissue in the base of the
wound. For heavily draining wounds, calcium alginate is a good
choice.
16). Pack the wound with alginate dressing using either a cotton
tip applicator or a gloved
finger. Do not let the alginate extend over the border of the
wound.
After removing the initial surgical dressing as ordered, perform a
direct assessment. - correct answer- a. First, inspect the
,dressing, noting whether it's dry and clean or shows signs of
bleeding or profuse drainage.
b. If a suture line exists, inspect it next. Normally, it may have:
1. Clean, well-approximated edges, possibly with crusts from
wound drainage
2. Inflamed, swollen outer edges for the first 2 to 3 days only
3. And bruised-looking skin around the suture line
c. Now assess for any odor and describe the wound color, which
represents the
balance between necrotic tissue and new scar tissue.
1. Black wounds represent full-thickness tissue destruction as in
necrotic or desiccated tissue.
2. Yellow wounds represent the death of subcutaneous fat
tissue and muscle degeneration as in necrotic slough and
purulent drainage.
3. Red wounds represent increased red or pink granulation
tissue.
d. Then palpate the wound edges. Note areas of localized
tenderness or drainage.
If you detect any drainage, note its:
, 1. Color
2. Consistency
3. And amount, which can be expressed as the percentage of
the dressing saturated or the quantity of drainage (such as scant,
moderate, or copious)
e. If indicated, collect a specimen of the drainage
f. Also measure the length and width of the patient's wound
using a disposable measuring tape.
g. Then determine its diameter based on the length and width
measurements.
h. If the wound is oddly shaped, make a drawing or take a
photograph of it.
i. Rotate a swab along the wound's edges to determine if there
are tunnels or deeper areas in the wound.
j. Then, if appropriate, measure the wound's depth with a
sterile applicator swab, and convert that depth to centimeters.
