How should a nurse obtain a culture of a patient’s wound?
Gently swab the center of the wound after irrigating with sterile saline.
Obtain a sample of the drainage from the dressing on the wound.
Use a sterile swab to collect a sample from the wound.
Collect a tissue sample from the wound during a surgical procedure.
The Correct Answer is C
Choice A rationale:
Irrigating with sterile saline before swabbing can dilute the wound specimen and reduce the accuracy of the culture results. This is because the saline can wash away some of the bacteria that are present in the wound, making it more difficult to identify the specific bacteria that are causing the infection.
Additionally, swabbing the center of the wound may not collect a representative sample of the bacteria present, as bacteria can often be found in higher concentrations at the edges of the wound. This is because the edges of the wound are often where the tissue is most damaged and where the bacteria are able to enter the body more easily.
Choice B rationale:
Obtaining a sample of the drainage from the dressing on the wound may not be as accurate as collecting a sample directly from the wound. This is because the drainage may contain bacteria from the surrounding skin or environment, which could contaminate the culture results.
Additionally, the drainage may not contain a representative sample of the bacteria present in the wound, as some bacteria may not be able to drain out of the wound.
Choice D rationale:
Collecting a tissue sample from the wound during a surgical procedure is the most accurate way to obtain a culture. However, this is not always feasible or necessary.
It is often possible to obtain an accurate culture by collecting a sample from the wound using a sterile swab. This is a less invasive procedure and can be done at the bedside.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
A superficial abrasion heals by secondary intention, not primary intention.
In secondary intention healing, the wound is left open to heal from the inside out. This type of healing is typically slower and results in more scar tissue formation.
The absence of active bleeding, drainage, or debris is a positive sign, but it does not guarantee that the wound is healing by primary intention.
Choice C rationale:
The presence of thick yellow slough indicates that the wound is infected and not healing properly. This is a sign of delayed healing, not primary intention healing.
Choice D rationale:
The presence of granulation tissue is a sign of healing, but it does not indicate whether the wound is healing by primary or secondary intention.
Granulation tissue is a type of new tissue that forms during the healing process. It is composed of blood vessels, collagen, and fibroblasts.
Correct Answer is C
Explanation
Choice A rationale:
Debridement refers to the removal of dead, damaged, or infected tissue to promote healing. It is not a term used to describe skin breakdown caused by moisture.
Choice B rationale:
Evisceration is the protrusion of internal organs through a wound or surgical incision. It is not relevant to the condition of perineal skin breakdown due to wetness.
Choice D rationale:
Dehiscence is the separation of a surgical wound. It is not applicable in this case, as there is no mention of a surgical wound.
Choice C rationale:
Maceration is a term used to describe skin that has become softened and broken down due to prolonged exposure to moisture. This is the most accurate term to describe the condition of perineal skin breakdown after sitting in wet underclothes for many hours.
Key features of maceration:
Skin softening: The skin becomes white and wrinkled, resembling a prune.
Epidermal loss: The outer layer of skin (epidermis) may slough off, leaving the underlying tissue exposed. Redness: The affected area may become red and inflamed.
Pain or tenderness: The area may be painful or tender to the touch.
Increased risk of infection: Macerated skin is more susceptible to infection due to the breakdown of the skin barrier. Causes of maceration:
Prolonged exposure to moisture: This can include sweat, urine, feces, wound drainage, or excessive bathing. Friction: Rubbing or chafing of the skin can also contribute to maceration.
Impaired circulation: Poor blood flow to the area can make it more vulnerable to maceration. Prevention of maceration:
Keep skin clean and dry: This is the most important step in preventing maceration. Change wet or soiled clothing or dressings promptly.
Apply barrier creams or ointments: These can help to protect the skin from moisture.
Use incontinence products: These can help to keep the skin dry if the patient is incontinent. Reposition the patient frequently: This helps to reduce pressure and friction on the skin.
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