{"id":143175,"date":"2024-09-23T06:22:48","date_gmt":"2024-09-23T06:22:48","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=143175"},"modified":"2024-09-23T06:22:50","modified_gmt":"2024-09-23T06:22:50","slug":"a-nurse-is-documenting-a-dressing-change-for-a-client-who-has-a-pressure-injury","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2024\/09\/23\/a-nurse-is-documenting-a-dressing-change-for-a-client-who-has-a-pressure-injury\/","title":{"rendered":"A nurse is documenting a dressing change for a client who has a pressure injury."},"content":{"rendered":"\n

A nurse is documenting a dressing change for a client who has a pressure injury. Which of the following entries by the nurse demonstrates correct documentation?<\/p>\n\n\n\n

A.
“No changes noted to the wound from previous nursing notes.”.<\/p>\n\n\n\n

B.
“New dressing applied as prescribed; no drainage on old dressing.”.<\/p>\n\n\n\n

C.
“The wound seems clean and does not appear to be infected.”.<\/p>\n\n\n\n

D.
“Client premedicated with MSO4 subq prior to dressing change.”.<\/p>\n\n\n\n

The Correct answer and Explanation is:<\/mark><\/strong><\/p>\n\n\n\n

The correct answer is B. “New dressing applied as prescribed; no drainage on old dressing.”<\/strong><\/p>\n\n\n\n

Explanation:<\/h3>\n\n\n\n

In this scenario, the nurse is documenting a dressing change for a client with a pressure injury. Documentation in nursing should always be accurate, objective, clear, and specific, reflecting the care provided and the client\u2019s current condition. Let\u2019s review why answer B<\/strong> is the best choice and examine why the others are incorrect.<\/p>\n\n\n\n

Why Option B is Correct:<\/strong><\/h4>\n\n\n\n

The entry “New dressing applied as prescribed; no drainage on old dressing” demonstrates proper documentation for several reasons:<\/p>\n\n\n\n

    \n
  1. Objectivity<\/strong>: The nurse provides factual and measurable information regarding the dressing change. The old dressing\u2019s condition is noted with the absence of drainage, which is an objective, observable detail.<\/li>\n\n\n\n
  2. Specificity<\/strong>: The documentation clearly specifies that the new dressing was applied according to the prescribed treatment plan. This is essential to ensure continuity of care and compliance with medical orders.<\/li>\n\n\n\n
  3. Relevance<\/strong>: The entry focuses on the intervention (dressing change) and the condition of the wound dressing, which is highly relevant to wound care and monitoring.<\/li>\n<\/ol>\n\n\n\n

    Why Other Options are Incorrect:<\/strong><\/h4>\n\n\n\n
      \n
    • A. “No changes noted to the wound from previous nursing notes.”<\/strong>
      This documentation lacks specificity and objectivity. It is vague because it does not describe the current status of the wound. Each entry should independently describe the wound\u2019s condition to provide a clear picture of its progression or healing, even if no changes are noted.<\/li>\n\n\n\n
    • C. “The wound seems clean and does not appear to be infected.”<\/strong>
      This statement uses subjective language (“seems” and “appears”), which is not appropriate for nursing documentation. Documentation should be based on objective observations, such as “wound clean with no signs of infection, such as redness, swelling, or purulent drainage.”<\/li>\n\n\n\n
    • D. “Client premedicated with MSO4 subq prior to dressing change.”<\/strong>
      While administering medication before the procedure is important to document, this entry does not provide any information about the dressing change itself. Additionally, “MSO4” (morphine sulfate) should be avoided in documentation due to potential confusion with “MgSO4” (magnesium sulfate). It is recommended to write the full name of the drug for clarity.<\/li>\n<\/ul>\n\n\n\n

      In conclusion, Option B<\/strong> follows best practices for documentation by being factual, objective, and specific, making it the most appropriate entry.<\/p>\n","protected":false},"excerpt":{"rendered":"

      A nurse is documenting a dressing change for a client who has a pressure injury. Which of the following entries by the nurse demonstrates correct documentation? A.“No changes noted to the wound from previous nursing notes.”. B.“New dressing applied as prescribed; no drainage on old dressing.”. C.“The wound seems clean and does not appear to […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-143175","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/143175","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=143175"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/143175\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=143175"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=143175"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=143175"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}