Chapter 23 Skin Integrity and Wound Care

Chapter 23 Skin Integrity and Wound Care

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)A home care nurse is teaching a family member to apply a hydrocolloid dressing over a wound.Which statement made by the family member indicates that the teaching about the procedure hasbeen effective?1)A)”If I notice any leakage, I’ll cover the dressing with one of those large sterile absorbent padsyou brought.”B)”If I notice any moisture under the dressing, I will change it right away.”C)”I’ll be sure to wash and dry the skin around the dressing each time I change it.”D)”I’ll try to keep the dressing in place for at least a week. If it starts to come loose, I’ll tape thesides.”Answer:CExplanation:A)A hydrocolloid dressing is designed to absorb exudates, produce a moistenvironment, and protect a wound from contamination. Each time a dressing ischanged, the skin around the area should be gently washed with a mild cleansingagent or normal saline. When dressings become loose, leak, or develop an odorthey should be changed.EvaluationPhysiological Integrity-Reduction of Risk PotentialAnalysisB)A hydrocolloid dressing is designed to absorb exudates, produce a moistenvironment, and protect a wound from contamination. Each time a dressing ischanged, the skin around the area should be gently washed with a mild cleansingagent or normal saline. When dressings become loose, leak, or develop an odorthey should be changed.EvaluationPhysiological Integrity-Reduction of Risk PotentialAnalysisC)A hydrocolloid dressing is designed to absorb exudates, produce a moistenvironment, and protect a wound from contamination. Each time a dressing ischanged, the skin around the area should be gently washed with a mild cleansingagent or normal saline. When dressings become loose, leak, or develop an odorthey should be changed.EvaluationPhysiological Integrity-Reduction of Risk PotentialAnalysisD)A hydrocolloid dressing is designed to absorb exudates, produce a moistenvironment, and protect a wound from contamination. Each time a dressing ischanged, the skin around the area should be gently washed with a mild cleansingagent or normal saline. When dressings become loose, leak, or develop an odorthey should be changed.EvaluationPhysiological Integrity-Reduction of Risk PotentialAnalysis1
2)Several hours after being catheterized, a client develops widespread erythema and pruritus in theperineal area, which extends to the lower abdomen and the inside aspects of the legs. The nurseshould recognize that these symptoms are most likely related to a/an:2)A)Urinary tract infection from the catheterization.B)Localized contact dermatitis from the bed linens.C)Allergic response to a medication the client is taking.D)Latex allergy from equipment used in the catheterization.Answer:DExplanation:A)The symptoms presented are associated with type 4 latex allergies (allergic contactdermatitis). The symptoms are localized and occurred following a procedure inwhich the client may have come into contact with latex equipment. These are notthe symptoms of a urinary tract infection. An allergy to bed linens would manifestmore widespread over the client’s body. Rashes from medication allergies typicallystart on the torso and neck.AssessmentSafe, Effective Care Environment-Safety and Infection ControlAnalysisB)The symptoms presented are associated with type 4 latex allergies (allergic contactdermatitis). The symptoms are localized and occurred following a procedure inwhich the client may have come into contact with latex equipment. These are notthe symptoms of a urinary tract infection. An allergy to bed linens would manifestmore widespread over the client’s body. Rashes from medication allergies typicallystart on the torso and neck.AssessmentSafe, Effective Care Environment-Safety and Infection ControlAnalysisC)The symptoms presented are associated with type 4 latex allergies (allergic contactdermatitis). The symptoms are localized and occurred following a procedure inwhich the client may have come into contact with latex equipment. These are notthe symptoms of a urinary tract infection. An allergy to bed linens would manifestmore widespread over the client’s body. Rashes from medication allergies typicallystart on the torso and neck.AssessmentSafe, Effective Care Environment-Safety and Infection ControlAnalysisD)The symptoms presented are associated with type 4 latex allergies (allergic contactdermatitis). The symptoms are localized and occurred following a procedure inwhich the client may have come into contact with latex equipment. These are notthe symptoms of a urinary tract infection. An allergy to bed linens would manifestmore widespread over the client’s body. Rashes from medication allergies typicallystart on the torso and neck.AssessmentSafe, Effective Care Environment-Safety and Infection ControlAnalysis3)The nurse would be least likely to consider potential problems with skin integrity when planningcare for which of the following hospitalized clients?3)A)An 85-year-old female with diabetes mellitusB)A 25-year-old male who received multiple abrasions in a motor vehicle accidentC)A 50-year-old female with pneumoniaD)A 45-year-old male in skeletal tractionAnswer:C2
Explanation:A)The potential for problems with skin integrity is greatest in older adults and inclients with diagnoses that limit mobility, affect peripheral circulation, and breakthe integrity of the skin (i.e., trauma, surgery). The 25-year-old male, 45-year-oldmale, and 85-year-old female all have one or more of these risk factors. The50-year-old female has no risk or is at minimal risk because of her age anddiagnosis.PlanningPhysiological Integrity-Reduction of Risk PotentialApplicationB)The potential for problems with skin integrity is greatest in older adults and inclients with diagnoses that limit mobility, affect peripheral circulation, and breakthe integrity of the skin (i.e., trauma, surgery). The 25-year-old male, 45-year-oldmale, and 85-year-old female all have one or more of these risk factors. The50-year-old female has no risk or is at minimal risk because of her age anddiagnosis.PlanningPhysiological Integrity-Reduction of Risk PotentialApplicationC)The potential for problems with skin integrity is greatest in older adults and inclients with diagnoses that limit mobility, affect peripheral circulation, and breakthe integrity of the skin (i.e., trauma, surgery). The 25-year-old male, 45-year-oldmale, and 85-year-old female all have one or more of these risk factors. The50-year-old female has no risk or is at minimal risk because of her age anddiagnosis.PlanningPhysiological Integrity-Reduction of Risk PotentialApplicationD)The potential for problems with skin integrity is greatest in older adults and inclients with diagnoses that limit mobility, affect peripheral circulation, and breakthe integrity of the skin (i.e., trauma, surgery). The 25-year-old male, 45-year-oldmale, and 85-year-old female all have one or more of these risk factors. The50-year-old female has no risk or is at minimal risk because of her age anddiagnosis.PlanningPhysiological Integrity-Reduction of Risk PotentialApplication