A nurse is assisting in the care of a client who is scheduled for surgery.

Exhibits
The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for delayed wound healing. Select all that apply.

History of diabetes mellitus

Prealbumin level

Cholesterol level

Mini Nutritional Assessment screening tool score

History of malnutrition

History of hyperlipidemia

Answer and Explanation

Correct Answer : A,B,D,E

A. History of diabetes mellitus: Diabetes causes impaired blood flow and neuropathy, which delay wound healing by reducing oxygen and nutrient delivery to tissues and increasing infection risk.

B. Prealbumin level: A low prealbumin level reflects inadequate protein stores, which are critical for cellular repair, immune function, and the synthesis of collagen during wound healing.

C. Cholesterol level: While elevated cholesterol increases cardiovascular risk, it does not directly affect the biochemical processes involved in wound healing or tissue repair.

D. Mini Nutritional Assessment screening tool score: A low score indicates poor nutritional status, often linked with deficiencies in vitamins, minerals, and protein that are necessary for effective tissue repair and immune response.

E. History of malnutrition: Malnutrition results in diminished energy reserves and nutrient deficiencies, both of which weaken the body's capacity to regenerate tissue and fight infections, prolonging wound healing time.

F. History of hyperlipidemia: Hyperlipidemia contributes to atherosclerosis but is not directly associated with impaired wound healing or immune function necessary for tissue recovery.

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Correct Answer is C

Explanation

A. "Don't worry. Everything will work out for you.": This response minimizes the client’s feelings and concerns, potentially invalidating their decision. It also avoids addressing the seriousness of the situation and does not encourage open communication or support.

B. "We should talk about your decision later.": Deferring the conversation may make the client feel ignored or unsupported. It is important to acknowledge and explore the client’s feelings and reasoning about discontinuing treatment promptly to provide appropriate care.

C. "How will you discuss this decision with your loved ones?": This response respects the client’s autonomy and opens a supportive dialogue. It encourages the client to consider communication with their support system and reflects a willingness to assist in the emotional and practical aspects of their decision.

D. "Your quality of life will be compromised if you make this decision.": This statement is judgmental and may induce guilt or fear. It does not respect the client’s right to make informed decisions about their own care and can hinder therapeutic communication.

A. A B. B C. B

Correct Answer is C

Explanation

A. Wheelchair is on the left side, which is the postoperative knee, risking strain or injury to the healing limb during transfer. Not ideal for maximizing client safety and independence in mobility.

B: Wheelchair is placed at the head of the bed, making it impractical and unsafe for transfer. No clear pivot point, and body mechanics would be compromised for both the nurse and the client.

C. The wheelchair is positioned on the client's right side, which is the unaffected leg, allowing the client to pivot and transfer using their stronger limb. This placement minimizes strain on the left surgical knee, which reduces pain and risk of injury.

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A nurse is assisting in the care of a client who is scheduled for surgery. Exhibits The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for delayed wound healing. Select all that apply.

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A nurse is assisting in the care of a client who is scheduled for surgery.

Exhibits
The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for delayed wound healing. Select all that apply.