A charge nurse is called to a client's room after a staff nurse reports a client has had a wound evisceration. Which of the following actions should the charge nurse take?

Wound evisceration is a surgical emergency in which abdominal organs protrude through an open incision, typically due to increased intra-abdominal pressure or wound dehiscence. This condition requires immediate intervention to protect exposed organs from drying, infection, and further injury. Nursing priorities focus on maintaining tissue viability, preventing contamination, and preparing the client for emergency surgical repair. Rapid, appropriate initial actions are critical to reduce complications. A. Obtaining warm, sterile 0.9% sodium chloride solution is the correct initial action because exposed abdominal viscera must be kept moist and sterile to prevent tissue desiccation and infection. Covering the organs with sterile saline-soaked dressings helps protect them until surgical intervention can be performed. This is a priority stabilization measure in wound evisceration. B. Attempting to reinsert the protruding viscera is contraindicated because it can cause further injury, contamination, and rupture of abdominal organs. The nurse should never manipulate or replace eviscerated organs. Instead, the area should be covered with sterile, moist dressings and surgical assistance should be obtained immediately. C. Applying a firm pressure dressing across the client’s abdomen is incorrect because pressure can damage exposed organs and increase intra-abdominal pressure. This may worsen tissue injury and compromise blood flow to the eviscerated structures. Gentle coverage with moist sterile dressings is the appropriate intervention instead of compression. D. Placing the client in a left lateral recumbent position is not appropriate for managing wound evisceration. The recommended position is typically supine with knees flexed to reduce tension on the abdominal incision. This positioning helps decrease strain on the wound while awaiting surgical repair.