A nurse is caring for a client with a nonhealing arterial lower leg ulcer.
What action by the nurse is best?

Choice A rationale

There is no conclusive scientific evidence to support the claim that specific foods like chocolate, peanuts, and cola directly cause or worsen acne. Acne is a multifactorial condition primarily driven by hormonal changes, sebum production, follicular hyperkeratinization, and the bacteria Propionibacterium acnes. While a high glycemic diet may be linked to acne, there is no direct causal link with these specific foods.

Choice B rationale

Over-washing the face with harsh cleansing products can strip the skin of its natural oils (sebum), leading to a rebound effect where the sebaceous glands produce even more oil. This can exacerbate acne by creating a more favorable environment for bacterial proliferation and follicular clogging. Gentle cleansing twice a day is recommended, not frequent washing, to maintain skin barrier integrity.

Choice C rationale

Moderate sun exposure can be beneficial for some individuals with acne. Ultraviolet (UV) light has anti-inflammatory and antibacterial properties that can reduce the population of Propionibacterium acnes. Avoiding sun exposure completely is not a standard recommendation for acne prevention, although excessive sun exposure can lead to other skin problems and should be avoided.

Choice D rationale

Stress and lack of rest can increase cortisol levels, which can stimulate sebum production and inflammation, contributing to acne formation. A balanced diet provides essential vitamins and minerals for skin health, and sufficient rest helps regulate hormonal balance. Promoting overall well-being through diet and rest indirectly supports skin health and can help in the prevention of acne.

Choice A rationale

An arterial ulcer is a complex wound resulting from chronic tissue ischemia. A wound care nurse possesses specialized knowledge in advanced wound management techniques, including debridement, moisture balance, and identifying appropriate dressings, which are crucial for promoting healing in these challenging, poorly perfused wounds.

Choice B rationale

While pain management is important for client comfort, it is not the most critical action. The best action is to address the underlying cause of the non-healing wound and implement specialized care that targets the specific challenges of arterial ulcers, such as poor perfusion and a high risk of infection.

Choice C rationale

Maintaining sterile technique is a standard of care to prevent infection, but it is insufficient on its own to heal an arterial ulcer. These wounds require a comprehensive approach that includes improving blood flow, debridement of non-viable tissue, and specialized dressings, which a wound care nurse can best guide.

Choice D rationale

Preparing the client for amputation is a premature and often psychologically damaging action. Amputation is a last resort after all conservative and revascularization options have been exhausted. The primary goal is to heal the ulcer through a concerted effort of specialized wound care and addressing the vascular insufficiency.