A nurse while changing the dressing of a bed sore found out that the wound is having a necrotic edge. Which intervention would the nurse expect the doctor to order next?

1. A

   irrigation

2. B

   culture

3. C

   incision and drain

4. D

   debridements

Appeared in: NORCET-11 Prelims

Explanation

• Necrotic tissue must be removed for wound healing to proceed.
• Debridement is the process of removing dead, nonviable tissue from a wound.
• Debridement can be mechanical, autolytic, chemical, or surgical depending on the wound.
• Without debridement, the wound cannot heal and is at risk for infection.

Why Other Options Were Wrong

• Option A: Irrigation cleans the wound and removes loose debris but does not remove established necrotic tissue.
• Option B: Culture is used to identify infection, not to treat necrotic tissue.
• Option C: Incision and drainage is for abscesses or localized pus, not for necrotic wound edges.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Management of necrotic tissue in pressure ulcers (bed sores) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Nurses must recognize necrotic tissue and advocate for timely debridement to prevent infection and promote healing.
• What if? If the wound showed signs of infection (purulent drainage, foul odor), a wound culture would also be indicated, but debridement would still be necessary for necrotic tissue.

How to Approach the Question

• Identify the main clinical finding: necrotic edge in a bedsore.
• Recall the primary goal in wound care: remove nonviable tissue to promote healing.
• Eliminate options that do not directly address necrotic tissue (e.g., culture, irrigation, incision and drain).
• Select the intervention that specifically removes dead tissue: debridement.
• Remember that debridement is a key step before other wound care measures can be effective.

Concept Tested & Keywords

• Concept Tested: Management of necrotic tissue in pressure ulcers (bed sores)
• Stem keywords: bed sore, necrotic edge, wound, dressing change
• Lead-in keywords: intervention, expect the doctor to order next
• Clinical cues: necrotic edge indicates presence of dead tissue requiring removal

Question ID

QEiqCTt773XScV4rjzhtmE

Copy ID

Reference Book

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 92-94