A nurse is caring for 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.

Mini Nutritional Assessment screening tool score

History of hyperlipidemia

History of malnutrition

History of diabetes mellitus

Cholesterol level

Prealbumin level

Answer and Explanation

Correct Answer : C,D,F

A.   Mini Nutritional Assessment screening tool score: While it indicates the risk of malnutrition, it's not directly linked to delayed wound healing.
B.   History of hyperlipidemia: Hyperlipidemia itself doesn't directly affect wound healing.
C.   History of malnutrition: Malnutrition significantly hampers the body's ability to heal wounds effectively.
D.   History of diabetes mellitus: Diabetes can impair wound healing due to poor blood sugar control affecting the immune system and circulation.
E.   Cholesterol level: Elevated cholesterol, while relevant to overall health, is not directly linked to delayed wound healing.
F.   Prealbumin level: Prealbumin is a marker for nutritional status; lower levels indicate inadequate protein intake and can contribute to delayed wound healing.

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Correct Answer is A

Explanation

A. Metabolic syndrome is a cluster of conditions that include high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels, all of which increase the risk of cardiovascular disease.
B. Participation in competitive sports might enhance cardiovascular fitness and decrease the risk of cardiovascular diseases.
C. While alcohol use disorder can have health implications, it's not a direct risk factor for cardiovascular disease.
D. Hypotension (low blood pressure) is generally not considered a significant risk factor for cardiovascular disease, unlike hypertension (high blood pressure).

A. Assess skin temperature and color before applying the restraints. B. Attach the client's restraints to the bed rail. C. Ensure that the client's bed is in the lowest position. D. Pad bony prominences before applying the restraints. E. Secure restraints to allow three fingers to slide under the restraints.

Correct Answer is ["A","C","D"]

Explanation

A. Assessing skin temperature and color is crucial to ensure circulation and skin integrity before applying restraints.
B. Attaching restraints to the bed rail isn't considered best practice, as it can lead to entrapment and injury.
C. Ensuring the client's bed is in the lowest position is essential to prevent falls and reduce the risk of injury if the client attempts to leave the bed.
D. Padding bony prominences helps prevent skin breakdown and discomfort.
E. Securing restraints to allow two fingers and not three,to slide under them ensures proper fit and prevents excessive tightness that could impair circulation.

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A nurse is caring for 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.

Nursing Test Bank

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A nurse is caring for 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.