Question

The nurse identifies an alteration in tissue integrity in a client with a foot wound. Which independent interventions should the nurse include when caring for this client?

1) Encourage the use of moisturizers after bathing
2) Review the process to discard soiled dressings
3) Instruct on cleaning and dressing the foot wound
4) Instruct on skin hygiene to include daily bathing
5) Teach the signs of wound infection

Answer 1

The nurse should include several independent interventions when caring for a client with a foot wound and alteration in tissue integrity. These interventions include encouraging the use of moisturizers after bathing, reviewing the process to discard soiled dressings, instructing on cleaning and dressing the foot wound, instructing on skin hygiene to include daily bathing, and teaching the signs of wound infection.

Step-by-step explanation:

The independent interventions that the nurse should include when caring for a client with a foot wound and alteration in tissue integrity are:

1. Encouraging the use of moisturizers after bathing: This helps to keep the skin hydrated and prevent further damage.
2. Reviewing the process to discard soiled dressings: Proper disposal of dressings reduces the risk of contamination and infection.
3. Instructing on cleaning and dressing the foot wound: Proper wound care can promote healing and prevent infection.
4. Instructing on skin hygiene to include daily bathing: Maintaining good skin hygiene helps prevent the buildup of bacteria and reduces the risk of infection.
5. Teaching the signs of wound infection: Knowing the signs of infection allows the client to seek prompt medical attention if needed.