- tunneling.
- dehiscence.
- undermining.
- evisceration.
An 80-year-old man with a decubitus ulcer has just been admitted to the floor. Upon assessment of the wound, the nurse notes that an area of skin under the wound extends and creates another opening in the skin 4 centimeters away. She would chart this as
Number 1 is correct.
Rationale: Tunneling occurs when a wound spreads and travels to another break or opening in the skin. Undermining is less extensive than tunneling and would not create as large an area to the decubitis ulcer. Dehiscence is the separation and disruption of previously joined wound edges. In evisceration, wound edges separate and the intestines protrude.