Difficulty: Medium
Average Score: 92%
Simulated
The nurse is providing postoperative care for the client with a split-thickness skin graft on the burn wound at the sole of the right foot. Which is appropriate care for this client?
Correct answer
A
Rationale
The graft must be immobilized so that it can remain in place and be able to revascularize. The client cannot place weight on the graft site. Bearing weight causes trauma. A dependent position impairs circulation and may cause further tissue injury.