client with a burn wound on the chest has a silver sulfadiazine (Silvadene) cream applied to the wound. Which adverse reaction should the nurse monitor for in this client?

Correct answer: D) A and B.

Rationale: Silver sulfadiazine (Silvadene) is a topical antimicrobial agent used to prevent or treat infection in burn wounds. The nurse should monitor for hypersensitivity or allergic reaction, such as rash, itching, swelling, or difficulty breathing; and leukopenia or decreased white blood cell count, which can increase the risk of infection. The nurse should obtain a baseline complete blood count (CBC) before applying the cream and repeat it every few days during treatment.

Incorrect option:

C) Hyperglycemia or increased blood glucose level. - This is not a common adverse reaction of silver sulfadiazine (Silvadene). However, the client with a burn wound may have hyperglycemia due to stress, inflammation, or infection. The nurse should monitor the blood glucose level regularly and administer insulin as prescribed.

Answer: A.

The presence of necrotic tissue increases the risk of infection by providing a medium for bacterial growth and impairing wound healing. Necrotic tissue should be debrided to promote wound healing.

B. The use of hydrocolloid dressing is not a risk factor for infection. Hydrocolloid dressings are occlusive and adhesive, which create a moist environment that facilitates wound healing and prevents bacterial contamination.

C. The frequency of wound irrigation is not a risk factor for infection. Wound irrigation is done to cleanse the wound and remove debris and exudate. It should be done gently and with sterile solution to avoid trauma and contamination.

D. The application of topical antibiotics is not a risk factor for infection. Topical antibiotics are used to treat or prevent infection in some wounds. They should be used with caution and as prescribed, as overuse may lead to resistance or allergic reactions.