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Integumentary > 9] Modalities > Flashcards

9] Modalities Flashcards

1
Q 
 Soften adherent necrotic tissue
 Increase blood flow and metabolic rate
 Proliferation of granulation tissue and epithelial cells
 Exudate removal to decrease infection
 Wound Cleansing
A

Whirlpool

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2
Q

Detrimental effects of whirlpool therapy

A

Maceration
Dependent position
Potential for burns
Cytotoxic additives

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3
Q

Contraindications for whirlpool (6)

A 
CHF/LE edema
Lung disease
Acute phlebitis 
Lethargy 
Gangrene
Renal failure
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4
Q

Hydrotherapy temperature

A

92-96 deg F

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5
Q

Hydrotherapy treatment time

A

10-15 min

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6
Q

 Suction, adjustable pump, hand piece, tip

 Used for cleansing and debridement

A

Pulses lavage with suction

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7
Q

Treatment time for pulsed lavage

A

10-15 min

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8
Q

Indications for pulsed lavage

A

Clean wound

Remove toxic residuals

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9
Q

Precaution of pulsed lavage

A

Tissue damage if the pressure is too high

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10
Q

2 considerations for pulsed lavage

A

Can be done at bedside

It’s expensive

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11
Q

What type of therapy is HPVC

A

Electrical stimulation

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12
Q

How does HPVC work?

A

Stimulates fibroblasts to enhance collagen and DNA synthesis

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13
Q

Increases number of receptor sites for growth factors

A

HPVC

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14
Q

 Alters the direction of fibroblast migration,
activates cells in the wound site, improves tissue perfusion, decreases edema
 Increases cutaneous oxygen transport
 Controls infection
 Stimulates wound contraction and scar healing

A

HPVC

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15
Q

Indications for HPVC (4)

A

Pressure ulcers stage 3-4

Diabetic, venous and arterial ulcers

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16
Q

Contraindications for HPVC (Estim) (9)

A 
 Osteomyelitis
 Pregnancy
 Malignancy
 Pacemaker
 Over carotid sinus or across heart
 Laryngeal musculature
 Along regions of phrenic nerve
 Over topical substances containing metal ions (remove silver dressings!)
 Over povidine iodine or mercurochrome
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17
Q

Medicare will only pay or EStim if wound is not progressing after ?

A

30 days of traditional wound care

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18
Q

In proliferation phase, whats the setting you would use?

A

(-) polarity for 1-5 days and then change it to (+) until it heals

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19
Q

What are the setting for the maturation phase?

A

Alternate every 3 days between - to +

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20
Q

Duration in min?

A

45-60 min

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21
Q

Frequency?

A

5-7x/week

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22
Q

Intensity/voltage?

A

100-150 volts

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23
Q

Where do you apply the electrode?

A

Directly over the wound

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24
Q

Do what for deeper wounds?

A

Increase distance b/w electrode and dispersive

25
Q

Do what for more shallow wounds?

A

Decrease distance b/w electrode and dispersive

26
Q

 Intermittent administration of 100% oxygen inhaled

at a pressure greater than sea level

A

Hyperbaric oxygen therapy

27
Q

Effects of hyperbaric oxygen therapy

A

Hyperoxygenation and decreases edema

28
Q

Two effects of HBOT

A

Toxin inhibition, antibiotic synergy and angiogenesis

29
Q

restoresthe body’s defense against infection;
increases the rate of killing some common
bacteria; inhibits the growth of anaerobic
organisms

A

Toxin inhibition, antibiotic synergy

30
Q

increases partial pressure ofthe oxygen tension to allow formation of the
collagen matrix and angiogenesis

A

Angiogenesis

31
Q

Indications for hyperbaric oxygen (7)

A 
 Acute burns
 Chronic wounds
 Radiation induced injury
 Necrotizing infection
 Sepsis
 Chronic osteomyelitis
 Carbon monoxide poisoning
32
Q

Major Contraindications for HBOT (4)

A

 Claustrophobia
 Pneumothorax
 COPD
 Malignant tumors

33
Q

What does NPWT stand for?

