A nurse is performing a dressing change for a child and notices that the gauze dressing is adhering to the wound bed. Which of the following actions should the nurse take?

Apply firm pressure to the wound base while removing the gauze dressing.

Irrigate the wound with half-strength hydrogen peroxide while removing the gauze dressing.

Continue to remove the gauze dressing by pulling it parallel to the skin.

Saturate the gauze dressing with sterile saline solution prior to removing it.

Answer and Explanation

The Correct Answer is D

A. "Apply firm pressure to the wound base while removing the gauze dressing." Applying firm pressure can cause pain and damage the wound bed, delaying healing and increasing the risk of bleeding.

B. "Irrigate the wound with half-strength hydrogen peroxide while removing the gauze dressing." Hydrogen peroxide can damage healthy tissue and delay wound healing. It is not recommended for routine wound care.

C. "Continue to remove the gauze dressing by pulling it parallel to the skin." Removing a dry gauze dressing without moistening it can cause trauma to the wound bed, increasing pain and impeding healing.

D. "Saturate the gauze dressing with sterile saline solution prior to removing it." Moistening the dressing with sterile saline reduces trauma to the wound, prevents tissue damage, and minimizes pain. This method is preferred for atraumatic dressing removal.

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Correct Answer is A

Explanation

A. "Keep the car seat in a rear-facing position until your infant is 2 years old." The American Academy of Pediatrics (AAP) recommends keeping infants in a rear-facing car seat until at least 2 years of age or until they reach the height and weight limits specified by the car seat manufacturer for optimal safety.

B. "Fasten the harness over your infant's winter coat." Bulky clothing (such as winter coats) should not be worn under the harness because it can create excess space, reducing the effectiveness of the restraint and increasing injury risk. Instead, the infant should be dressed in thin layers, and a blanket can be placed over the secured harness if warmth is needed.

C. "Ensure the airbag is activated if the car seat is in the front passenger seat." Infants should never be placed in the front passenger seat if the car has an active airbag. Airbags can cause severe injury or death if deployed while a rear-facing car seat is in place. The safest position is always in the back seat.

D. "Pad the backrest of the car seat with a thick blanket before securing your infant." Additional padding should not be used, as it can interfere with the proper fit of the harness and compromise safety. Car seats are designed to provide adequate support and protection without extra cushioning.

A. Pinpoint pupils B. Sunken anterior fontanel C. Hypertonia D. Vomiting

Correct Answer is D

Explanation

A. "Pinpoint pupils." A subdural hematoma typically causes unequal or dilated pupils due to increased intracranial pressure (ICP), rather than pinpoint pupils, which are more commonly associated with opioid toxicity or pontine damage.

B. "Sunken anterior fontanel." A sunken fontanel is a sign of dehydration. In cases of increased ICP, as seen with a subdural hematoma, the anterior fontanel is more likely to be bulging.

C. "Hypertonia." Neurological changes can occur, but hypotonia (decreased muscle tone) is more common in infants with increased ICP rather than hypertonia (increased muscle tone).

D. "Vomiting." Vomiting is a classic sign of increased ICP in infants, which occurs due to the pressure on the brainstem. Other symptoms may include irritability, a bulging fontanel, seizures, and lethargy.

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A nurse is performing a dressing change for a child and notices that the gauze dressing is adhering to the wound bed. Which of the following actions should the nurse take?

Nursing Test Bank

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