A nurse is admitting a client who sustained severe burn injuries. The nurse refers to the rule of nines to determine the total body surface area of Your injury What percentage of body surface area should the nurse estimate the client has burned?

- A: Swabbing the wound bed is an essential step in obtaining a wound culture, but it is not the first action that should be taken. This step is performed after the wound has been cleansed to ensure that the sample is not contaminated with debris or bacteria from the surrounding skin.
- B: Cleansing the area around the wound with sterile saline is the correct first step. This action helps to remove any contaminants or debris from the wound surface, ensuring that the culture obtained is from the wound itself and not from the surrounding skin, which could lead to inaccurate results.
- C: Donning sterile gloves is a crucial step to maintain sterility during the procedure. However, it is not the first action because the nurse must first cleanse the wound area to prevent contamination of the culture specimen.
- D: Placing the collection tube in a specimen bag is done after obtaining the wound culture to transport the specimen to the laboratory. This is one of the final steps in the process, not the first.

Choice A rationale: Hyperlipidemia, particularly elevated cholesterol levels, can be associated with impaired wound healing. High cholesterol levels can contribute to atherosclerosis, leading to reduced blood flow to the wound site. Adequate blood supply is crucial for delivering oxygen and nutrients essential for the healing process.
Choice B rationale: Diabetes mellitus is a well-known risk factor for delayed wound healing. High blood sugar levels can impair the function of white blood cells, reduce collagen formation, and impair the overall healing process. Furthermore, individuals with diabetes are more prone to infections and may experience slower wound closure.
Choice C rationale: Medication history alone does not provide specific information about factors that directly affect wound healing. However, certain medications, such as corticosteroids or immunosuppressive drugs, may impact the healing process.
Choice D rationale: High cholesterol levels can contribute to atherosclerosis, leading to reduced blood flow to the wound site. Adequate blood supply is crucial for delivering oxygen and nutrients essential for the healing process.
Choice E rationale: Prealbumin is a marker of protein status and nutritional adequacy. Low prealbumin levels can indicate malnutrition, which is a risk factor for delayed wound healing. Adequate protein intake is crucial for collagen synthesis and overall tissue repair.