A postoperative client with obesity and diabetes mellitus has an abdominal incision and is at risk for poor wound healing. Which interventions should the nurse include in the plan of care to promote wound healing and prevent dehiscence? Select all that apply.

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11ecbb05_cb20_1239_b433_194db828a8c2_MD0009_00 Dehiscence is a complication of poor wound healing that occurs when the edges of a surgical wound fail to approximate and separate (ie, partial or total separation of the skin and/or tissue layers). Dehiscence is associated with factors that impair circulation, tissue oxygenation, and wound healing (eg, diabetes, smoking, obesity, advanced age, malnutrition, infection, steroid use) and with mechanical stress on the wound (eg, straining to cough, vomit, or defecate). Interventions to prevent abdominal wound dehiscence include: Administering stool softeners (eg, docusate) to prevent straining and constipation from postoperative immobility and opioid pain medications (Option A) Administering antiemetics (eg, ondansetron) as needed for nausea to prevent straining that can occur with vomiting (Option B) Applying an abdominal binder to provide hemostasis, support the incision, and reduce mechanical stress on the wound when coughing and moving (Option C) Monitoring blood sugar to maintain tight glycemic control (<140 mg/dL [7.8 mmol/L] fasting glucose; <180 mg/dL [10 mmol/L] random glucose) to decrease infection risk and promote wound healing (Option E) Splinting the abdomen by holding a pillow or folded blanket against the wound for support when coughing and moving (Option D) Wound healing requires adequate caloric and protein intake. Although this client is obese and needs education to promote weight loss, caloric restriction could delay wound healing. Educational objective: Interventions to prevent wound dehiscence include administering stool softeners and antiemetics, applying an abdominal binder, and maintaining tight blood glucose control.

A Postoperative Client with Obesity and Diabetes Mellitus Has an Abdominal