Asked by Isabella Wright on Apr 27, 2024
Verified
On the fourth post-operative day,the client has a sudden coughing episode and tells the nurse that "something popped" in the abdominal incision.Upon inspection,the nurse finds that evisceration has occurred.What nursing action should be taken first?
A) Notify the client's surgeon
B) Cover the area with a large saline-soaked dressing
C) Position the client in bed with knees bent
D) Pack the wound with nonadherent gauze
Evisceration
Extrusion of the internal organs.
Post-Operative Day
The period following a surgical operation, specifically used to denote the days as recovery progresses.
Saline-Soaked Dressing
A wound dressing moistened with saline solution to aid in the healing process by keeping the wound clean and moist.
- Determine strategies to avoid complications in the process of wound care and healing.
- Conduct evaluations and handle a variety of wounds, including decubitus ulcers, incisions, and contaminated wounds.
Verified Answer
AG
Alexis GalenoMay 02, 2024
Final Answer :
B
Explanation :
Covering the area of evisceration with a large saline-soaked dressing is the first priority. This action will protect the displaced organs from dehydration and contamination while waiting for the surgeon's arrival. Option A is incorrect because notification of the surgeon can wait until after the initial intervention. Options C and D are incorrect because positioning the client with knees bent and packing the wound may cause further damage, especially if the organs are exposed.
Learning Objectives
- Determine strategies to avoid complications in the process of wound care and healing.
- Conduct evaluations and handle a variety of wounds, including decubitus ulcers, incisions, and contaminated wounds.
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