A nurse is performing a dressing change for a client who has a sacral wound using negative pressure wound therapy. Which of the following actions should the nurse take first?

A. Determine the client's pain level: Assessing pain is the first action because dressing changes, especially with negative pressure wound therapy, can be painful. Knowing the client’s pain level allows the nurse to administer analgesics if needed before the procedure, promoting comfort and cooperation and preventing procedural distress. B. Irrigate the wound with 0.9% sodium chloride irrigation: Wound irrigation is an important step in cleansing before applying negative pressure wound therapy, but it should occur after assessing and managing pain. Performing irrigation without addressing pain first can cause unnecessary discomfort and increase the client’s anxiety. C. Apply skin preparation to wound edges: Skin preparation protects the surrounding tissue from the adhesive used in negative pressure wound therapy. This step is necessary but should follow pain assessment and any analgesic administration to ensure client comfort during application. D. Don sterile gloves: Sterile gloves are required to maintain asepsis during the dressing change, but donning them should occur after assessing pain and preparing the client. Starting the procedure without first assessing and managing pain can compromise the client’s safety and experience.