A patient presents with a skin abrasion on the forearm. Which of the following interventions is most important to prevent infection?

A. Leave the wound open for 5 to 10 days and then close with sutures: Delayed primary (tertiary) intention involves initially leaving a contaminated or high-risk wound open to allow drainage and reduce infection risk. After the wound shows no signs of infection, it is then surgically closed, promoting healing while minimizing complications.

B. Immediately close the wound with sutures to prevent infection: Primary closure of a contaminated wound increases the risk of infection because bacteria may be trapped inside. Immediate closure is inappropriate in wounds that are not clean or are at high risk for contamination.

C. Apply a hydrocolloid dressing to maintain a moist environment: Hydrocolloid dressings are suitable for clean or minimally exudative wounds. For contaminated wounds planned for tertiary intention, the priority is drainage and infection control, which may not be achieved with an occlusive dressing.

D. Use mechanical debridement to remove necrotic tissue daily: While debridement is important for necrotic tissue removal, routine daily mechanical debridement may damage healthy tissue. The primary focus in delayed primary closure is infection prevention and monitoring, rather than aggressive debridement.

A. She introduced the concept of patient confidentiality: While patient confidentiality is an important nursing principle, Nightingale is not credited with introducing this concept. It was emphasized in later professional nursing codes.

B. She demonstrated that sanitation and hygiene could drastically reduce mortality rates: During the Crimean War, Nightingale implemented strict sanitation measures, improved ventilation, and emphasized hand hygiene. These interventions significantly reduced infection and death rates among wounded soldiers and established hygiene as a cornerstone of nursing practice.

C. She established the first hospital in England: Nightingale did not found the first hospital; she improved care within existing military hospitals and later influenced hospital design and organization.

D. She developed the first nursing licensure examination: Nightingale contributed to nursing education and training standards but did not create a licensure examination. Formal licensure systems were developed later in various countries.