A nurse is caring for a client who has a non-healing pressure injury on the right ankle.
Which action would the nurse take first?

Choice A rationale

This statement describes secondary hypertension, where an underlying medical condition, such as kidney disease or an endocrine disorder, is the identifiable cause. Secondary hypertension accounts for a minority of cases, and treating the underlying disease is the primary focus.

Choice B rationale

This response uses a colloquial interpretation of the word "essential" rather than the medical definition. While treatment is indeed essential for all hypertension, this explanation does not accurately describe the etiology or classification of the condition from a scientific perspective.

Choice C rationale

Essential hypertension, also known as primary hypertension, is the medical term for high blood pressure that has no identifiable, specific cause. It accounts for the vast majority of hypertension cases and is believed to result from a combination of genetic and environmental factors.

Choice D rationale

This statement is incorrect. While some cases of essential hypertension can be severe, the term "essential" refers to the absence of a known cause, not the severity of the condition. Hypertension severity is categorized separately, regardless of its underlying etiology.

Choice A rationale

Healing by primary intention, also known as primary union, occurs when a wound has clean edges that are approximated and sutured, stapled, or glued together. This process minimizes tissue loss and results in a fine scar. The wound's integrity is re-established with minimal granulation tissue formation.

Choice B rationale

This describes a form of delayed primary closure or tertiary intention healing. The wound is initially left open to allow for drainage and to clear infection. Once the wound is considered clean and free of infection, the edges are then approximated and closed, often with staples, to promote healing.

Choice C rationale

Healing by secondary intention, or secondary union, occurs in large, open wounds with significant tissue loss and non-approximated edges. The wound heals from the base up. This process involves the formation of new connective tissue and capillaries, called granulation tissue, to fill the defect before epithelialization can occur.

Choice D rationale

While contaminated wounds can heal by secondary intention, this description is not a complete definition. Secondary intention healing is a specific biological process involving granulation tissue, not just a description of a wound that is open due to contamination or debris. The defining characteristic is the formation of granulation tissue.