The nurse is assessing a client's pressure ulcer.To determine the depth of the ulcer,the nurse should take which action?

Question

Quizplus · Accepted Answer

To determine the depth of a pressure ulcer, the nurse should insert a sterile swab into the deepest part of the wound, which will provide information about the tissue layers affected. Measuring the width or length of the ulcer will not provide information about its depth. Using the face of a clock to identify the location of the ulcer is a helpful method of documentation, but it does not provide information about the depth of the wound.

The Nurse Is Assessing a Client's Pressure Ulcer