A

Negative pressure wound therapy

34
Q

Goals for NPWT? (6)

A 
 Increase blood flow
 Decrease bacteria colonies
 Able to measure and assess wound fluid
 Increases granular tissue base
 Contraction of wound
 Epithelialization
35
Q

Indications for NPWT (8)

A 
 Acute wounds
 PTW/FTW from burns
 Surgical wounds/incisions and dehiscence
 Diabetic wounds
 Venous/arterial wounds
 Pressure ulcers
 Grafts/flaps
 Enteric fistulas
36
Q

Major Contraindications for NPWT (4)

A

 Necrotic tissue with eschar/ NO SLOUGH
 Malignancy
 Exposed blood vessels or organs
 Non-enteric or unexplored fistulas

37
Q

Indicators of Ineffective V.A.C. Therapy (5)

WHEN ITS NOT WORKING:

A 
 Minimal changes in wound size
 Deterioration of the wound
 Changes in wound color
 Wound appears white, excessively moistor macerated
 Wound odors
38
Q

Intermittent/Pneumatic Compression indications (4)

A 
 Primary/Congenital Lymphedema
 Secondary Lymphedema from lymph node 
resection after cancer
 Chronic venous insufficiency, venous stasis,venous ulcers
 Reduce and control peripheral edema
39
Q

Contraindications for intermittent/pneumatic compression (6)

A 
 Phlebitis
 CHF
 PE
 Suspected DVT
 Increase of venous/lymphatic return is notdesired
 decreased sensation
40
Q

Semi-rigid dressing
 Useful in ambulatory patients to aid the calf
muscle pump mechanism (used on lower leg only)

A

Unna boot

41
Q

gauze impregnated with zinc oxide, glycerine, and calamine

A

First Unna boot layer

42
Q

gauze and/or self-adherent or compressive bandage

A

Second Unna boot layer

43
Q

 A mechanical vibration delivered at afrequency above the range of human hearing

A

Ultrasound

44
Q

Two delivery methods of ultrasound

A

Contact and no contact

45
Q

noncontact US which administers

continuous US energy via an atomized saline solution. Used for cleansing and debridement

A

MIST therapy’s system by Celleration

46
Q

What does ultrasound do? (6)

A

 Accelerates acute inflammatory phase
 Stimulates fibroblasts to secrete collagen
 Provides heat to deeper tissue prior to stretch
 Accelerates wound contraction
 Promotes strong, more elastic scars
 Increases blood flow

47
Q

Contraindications for ultrasound (8)

A 
 Thrombophlebitis
 Acute infection
 Pregnancy
 Malignancy
 Over the eye
 Hemophiliacs not covered by factor replacement
 Concurrent or post radiation
 Over bony prominence
48
Q

Ultrasound indications (9)

A 
 Colonized wounds
 Arterial & venous wounds
 Diabetic foot ulcers
 Chronic leg ulcers
 Pressure ulcers
 Burns
 Acute wounds
 Post operative wounds
 Sickle cell ulcers
49
Q

What does ultrasound use to transmit US energy?

A

Gel or sterile saline

50
Q

Used to diminish venous congestion with reattachment surgery

A

Leeches

51
Q

Saliva of leeches has?

A

Anticoagulant properties

52
Q

Selectively debride necrotic tissue

A

Maggots

53
Q

Increases tissue temperature causing an increase in blood flow

A

Electromagnetic Therapy (Diathermy)

54
Q

Use electromagnetic therapy (diathermy) with what ulcers?

A

Arterial, diabetic and pressure ulcers

55
Q

Contraindications for diathermy (electromagnetic therapy) 3 major ones!!

A

Pacemaker
Defibrillator
Any hardware

56
Q

Contraindication for Unna boot?

A

Can’t use it on someone with ABI less than 0.7 !!

57
Q

MIST is used with?

A

In conjunction with your treatment

58
Q

Wound vac not used for?

A

Malignancy
If theyre bleeding
If theyre not getting better

Integumentary (15 decks)

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