A stage 3 pressure ulcer wound cleansing and dressing change can be exceedingly painful and appropriate pain management is vital. However, EMLA cream should not be applied to open skin. Therefore, the appropriate nursing action is to advocate for an order for IV fentanyl given 15 minutes before the procedure. Applying the medication to the intact skin around the wound will not result in effective pain management. A fentanyl patch may be necessary to provide long-term management for this patient, but the patch will not provide the acute pain management necessary for the dressing change.