The client with rheumatoid arthritis is having her rheumatoid factor (RF) drawn while she is having a flareup of the disease. Which result is seen in clients with rheumatoid arthritis?

Choice A reason: Blanching is not the term for black and necrotic tissue. Blanching is the temporary whitening of the skin when pressure is applied. It indicates that the blood flow is intact and the tissue is healthy.

Choice B reason: Cellulitis is not the term for black and necrotic tissue. Cellulitis is a bacterial infection of the skin and subcutaneous tissue. It causes redness, swelling, warmth, and pain in the affected area.

Choice C reason: Tunneling is not the term for black and necrotic tissue. Tunneling is a narrow channel or pathway that extends from the wound into the surrounding tissue. It indicates a deeper and more complex wound.

Choice D reason: Eschar is the term for black and necrotic tissue. Eschar is a thick, dry, and hard crust that forms over a wound. It indicates a severe tissue damage and impaired healing.

Choice A reason: Putting on nonsterile gloves is the first action that the nurse should take before performing a wound culture. This is to protect the nurse from exposure to blood and body fluids and to prevent crosscontamination. Nonsterile gloves are sufficient for wound care as long as the wound is not sterile or infected.

Choice B reason: Gently removing the soiled dressings is the second action that the nurse should take after putting on nonsterile gloves. This is to expose the wound and prepare it for irrigation and culture. The nurse should discard the soiled dressings in a biohazard bag and observe the wound for any signs of infection, such as redness, swelling, or odor.

Choice C reason: Irrigating the wound is the third action that the nurse should take after removing the soiled dressings. This is to cleanse the wound and remove any debris or bacteria. The nurse should use sterile normal saline or an antiseptic solution as prescribed by the provider and irrigate the wound with a syringe or a spray bottle. The nurse should avoid touching the wound with the irrigation device and collect the runoff in a basin or a towel.

Choice D reason: Labeling the specimen tube is the last action that the nurse should take after irrigating the wound and obtaining the culture. This is to ensure that the specimen is correctly identified and processed by the laboratory. The nurse should label the tube with the client's name, date, time, and site of the wound. The nurse should also document the procedure and the wound assessment in the client's chart.