Question

a nurse is caring for a 45 - year - old client who is 2 days postoperative following an appendectomy and has type i diabetes mellitus. their hgb is 12 g/dl and bmi is 17.1. the incision is approximated and free of redness, with scant serous drainage on the dressing. the nurse should recognize that the client has which of the following risk factors for impaired wound healing? select all that apply. a age b chronic illness c low hemoglobin d malnutrition e poor wound care

Explanation:

• Chronic illness (B): Type I diabetes mellitus is a chronic illness. Diabetes can impair wound healing due to microvascular and macrovascular complications, as well as impaired immune function.
• Low hemoglobin (C): Hemoglobin of 12 g/dL is low (normal for adult males is 13.5 - 17.5 g/dL, for adult females is 12 - 15.5 g/dL). Low hemoglobin means less oxygen - carrying capacity, and oxygen is essential for wound healing (for fibroblast function, collagen synthesis, etc.).
• Malnutrition (D): A BMI of 17.1 is underweight (normal BMI is 18.5 - 24.9). Malnutrition, especially lack of protein (important for wound repair as collagen is a protein), vitamins (like vitamin C for collagen synthesis) and minerals (like zinc for cell - mediated immunity and protein synthesis) impairs wound healing.
• Age (A): 45 - year - old is not an age - related risk factor for impaired wound healing in the context of this question. Generally, advanced age (older than 65 - 70 years) is more associated with impaired wound healing due to decreased cell proliferation, reduced blood flow, etc.
• Poor wound care (E): The incision is approximated, free of redness, with scant serous drainage. There is no indication of poor wound care.

Answer:

B. Chronic illness, C. Low hemoglobin, D. Malnutrition