A nurse is caring for a client who has a stage 4 sacral pressure injury for which the provider has prescribed mechanical debridement.
Which of the following is a form of mechanical debridement that the nurse should expect the client to receive?

applying hydrocolloids to the wound bed.

placing a transparent dressing over the pressure injury.

pulsating lavage.

using a topical enzyme solution in the wound bed.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Hydrocolloids are not a form of mechanical debridement. They are dressings that promote autolytic debridement by maintaining a moist wound environment.

Choice B rationale:

Transparent dressings are not a form of mechanical debridement. They are used to protect the wound and allow for visual inspection.

Choice C rationale:

Pulsating lavage is a form of mechanical debridement. It involves using a pressurized, pulsed solution to remove necrotic tissue from the wound bed.

Choice D rationale:

Topical enzyme solutions are not a form of mechanical debridement. They are a form of chemical debridement that breaks down necrotic tissue.

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Correct Answer is C

Explanation

Choice A rationale:

A pressure injury is a general term for localized damage to the skin and underlying soft tissue, but it doesn’t specify the stage.

Choice B rationale:

Stage 2 pressure injuries involve partial-thickness loss of skin with exposed dermis.

Choice C rationale:

Stage 1 pressure injuries are characterized by a reddened area on the skin that does not blanch with pressure.

Choice D rationale:

Stage 3 pressure injuries involve full-thickness skin loss.

Choice E rationale:

Stage 4 pressure injuries involve full-thickness skin and tissue loss with exposed or directly palpable fascia.

A. Abdominal pads. B. Hydrogel. C. Wet-to-dry. D. Dry gauze.

Correct Answer is B

Explanation

Choice A rationale:

Abdominal pads are not designed to minimize pain during dressing changes.

Choice B rationale:

Hydrogel dressings are known to minimize pain during dressing changes.

Choice C rationale:

Wet-to-dry dressings can cause discomfort during dressing changes.

Choice D rationale:

Dry gauze can stick to the wound bed and cause pain during dressing changes.

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A nurse is caring for a client who has a stage 4 sacral pressure injury for which the provider has prescribed mechanical debridement.Which of the following is a form of mechanical debridement that the nurse should expect the client to receive?

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Naxlex Comprehensive Predictor Exams

The patient entered the hospital with a reddened area that does not blanch with pressure over the left hip.He states that it is painful.This is a:

Correct Answer is C

Explanation

Correct Answer is B

Explanation

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A nurse is caring for a client who has a stage 4 sacral pressure injury for which the provider has prescribed mechanical debridement.
Which of the following is a form of mechanical debridement that the nurse should expect the client to receive?