The nurse is monitoring a patient's stage 3 pressure ulcer for healing during treatment. Which finding indicates that the nursing interventions have been effective?

Question

Quizplus · Accepted Answer

A stage 3 pressure ulcer is characterized by full-thickness skin loss with damage to or necrosis of subcutaneous tissue. The wound bed should be visible, and granulation tissue, which has a grainy or spongy texture, should be present. This indicates that the body is actively working to heal the wound by forming new tissue. The presence of a hard crust or scab (B) may indicate that the wound is not healing properly and that the nurse may need to assess for infection. Serosanguinous drainage (C) is a normal sign of healing and indicates that there is some moisture in the wound, which is necessary to promote healing. Minimal pain (D) is a good sign, but it does not provide information on the state of the wound itself. Therefore, choice A is the best answer.

The Nurse Is Monitoring a Patient's Stage 3 Pressure Ulcer