You are doing a sterile dressing change for a client with infected deep partial-thickness burns of the chest and abdomen. List the steps of the care plan in the order each should be accomplished.

Correct Answer: C

Rationale: In this scenario, administering morphine sulfate 10 mg IV (Option C) is the correct first step in the care plan for a client with infected deep partial-thickness burns of the chest and abdomen. Pain management is crucial to ensure the client's comfort and cooperation during the dressing change procedure, which can be extremely painful. The other options are incorrect for the following reasons: A) Applying silver sulfadiazine (Silvadene) ointment (Option A) should come after wound debridement, as the medication is more effective when applied to clean wound beds. B) Obtaining aerobic and anaerobic wound cultures (Option B) is important but should be done after wound debridement to avoid contamination during the sampling process. D) Debriding the wound of eschar using gauze sponges (Option D) should come after pain management to minimize the discomfort experienced by the client during the procedure. Educationally, it is vital for healthcare providers to prioritize pain management in clients with burns to ensure holistic care and effective treatment. Understanding the sequence of steps in wound care is essential for providing safe and efficient care to clients with complex wound conditions like infected burns. By emphasizing the rationale behind each step, healthcare professionals can enhance their clinical decision-making skills and improve patient outcomes.

Correct Answer: B

Rationale: In this scenario, the most immediate action required is option B) Administration of tetracycline with a glass of milk to a client with cellulitis. The rationale behind this choice is that tetracycline should not be administered with dairy products like milk, as calcium in milk can interfere with the absorption of tetracycline, reducing its effectiveness. Option A is incorrect because obtaining an anaerobic culture of a superficial partial-thickness arm burn is a standard procedure for assessing infection, but it does not pose an immediate risk to the client. Option C is incorrect because debriding a deep partial-thickness burn wound using wet-to-dry dressings is a common practice in wound care, although there may be more optimal methods available. Option D is incorrect as teaching a newly admitted burn client about the use of pressure garments is an important aspect of burn care but does not pose an immediate risk to the client's health. In an educational context, this question highlights the importance of medication administration knowledge, understanding drug-food interactions, and the significance of timely interventions in nursing practice to ensure patient safety and optimal outcomes. Nurses need to be vigilant in their medication administration practices to prevent adverse reactions and ensure the effectiveness of treatment.

Correct Answer: D

Rationale: The correct answer is D) Turn and reposition the client frequently. This is the most appropriate action because blanching of the skin indicates impaired circulation, which can lead to pressure ulcers or bedsores in clients who are bedridden. Turning and repositioning the client helps to relieve pressure on specific areas of the body, improving circulation and reducing the risk of skin breakdown. Option A) Massage bony areas is incorrect because massaging areas with compromised circulation can further damage the skin and tissues, increasing the risk of pressure ulcers. Option B) Using a moisturizing skin cleanser is not the most appropriate action in this scenario as it does not directly address the issue of pressure relief and prevention of pressure ulcers. Option C) Padding body areas may provide some comfort but does not address the underlying issue of pressure relief and prevention of pressure ulcers. In an educational context, it is crucial for nurses and healthcare providers to understand the importance of skin integrity in clients who are immobile. Proper positioning, turning, and repositioning are essential to prevent pressure ulcers, maintain skin health, and overall promote the well-being of bedridden clients. It is vital for healthcare professionals to be knowledgeable about effective strategies to prevent complications associated with immobility.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Encourage the client to join a psoriasis support group. This option is the most appropriate because it focuses on addressing the client's emotional distress and provides a sense of community and understanding. Psoriasis is a chronic condition without a known cure, so emotional support and coping strategies are essential for individuals living with it. By joining a support group, the client can connect with others facing similar challenges, share experiences, and learn effective ways to manage the condition. Option B) Recommend dermabrasion is incorrect because dermabrasion is a cosmetic procedure that involves removing the top layer of skin and is not a suitable treatment for psoriasis. Option C) Apply anthralin is incorrect because anthralin is a topical medication used to treat psoriasis symptoms, such as slowing down skin cell growth and reducing inflammation, but it does not address the client's emotional distress or help them accept their condition. Option D) Recommend a skin graft is incorrect as it is a surgical procedure used for specific cases like severe burns or injuries, not for treating psoriasis. In an educational context, it is crucial for healthcare providers to not only focus on the physical aspects of a condition but also address the emotional and psychological impact on patients. Encouraging patients to seek support from others who understand their situation can significantly improve their quality of life and ability to cope with chronic conditions like psoriasis. It is important for nurses to be empathetic, supportive, and provide holistic care to meet the needs of the whole patient.

Correct Answer: C

Rationale: In the context of extensive burns, grafting of skin is the most effective intervention in minimizing the risk of morbidity and mortality after fluid resuscitation. Skin grafting helps to cover and protect the wounded area, promote healing, prevent infection, and reduce fluid loss. This intervention plays a crucial role in restoring the skin's barrier function and aiding in the overall recovery process for burn patients. Providing the client with antibiotics (Option A) may be necessary if there is an infection present but it is not the primary intervention to minimize risk post-fluid resuscitation. Addressing the client's depression (Option B) is important for holistic care but is not directly related to minimizing risks post-fluid resuscitation for burns. Monitoring electrolyte balance (Option D) is important in burn patients but skin grafting takes precedence in minimizing morbidity and mortality. In an educational context, understanding the priority interventions in burn care is crucial for healthcare providers. Skin grafting is a fundamental aspect of burn treatment and is essential for improving outcomes in patients with extensive burns. Educating healthcare professionals on the significance of timely and appropriate interventions post-fluid resuscitation can lead to better patient outcomes and quality of care in burn management.