What is the correct nursing response to a mother who asks, "How can I get rid of the baby's cradle cap?"

Choice A rationale

Healing by primary intention, also known as primary union, occurs when a wound has clean edges that are approximated and sutured, stapled, or glued together. This process minimizes tissue loss and results in a fine scar. The wound's integrity is re-established with minimal granulation tissue formation.

Choice B rationale

This describes a form of delayed primary closure or tertiary intention healing. The wound is initially left open to allow for drainage and to clear infection. Once the wound is considered clean and free of infection, the edges are then approximated and closed, often with staples, to promote healing.

Choice C rationale

Healing by secondary intention, or secondary union, occurs in large, open wounds with significant tissue loss and non-approximated edges. The wound heals from the base up. This process involves the formation of new connective tissue and capillaries, called granulation tissue, to fill the defect before epithelialization can occur.

Choice D rationale

While contaminated wounds can heal by secondary intention, this description is not a complete definition. Secondary intention healing is a specific biological process involving granulation tissue, not just a description of a wound that is open due to contamination or debris. The defining characteristic is the formation of granulation tissue.

Choice A rationale

An arterial ulcer is a complex wound resulting from chronic tissue ischemia. A wound care nurse possesses specialized knowledge in advanced wound management techniques, including debridement, moisture balance, and identifying appropriate dressings, which are crucial for promoting healing in these challenging, poorly perfused wounds.

Choice B rationale

While pain management is important for client comfort, it is not the most critical action. The best action is to address the underlying cause of the non-healing wound and implement specialized care that targets the specific challenges of arterial ulcers, such as poor perfusion and a high risk of infection.

Choice C rationale

Maintaining sterile technique is a standard of care to prevent infection, but it is insufficient on its own to heal an arterial ulcer. These wounds require a comprehensive approach that includes improving blood flow, debridement of non-viable tissue, and specialized dressings, which a wound care nurse can best guide.

Choice D rationale

Preparing the client for amputation is a premature and often psychologically damaging action. Amputation is a last resort after all conservative and revascularization options have been exhausted. The primary goal is to heal the ulcer through a concerted effort of specialized wound care and addressing the vascular insufficiency.