The nurse is using an elastic bandage to secure a dressing on an ...

[ashley]

The nurse is using an elastic bandage to secure a dressing on an extremity. The bandage should be wrapped in the ___________ to ___________ direction.
 
  What will be an ideal response?

Question 2

Multiple severely injured clients have arrived in the emergency department. On rapid assessment, the nurse notes that a leg wound dressing has a 4 cm 6 cm blood spot that has soaked through the bandage. The client is otherwise stable.
 
  What action should the nurse take?
  1. Place a tourniquet above the wound.
  2. Remove the dressing and place direct pressure on the wound.
  3. Add additional dressing to the wound without removing the original.
  4. Remove the dressing and replace it with a new sterile dressing.

[BUTTHOL369]

Answer to Question 1

Correct Answer: Distal / proximal
Rationale : Wrapping the elastic bandage from distal to proximal supports venous return. Wrapping in the other direction can trap blood in the distal portion of the extremity.

Answer to Question 2

Correct Answer: 3
Rationale 1: A tourniquet should not be applied because of the risk of interrupting arterial flow to the tissues.
Rationale 2: Removing the dressing and applying direct pressure would take too much time at this point.
Rationale 3: In this scenario, where there are multiple clients in need of care and since this client is stable, the correct nursing action is to add additional dressing to the wound without removing the original.
Rationale 4: Removing the dressing and replacing the dressing with a new sterile dressing would take too much time at this point.

[ashley]

TYSM

[flexer1n1]

Gracias!