Download Wound Care and Venous Stasis Ulcer Management and more Exams Nursing in PDF only on Docsity! Josephine Morrow VSIM Pre/Post Quiz (latest 2023 – 2024) Graded A The nurse is reviewing Josephine Morrow's medical records before initiating her plan of care. Which of the following factor(s) contributed to the development of her venous stasis ulcer? (Select all that apply.) a. Diabetes b. Poor circulation c. Hypertension d. Obesity e. Poor hygiene f. Poor nutrition - b , d, e, f Following the review of Josephine Morrow's medical record, the nurse recognizes which of the following assessment(s) are part of her focused assessment? (Select all that apply.) a. Vital signs assessment b. Pain assessment c. Peripheral pulse assessment d. Bowel assessment e. Home safety assessment f. Wound assessment - a, b, c, f The nurse is preparing to irrigate Josephine Morrow's wound. Upon wound assessment, the nurse will most likely consider that which of the following indicate poor wound healing? (Select all that apply.) a. Creamy, yellow, purulent drainage b. Red/pink granulated wound bed c. Presence of new epithelization d. Persistent tunneling e. A 2 mm increase in wound length f. Black, avascular tissue - a, d, e, f The nurse knows __________ will help to promote ___________, leading to improvements in Josephine Morrow's wound healing. - applying compression stocking venous return When performing wound irrigation, the nurse understands to include which of the following during implementation of the procedure? (Select all that apply.) a. Assess the client's pain level during irrigation. b. Irrigate from most to least contaminated area. c. Apply gown, gloves, and mask with goggles. d. Dry intact skin prior to applying dressing. e. Assess wound bed for appearance. f. Keep tip of syringe less than 1 inch from wound. - When performing wound irrigation, the nurse understands to include which of the following during implementation of the procedure? (Select all that apply.) a. Assess the client's pain level during irrigation. b. Irrigate from most to least contaminated area. c. Apply gown, gloves, and mask with goggles. d. Dry intact skin prior to applying dressing. e. Assess wound bed for appearance. f. Keep tip of syringe less than 1 inch from wound. - b, c, d, e The nurse is preparing to irrigate a wound. Which statement, if made by the nurse, indicates an understanding of the procedure? a. "I will use a sterile specimen cup to slowly pour irrigation solution over the entire wound bed." b. "I will make sure the tip of the syringe touches the wound bed while performing the irrigation." c. "In order to debride the wound, I will use a moderate amount of force to instill the solution."
