A client with a large abdominal wound requires a dressing change ...

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A client with a large abdominal wound requires a dressing change every 4 hours. The client will be discharged to the home setting, where the dressing care will be continued. Which of the fol-lowing is true concerning this client's wound healing process?
 
  1. An antiseptic agent is best followed with a rinse of sterile saline solution.
  2. A heat lamp should be used every 2 hours to rid the wound area of contaminants.
  3. Sterile technique should be emphasized to the client and family.
  4. A dressing covering will allow the wound area to remain moist.

Question 2

A client requires wound debridement. The nurse is aware that which one of the following state-ments is correct regarding this procedure?
 
  1. It allows the healthy tissue to regenerate.
  2. When performed by autolytic means, the wound is irrigated.
  3. Mechanical methods involve direct surgical removal of the eschar layer of the wound.
  4. Enzymatic debridement may be implemented independently by the nurse when-ever it is required.

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Answer to Question 1

ANS: 4
A dressing should support a moist wound environment if the wound is healing by secondary in-tention, such as with a large abdominal wound. A moist wound base facilitates the movement of epithelialization, thus allowing the wound to resurface as quickly as possible. Only mild soap may be used or saline. Antiseptics may be damaging to granulation tissue. A heat lamp should not be used because it will dry out the wound and impair the movement of epithelialization. Clean dressings may be used in the home setting.

Answer to Question 2

ANS: 2
Removal of necrotic tissue is necessary to rid the ulcer of a source of infection, to enable visuali-zation of the wound bed, and to provide a clean base necessary for healthy tissue to regenerate. Autolytic debridement uses synthetic dressings over a wound to allow the eschar to be self-digested by the action of enzymes that are present in wound fluids. The wound is not irri-gated. Mechanical methods include wet-to-dry dressings, wound irrigation, and whirlpool treat-ments. Surgical debridement involves direct surgical removal of the eschar layer of the wound. Enzymatic debridement requires a health care provider's order.

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