Practice test question

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Hello I am not understand this question. Patient has midline abdominal incision and requires daily dressing changes. Which principle of asepsis would be most important to follow when cleansing the wound.

The answer is clean from proximal to distal using the midline, far side, near side priniciple.

For some reason I am not understanding the prioximal to distal part. I cannot picture this.

Can someone please explain this to me. Thank you!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

proximal to distal: top to bottom

midline: suture line

far side: furthest away from you

near side : closest to you

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proximal to distal: top to bottom

midline: suture line

far side: furthest away from you

near side : closest to you

Thank you I understand now!!

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Specializes in Hospital Education Coordinator.

inside to outside so you do not drag in any germs.

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Keep in mind that proximal and distal are relative terms.

In this context, I interpret proximal-to-distal to mean from the center of the incision to one end and then from the middle of the incision to the other end.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

hummm....I have always taught top to bottom in one motion going least contaminated to the most contaminated area. Illustrated Manual of Nursing Practice 3rd addition

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hummm....I have always taught top to bottom in one motion going least contaminated to the most contaminated area. Illustrated Manual of Nursing Practice 3rd addition
Being in the ED, I don't do a lot of wound care except to fresh trauma wounds... and even those are typically handled by the trauma interns.

That said, top and bottom are arbitrary and there's nothing uniquely cleaner about the superior part of the wound versus the inferior part of the wound. Not to mention things like lateral incisions which don't have a top and bottom unless you're referring to the edge.

Regardless, the question uses the terms proximal and distal which have specific, defined meanings:

proximal (pro˘k sı˘m-a˘l) Nearest the point of attachment, center of the body, or point of reference; the opposite of distal. (Taber's, 21st ed)

With no other information regarding the specific location of the wound, I'd go with center out.

Strictly speaking, the terms proximal and distal don't seem appropriate to the situation described.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

When I did open heart we did "top to bottom" on clean intact suture lines....or it there was an open area....wound to each end with different swabs...if draining clean to dirty. The only (well mostly) things center to outer were central line drsg changes

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Sternals are no longer cleaned this way. We use Chlorhexadine sticks/swabs and just clean. Side to side and top to bottom in no particular order, its the friction that helps rubs out the bacteria.

But, go with what school teaches you:)

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My wound care instructor explained that generally you clean/flush a wound from superior to inferior (proximal to distal on appendages) to enlist gravity to carry the contaminated solution away from the wound. Well that, and she said it was easier to predict where it would flow. :)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Ok...the facility I know still uses top to bottom clean to dirty ....it is important to follow the policy/preference of the facility.

In reference to the question....

Patient has midline abdominal incision and requires daily dressing changes. Which principle of asepsis would be most important to follow when cleansing the wound.

The answer is clean from proximal to distal using the midline, far side, near side priniciple.

It describes aseptic technique

proximal to distal: top to bottom...clean to dirty

midline: suture line

far side: furthest away from you

near side : closest to you

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Hello everyone,

I had a question on our test that a patient is telling the nurse that her husband hits their children what shud the PN do?

a. Report it

b. Document it

I don't remember the other options

I know we need to report child abuse but we haven't witnessed it yet I don't know do we report it or document it

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