A patient has a contaminated right hip wound that requires ...

[809779]

A patient has a contaminated right hip wound that requires dressing changes twice daily. The surgeon informs the nurse that when the wound heals a little more he will suture it closed.
 
  The nurse recognizes that the surgeon is using which form of wound healing?
  a. Primary intention
  b. Regenerative healing
  c. Secondary intention
  d. Tertiary intention

Question 2

The nurse is caring for a patient who is normally healthy but is experiencing dehydration secondary to acute diarrhea and vomiting. What assessment findings would indicate a return to fluid homeostasis? Select all that apply.
 
  a. Urine output of 35 mL/hour
  b. Elevated antidiuretic hormone levels
  c. Reduced renin production
  d. Reduced aldosterone release
  e. Formed stools

[jesse.fleming]

Answer to Question 1

D
Tertiary intention is used when a wound is clean-contaminated or dirty (potentially infected). Initially, the wound is allowed to heal by secondary intention, and when there is no evidence of edema, infection, or foreign matter, granulating tissue is brought together and the wound edges are sutured closed.

Answer to Question 2

A, C, D
Urine output within normal limits (e.g., 35 mL/hr) would indicate the patient's fluid status has returned to homeostasis. Renin converts angiotensinogen to angiotensin II to retain sodium and water. Absence of renin would indicate water is no longer being reabsorbed and fluid homeostasis has been reached; therefore, a reduced renin production would indicate return to fluid homeostasis. Aldosterone promotes reabsorption of sodium resulting in passive reabsorption of water and will be elevated during periods of dehydration. Production will decline with return to fluid homeostasis. Elevated antidiuretic hormone levels do not indicate fluid homeostasis: Antidiuretic hormone causes the kidneys to retain fluid, which would be seen while the patient was dehydrated but should return to normal levels with homeostasis rather than being elevated. Formed stools will occur when the bowel returns to normal function, but this is not an indicator of fluid homeostasis.