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7313/7333 Bringman > 1.21 Differentiating Ulcers > Flashcards

1.21 Differentiating Ulcers Flashcards

1
Q

arterial ulcers: predisposing factors

A
  • diabetes
  • atherosclerosis
  • Raynaud’s
  • smoking
  • PVD
  • sedentary lifestyle
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2
Q

venous ulcers: predisposing factors

A
  • PVD
  • chronic venous insufficiency
  • diabetes
  • lack of exercise
  • obesity
  • pregnancy
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3
Q

diabetic ulcers: predisposing factors

A

diabetes

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4
Q

What are diabetic ulcers also referred to as?

A

neuropathic

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5
Q

arterial ulcers: anatomic locations

A
  • lateral malleolus
  • dorsum of foot
  • tips or between toes
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6
Q

venous ulcers: anatomic locations

A
  • medial malleolus

- medial aspect of leg

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7
Q

diabetic ulcers: anatomic locations

A
  • typically over WB surfaces
  • heel
  • first metatarsal head
  • dorsal metatarsal heads due to shoes
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8
Q

arterial ulcers: other features of patients

A
  • pale
  • thin
  • shiny
  • lower leg missing hair
  • thick toenails
  • fat pads die on bottom of foot
  • no dorsalis pedis pulse
  • cold
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9
Q

venous ulcers: other features of patients

A
  • dilated veins
  • swelling
  • weirdly warm
  • brawny edema
  • limb is heavy
  • activity tolerance low
  • fatigue
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10
Q

diabetic ulcers: other features of patients

A
  • excessive callus formation
  • still have a warm foot
  • thick toenails
  • may have pulses
  • subcutaneous fat pads gone as well
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11
Q

wound characteristics: margin/border

arterial ulcer

A
  • circular

- even

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12
Q

wound characteristics: margin/border

venous ulcer

A

random, heaped, irregular edges

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13
Q

wound characteristics: margin/border

diabetic ulcer

A

even, perfect ulcer (due to pressure)

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14
Q

wound characteristics: color of wound bed

arterial ulcer

A

pale with necrotic tissue

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15
Q

wound characteristics: color of wound bed

venous ulcer

A
  • granular
  • dark
  • brawny skin
  • red/ruby color
  • hemosiderin staining
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16
Q

hemosiderin staining

A
  • dark, reddish brown color due to iron

- doesn’t go back to normal

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17
Q

wound characteristics: color of wound bed

diabetic ulcer

A
  • pale

- clean base of wound

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18
Q

wound characteristics: periwound skin

arterial ulcer

A
  • necrotic tissue, pale, eschar
  • typically no slough
  • gangrene
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19
Q

wound characteristics: periwound skin

venous ulcer

A
  • yellow
  • mucousy
  • moist
  • slough
20
Q

wound characteristics: periwound skin

diabetic ulcer

A

pale, not much necrotic tissue

21
Q

wound characteristics: pain?

arterial ulcer

A

severe pain, even at rest

22
Q

wound characteristics: pain?

venous ulcer

A

none

23
Q

wound characteristics: pain?

diabetic ulcer

A
  • no pain

- slow onset cell death so they can’t feel it

24
Q

wound characteristics: exudate?

arterial ulcer

A
  • not much (dead tissue)

- no fluid (blood)

25
Q

wound characteristics: exudate?

venous ulcer

A
  • lots, heavy exudate

- waterfall, drippy

26
Q

wound characteristics: exudate?

diabetic ulcer

A

low

27
Q

wound characteristics: depth

arterial ulcer

A
  • deep

- to where blood supply should be coming from

28
Q

wound characteristics: depth

venous ulcer

A
  • very shallow

- epidermis gone, down to some of the dermis

29
Q

wound characteristics: depth

diabetic ulcer

A

deep

30
Q

Which ulcer type has the highest chance of gangrene?

A

arterial ulcer

31
Q

80% of LE ulcers are this type

A

venous

32
Q

Which ulcer type carries with it a high risk for osteomyelitis?

A

diabetic

33
Q

Which ulcer type is indicative of people who might have cellulitis?

A

arterial

34
Q

What is osteomyelitis?

A
  • bone infection

- can happen when a wound bed bottoms out at or close to the bone

35
Q

What test is used to see how well blood sugar is maintained long term?

A

A1C

36
Q

patient education: arterial ulcers

A
  • no elevation (crossing legs, tight socks, recliner with legs up)
  • stop smoking
  • activity
  • water checks before bathing with a body part that has sensation
37
Q

patient education: If they have PVD, they are at risk for arterial ulcers. What preventative measures would you educate them on?

A
  • wear shoes
  • don’t pick your nails
  • don’t compress
  • keep feet in dependent positions
38
Q

patient education: venous ulcers

A
  • elevate the foot
  • compress (as long as there’s no comorbidity), daily compression hose if skin is healthy without an active wound
  • intermittent compression device
  • any type of activity (develop more active lifestyle)
  • avoid dependent positions
39
Q

patient education: diabetic ulcers

A
  • water checks before bathing
  • daily foot inspection
  • prevention
  • proper footwear (specialty shoes)
  • controlling sugars
  • avoid pressure
40
Q

What are arterial ulcers caused by overall?

A

anything that prevents blood flow to the tissue

41
Q

What might be done for patients with PVD (surgery)?

A
  • bypass (usu saphenous vein)
    • may cause more pain after because suddenly they have blood flow
  • may have to do slice and dice amputation
42
Q

chronic venous insufficiency produces

A

varicose veins

43
Q

Why might hypertension cause venous ulcers?

A

blood pushing through, but pooling

44
Q

Why does a diabetic lose motor and sensory function?

A
  • lose circulation
  • cells die
  • function lost
45
Q

Why do diabetics form such large calluses? Should you address these?

A
  • lays down more skin to recreate the padding that gets lost

- don’t want them to fall off or remove

7313/7333 Bringman (56 decks)

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