A young adult is being treated for second and third-degree burns over 25% of his body and is now ready for discharge. The nurse evaluates his understanding of discharge instructions relating to wound care and is satisfied that he is prepared for home care when he makes which statement?
A. “I will need to take sponge baths at home to avoid exposing the wounds to unsterile bathwater.”
B. “I can expect occasional periods of low-grade fever and can take Tylenol every 4 hours.”
C. “I must wear my Jobst elastic garment all day and can only remove it when I’m going to bed.”
D. “If any healed areas break open I should first cover them with a sterile dressing and then report it.”
Correct Answer: D. “If any healed areas break open I should first cover them with a sterile dressing and then report it.”
The client is taught to report changes in wound healing such as blister formation, signs of infection, and opening of a previously healed area. Sterile dressings are applied until the wound is assessed and a plan of care developed. While many factors must be considered in dressing selection, the goals in selecting the most appropriate dressing should include providing protection from contamination (bacterial or otherwise) and from physical damage, allowing gas exchange and moisture retention, and providing comfort to enhance functional recovery.
Option A: Bathing or showering in the usual manner is permitted, using a mild detergent soap such as Ivory Snow. This cleanses the wounds, especially those that are still open and removes dead tissue.
Option B: The client must be aware that infection of the wound may occur; signs of infection, including fever, redness, pain, warmth in and around the wound and increased or foul-smelling drainage must be reported immediately.
Option C: The Jobs garment is designed to place constant pressure on the new healthy tissue that is forming to promote adherence to the underlying structure in order to prevent hypertrophic scarring. In order to be effective, the garment must be worn for 23 hours daily. It is removed for wound assessment and wound care and to permit bathing.