The nurse is informed that a client with a large surgical incision is being transferred 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

   Mephyton

3. C

   Vitamin B12 complex

4. D

   Vitamin A

Appeared in: AIIMS Nagpur NO- 2020

Explanation

• Ascorbic acid (Vitamin C) is the correct answer because it is fundamentally required for wound healing.
• Its primary role is in collagen synthesis, which is the protein framework for new tissue in a healing wound.
• Vitamin C also supports capillary formation and enhances the immune system, reducing the risk of post-operative wound infections.
• For large surgical wounds, the body's demand for Vitamin C increases significantly to support the extensive tissue repair process.

Why Other Options Were Wrong

• Option B: Mephyton is Vitamin K. Its primary function is to promote blood clotting by aiding in the synthesis of prothrombin and other clotting factors.
• Option C: Vitamin B12 is crucial for hematopoiesis (red blood cell formation) and nerve function. Its role in wound healing is indirect, supporting overall cellular energy metabolism.
• Option D: While Vitamin A is important for wound healing, particularly for epithelialization and immune function, Vitamin C's role in collagen synthesis is considered more critical and fundamental, especially for large wounds.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Post-operative nutritional support for wound healing to guide bedside assessment, documentation, and the next nursing action.
• Nurses must assess the nutritional status of post-operative patients, as malnutrition is a major risk factor for delayed wound healing, dehiscence, and infection.
• Monitoring for signs of poor healing (e.g., persistent drainage, redness, wound edges not approximating) is a critical nursing responsibility.
• What if the client was a chronic alcoholic? The nurse should have a higher suspicion for multiple nutritional deficiencies, including thiamine (Vitamin B1) and folate, in addition to those directly related to wound healing, and would need to advocate for broader nutritional screening and support.

How to Approach the Question

• First, identify the core concept of the question: the physiological needs of a patient with a 'large surgical incision'. This immediately points towards wound healing.
• Next, analyze the options provided. All are vitamins. The task is to determine which vitamin plays the most direct and critical role in the healing of a large wound.
• Recall or deduce the primary function of each vitamin: Ascorbic acid (collagen), Mephyton (clotting), B12 (RBCs/nerves), Vitamin A (epithelialization).
• Compare these functions to the primary need of a large wound: building new tissue. Collagen is the 'scaffolding' for new tissue.
• Conclude that Ascorbic acid (Vitamin C) is the most essential nutrient for this primary need, making it the most likely medication to be ordered to support healing.

Concept Tested & Keywords

• Concept Tested: Post-operative nutritional support for wound healing.
• Stem keywords: large surgical incision, transferred, intensive care unit, medication
• Lead-in keywords: anticipate
• Clinical cues: The presence of a 'large surgical incision' is the key clinical cue, indicating a high metabolic demand for tissue repair and a need for nutrients essential for healing, particularly collagen synthesis.

Question ID

QxxLuq_Fuzebq2TtqWZty_

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