A WOCN is reviewing the wound healing process with a group of nurses on a unit. The WOCN should include in the information which of the following alterations for wound healing by secondary intention? (Select all that apply)
Laceration sealed with adhesive
Skin tear on the forearm
Stapled hip incision
Stage 4 pressure injury
Infected re-opened abdominal incision
Correct Answer : B,D,E
A. Laceration sealed with adhesive: This wound is healing by primary intention, where the wound edges are approximated and closed using sutures, staples, or adhesive. Healing is typically faster with minimal scarring and reduced risk of infection.
B. Skin tear on the forearm: A skin tear often involves partial loss of skin integrity and may not have edges that can be approximated. When left open to heal naturally, it undergoes secondary intention, which involves granulation tissue formation, contraction, and epithelialization.
C. Stapled hip incision: This wound is healing by primary intention because the edges have been brought together and secured using staples. There is minimal tissue loss and faster healing with less scarring compared to secondary intention.
D. Stage 4 pressure injury: A stage 4 pressure injury involves full-thickness tissue loss that often exposes muscle, tendon, or bone. Due to extensive tissue damage and inability to approximate wound edges, it heals by secondary intention through granulation and scar tissue formation.
E. Infected re-opened abdominal incision: If a surgical incision becomes infected and dehisces, it can no longer heal by primary intention. It must be managed as an open wound, healing by secondary intention, involving a longer healing process and greater risk of scarring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Pour out the top 10 mL of liquid and continue to utilize the bottle: Discarding a small portion of the solution does not ensure sterility after the bottle has been open for more than 24 hours. Continued use beyond the recommended time can increase the risk of contamination and infection.
B. Obtain a new bottle of sterile saline: Once a sterile saline bottle is opened, it is typically considered safe for use only within 24 hours. To maintain sterility and prevent infection, a new bottle should be used for the dressing change.
C. Shake the bottle to ensure contents are mixed: Shaking the bottle does not address sterility or contamination concerns. Sterile saline does not require mixing, and shaking it does not make it safe to use after the expiration of the safe usage window.
D. Switch to a bottle of sterile water: Sterile water is not an appropriate substitute for sterile saline in all clinical situations. The choice of solution should be based on wound care protocols, and switching without clinical justification is not appropriate.
Correct Answer is ["0.57"]
Explanation
Identify the desired dose: 200 mg
Identify the available concentration for IM administration: The package insert information states that "Each 1 mL of solution contains approximately 350 mg equivalent of ceftriaxone." So, the available concentration is 350 mg/mL.
Calculate the volume to administer (mL):
Volume (mL) = Desired dose (mg) / Available concentration (mg/mL)
= 200 mg / 350 mg/mL
= 0.5714... mL
Round the answer to the nearest hundredth:
= 0.57 mL
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