A nurse is reviewing documentation on a group of clients as part of a quality improvement initiative. Which of the following actions should the nurse document as decreasing the risk for skin breakdown?

A. Changing the dressing is an action that comes after assessing and selecting the appropriate dressing. Before changing the dressing, the nurse needs to gather information and make decisions about the most suitable type of dressing based on the characteristics of the wound.

B. Selecting the appropriate dressing is an essential step, but before doing so, the nurse should review available dressing types to make an informed decision about which dressing will best meet the needs of the wound. This involves considering factors such as the wound's characteristics, exudate level, and the overall condition of the client.

C. Reviewing available dressing types is the first step because it allows the nurse to assess the wound, gather information about the client's condition, and make an informed decision about the most appropriate dressing. This step ensures that the chosen dressing aligns with the wound's characteristics and promotes optimal healing.

D. Documenting the dressing change is an important step in the process, but it typically occurs after the dressing change has been completed. Documentation is crucial for tracking the client's progress, ensuring continuity of care, and providing a record for other healthcare team members.

"I might have trouble staying on a low-fat diet after my surgery." This statement, while relevant to postoperative care, is not a reason to delay obtaining the signature or notify the provider. The client's ability to adhere to a low-fat diet is a matter for preoperative education and counseling.

"I can resume my normal activities in 1 to 2 weeks." This statement, while reflecting the client's expectations for recovery, is not a reason to delay obtaining the signature or notify the provider. It indicates the client's understanding of the anticipated postoperative timeline.

"I will plan to be in the hospital for 24 hours following my surgery." This statement is incorrect as it relates to the type of surgery being performed (laparoscopic total cholecystectomy). Hospital stays for this procedure are typically shorter, often involving an overnight stay or even less. This discrepancy should be clarified with the provider before obtaining the signature.

"I hope that removing my appendix will make me feel better." This statement is incorrect and indicates a misunderstanding of the procedure. A laparoscopic total cholecystectomy involves the removal of the gallbladder, not the appendix. The nurse should delay obtaining the signature and notify the provider to ensure the client understands the correct procedure and its implications.