Exam 9: Wound Healing, dressings, and Drains

Which statement about surgical dressings is true?

Infection control and prevention surveillance was underway in the cardiac ICU because of an alarming prevalence of sternal wound infections.The infection preventionist and perioperative clinical nurse specialist reviewed the criteria to define the SSI and develop strategies for further investigation and prevention.The infectious signs and symptoms arose on postoperative day 2 with edema,redness,and purulent exudates that appeared to be isolated to the subcutaneous plane above the sternum.What two important criteria must be met to conclusively define this SSI?

A 62-year-old man had surgery 6 days ago for a ruptured diverticulum.What was the wound classification at the time of his emergency surgery?

A patient recently operated on for a ruptured appendix had a temperature of 103° F and returned to the OR for a debridement and washout of purulent drainage from his wound on postoperative day 3.What was the wound classification at the time of his debridement and washout surgery?

Before the patient leaves the OR for transport to the postanesthesia care unit (PACU)or intensive care unit (ICU),the circulating nurse empties the closed drain reservoir.What important information must the circulating nurse document and communicate about the drain to the PACU or ICU nurse during transition of care?

Surgical team members have control of many of the factors that have been shown to contribute to SSIs.Which statement below reflects a best practice for surgical scrub/surgical hand asepsis?

A 62-year-old man had surgery 6 days ago for a ruptured diverticulum.He is back in the OR for a debridement and washout.The patient's fever has subsided,and the drainage is clear.The surgeon will schedule the patient to return to the OR in 3 days for:

A 48-year-old tetraplegic with a chronic sacral wound is scheduled for wound debridement.What is the purpose of doing a wound debridement on a chronic wound?

There are many factors that influence surgical wound healing.Select the response below that reflects a factor with high influence over wound healing and is within the control of the surgical team.

Also known as vacuum-assisted closure (VAC),negative-pressure wound therapy (NPWT)is used for difficult to manage wounds that do not respond to traditional wound care methods.What wounds are appropriate for this therapy?

An evolving technology for the treatment of wounds is the use of an engineered skin substitute.The skin substitute stimulates wound epithelialization and is capable of producing growth factors.Descriptions of commercially available skin substitutes include:

Identify the primary substance that composes a layer of the epidermis,is responsible for hardening nails and hair,and protects the body from fluid loss and invasion by pathogens.

Hydrotherapy for wound care was traditionally accomplished in an immersion bath whirlpool system.Because immersion in a tank is not practical from an intraoperative perspective,the hydrotherapy method most frequently used in the OR is:

Which statement best reflects the appropriate purpose of a surgical drain?

What term represents a fibrous band between serous membranes that can cause obstructions and subsequent surgical emergencies?

Criteria for defining a deep incisional SSI include?

An experienced perioperative nurse was precepting a new perioperative nurse in the circulating role.She watched and coached as the new nurse prepared to perform the skin prep on a patient for closure of a colostomy.The new nurse had never had the opportunity to prep a patient with an existing colostomy and was concerned about the potential of her actions contributing to an SSI.After the successful prep and the onset of the procedure,the experienced nurse and the new nurse had an opportunity to discuss SSIs in this patient population and preventive measures.What combinations of topic should they have discussed?

A 76-year-old male patient has been approved as a candidate for hyperbaric oxygenation as a management therapy for his chronic sacral wound.He responded well to his surgical debridement and the nurse is planning to explain the next course of therapy.He will describe to him how hyperbaric oxygenation:

A 2011 systematic review found that approximately 55% of surgical site infections (SSIs)in the United States may be preventable by using evidence-based guidelines.The surgical team is responsible for understanding the factors that contribute to SSIs and preventive measures.Which of the following is a true statement about preparation of the patient?

When providing discharge instructions to a 59-year-old woman who just underwent laparoscopic ACL repair,the RN informs the patient and responsible adult; "I am going to talk to you about when you need to call the surgeon.You should call your doctor if you have a fever greater than 101° F; if the surgical site has redness,swelling,or drainage; if your pain medication is not working; if you cannot eat or drink because of nausea or vomiting; if you have jaundice; or you are unable to urinate.I want to be sure that I did a good job of teaching you.Could you please tell me in your own words the reasons you should call the surgeon?" What health literacy strategy is the nurse using?