Wound infection escalation
Question
An adult client has a wound. For each separate new finding, sort the nurse’s response by urgency. Follow facility escalation procedures for urgent findings.
Report new sign to provider
- Report new foul-smelling wound drainage
- Report new hardened tissue around the wound
Obtain urgent medical management
- Escalate new confusion with wound infection
- Escalate loss of movement in the wounded area
Answer
Report new sign to provider: Report new foul-smelling wound drainage; Report new hardened tissue around the wound · Obtain urgent medical management: Escalate new confusion with wound infection; Escalate loss of movement in the wounded area
Rationale
A new local infection sign needs reporting. Confusion or loss of function in this context can signal a more serious progression that needs urgent management.
Sources
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