A nurse is assisting in caring for a client who has an abdominal surgical incision and notes an evisceration. Which of the following actions should the nurse take?

Evisceration is a surgical emergency in which abdominal organs protrude through a dehisced incision. It most commonly occurs after abdominal surgery due to increased intra-abdominal pressure or wound failure. Immediate nursing actions focus on protecting exposed organs, preventing further injury, and preparing for surgical intervention. Positioning is critical to reduce tension on the incision and minimize additional protrusion of abdominal contents. Rationale: A. Placing the client in a supine position with knees flexed helps reduce strain on the abdominal incision and decreases tension on the exposed organs. Flexing the knees relaxes abdominal muscles, minimizing further evisceration. This position is the immediate priority to stabilize the situation while awaiting surgical intervention. B. Semi-Fowler’s position increases pressure on the abdominal cavity due to gravitational force and may worsen organ protrusion. This position places additional strain on the surgical incision and is therefore contraindicated in cases of evisceration. Immediate reduction of abdominal tension is the priority. C. Covering the wound with a transparent dressing is not appropriate because it does not adequately protect exposed abdominal organs. Evisceration requires sterile, moist, and bulky dressings to prevent tissue drying and contamination. Transparent dressings do not provide sufficient coverage or moisture maintenance. D. Covering the wound with a dry sterile dressing is also incorrect because exposed abdominal organs must be kept moist to prevent tissue desiccation and necrosis. Dry dressings can cause damage to protruding tissues. Instead, sterile gauze soaked in sterile saline is typically used to cover the site.