The nurse is informed that a client with a large surgical incision is being referred from the intensive care unit to the surgical unit. What medication does the nurse anticipate the physician will order for this client?

1. A

   Ascorbic acid

2. B

   Vitamin A

3. C

   Vitamin B12 complex

4. D

   Metformin

Appeared in: NCL (MP) Nursing Officer - 2020

Explanation

• Ascorbic acid, also known as Vitamin C, is a critical nutrient for postoperative recovery.
• It is essential for the synthesis of collagen, the primary protein that forms the structure of new tissue in a healing wound.
• Vitamin C is also necessary for capillary formation and tissue synthesis, which are vital processes for repairing a large surgical incision.
• A deficiency in Vitamin C can result in impaired collagen formation, leading to delayed wound healing, increased capillary fragility, and a higher risk of infection.

Why Other Options Were Wrong

• Option B: While Vitamin A is important for wound healing, its primary roles are in promoting the inflammatory response and epithelialization. It is not the principal nutrient for collagen synthesis.
• Option C: The Vitamin B complex has an indirect role in wound healing by supporting energy metabolism and host resistance. It is not directly involved in the structural repair of tissue like collagen synthesis.
• Option D: Metformin is an oral hypoglycemic agent used to manage type 2 diabetes. It is not prescribed for the purpose of promoting wound healing.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Nutritional support for postoperative wound healing to guide bedside assessment, documentation, and the next nursing action.
• Nurses play a key role in assessing a postoperative patient's nutritional status and identifying risk factors for poor healing, such as malnutrition.
• It is a crucial nursing responsibility to administer prescribed supplements like Vitamin C and to monitor the wound for signs of effective healing (e.g., well-approximated edges, minimal drainage) or complications (e.g., dehiscence, infection).
• Patient education on a diet rich in protein and vitamins is a vital nursing intervention to support recovery after discharge.

How to Approach the Question

• First, identify the central issue in the question: the need to support the healing of a large surgical incision.
• Next, recall the physiological process of wound healing, specifically the formation of new tissue.
• Recognize that collagen synthesis is the fundamental process for building this new tissue.
• Evaluate each medication option based on its primary role in the body.
• Connect Ascorbic acid (Vitamin C) to its well-established, direct, and essential role as a cofactor in collagen synthesis.
• Differentiate this from the other options: Vitamin A (epithelialization), Vitamin B12 (nerve/blood cells), and Metformin (blood glucose control), to determine the most directly relevant and anticipated order.

Concept Tested & Keywords

• Concept Tested: Nutritional support for postoperative wound healing.
• Stem keywords: large surgical incision, postoperative, wound healing
• Lead-in keywords: anticipate
• Clinical cues: The presence of a large surgical incision indicates a significant physiological stress and a high demand for nutrients to support tissue repair.

Question ID

QdI554auTm9XwZBUNNmdGz

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 58-60

E6 Pharmacology Nursing Lilley 11e Part 3 p. 247-249