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Acute > Braces/Wound Care > Flashcards

Braces/Wound Care Flashcards

1
Q

What motions does a Philadelphia brace restrict?

A

flexion and extension restriction

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2
Q

What motions do the aspen and miami J brace restrict?

A

rotation and lateral flexion as well as flexion and extension

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3
Q

What is the ultimate restriction device for cervical mobility?

A

halo - screwed into head

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4
Q

Do’s and Don’ts of pillows during positioning

A

DO: float heels, elevate UE, use for sidelying, prevent ER in supine

DON’T: place under knees, keep neck flexed

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5
Q

What cushion provides good stability but worst for pressure relief?

A

foam

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6
Q

What cushion has moderate pressure relief?

A

gel

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7
Q

What cushion provides best pressure relief but has the least stability?

A

air flow chamber

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8
Q

Wounds that are partial-thickness that only go into layer of dermis are _________. Deep wounds are considered _________. Why?

A

partial-thickness - very painful - nerves are in dermis

deep wounds - painless

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9
Q

Which type of wound will have decreased pedal pulse and which type of wound has pedal pulse present?

A

decreased pedal pulse - arterial

pedal pulse present - venous

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10
Q

Which type of wound will have wet wounds and which type of wound has dry wounds?

A

wet wounds - venous

dry wounds - arterial

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11
Q

arterial wound characteristics (6)

A
  • decreased pedal pulse
  • intermittent claudication
  • anteriolateral foot/ankle, toes
  • full thickness w/ well defined borders
  • dry
  • shiny, anhydrous, pale
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12
Q

venous wound characteristics (5)

A
  • pedal pulse present
  • LE edema
  • irregular shaped, shallow wound
  • wet
  • trophic changes
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13
Q

diabetic foot ulcer characteristics (5)

A
  • absent pedal pulse
  • painless w/ decreased temp
  • located at pressure points of foot/toes
  • pale and dry
  • trophic changes
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14
Q

pressure injury characteristics (4)

A
  • pulse intact
  • painful if sensation intact
  • varying depth and appearance
  • stage 1-4
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15
Q

What type of wound heals rapidly through regeneration of the epithelial cells?

A

superficial

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16
Q

Which wound involves dermal layers and is associated with vessel damage?

A

partail thickness

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17
Q

Which wound involves subcutaneous fat and deeper and takes the longest to heal?

A

full-thickness

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18
Q

stage 1 pressure wound

A

Intact, reddened skin that does not lighten when palpated

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19
Q

stage 2 pressure wound

A

Partial thickness with exposed, viable dermis; no slough (yellow) or eschar (black crusty) – have open wound

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20
Q

stage 3 pressure wound

A
  • full thickness
  • slough and eschar present
  • tunneling, undermining, epibole - rolled edges
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21
Q

stage 4 pressure wound

A
  • full-thickness w/ exposed muscle, fascia, bone, etc
  • tunneling, undermining, epibole - rolled edges
  • slough, eschar
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22
Q

unstageable pressure injury

A

Slough/eschar covers full-thickness wound, unable to detect depth

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23
Q

deep tissue pressure injury

A

Intact or nonintact skin appearing as non-blanchable red, maroon, or purple in color.

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24
Q

acute vs chronic wounds

A

acute - known cause and goes through proper recovery stages

chronic - result from underlying condition and does not go through recovery stages

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25
Q

epibole

A

rolled over edge w/ dry skin

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26
Q

hyperkeratosis

A

excess of skin

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27
Q

serous, serosanguineous, sanguineous, purulent

A

serous - clear

serosanguineous - mix of blood

sanguineous - bloody

purulent - pus

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28
Q

What is critical colonization? What is required?

A

bacteria is replicating and antibiotics are required

29
Q

sharp debridement

A

carefully cut off part of wound

Non-selective

30
Q

autolytic debridement

A

dressing placed on wound and body natural enzymes used
- moisture accumulates, old tissue swells up and separates from the wound

Selective

31
Q

enzymatic debridement

A

add certain enzymes to dressing

Selective

32
Q

mechanical debridement

A

dry dressing put on and soaks up wound and then ripped off

Non-selective

33
Q

What braces limit spinal flexion and are used for a compression fracture on anterior part of the vertebrae?

A

Jewett and CASH brace

34
Q

Sterile vs clean technique

A

sterile - sterile field, equipment, PPE and for high-risk patients

clean - clean gloves, clean field and for non-immunocompromised patients

35
Q

What is the Braden scale? Scoring?

A
  • asses wound risk
  • lower score = more risk (max score 18)

Sever risk < or = 9
High risk 10-12
Moderate risk 13-14
Mild risk 15-18

36
Q

repositioning schedules for bed and chair

A

bed - every 2 hours

chair - every 1 hour and weight shifts every 15 min

37
Q

Braden scale 6 risk factors

A
  • sensory perception
  • moisture
  • activity level
  • mobility level
  • nutrition
  • friction/shear
38
Q

What is used to assess protein metabolism or nutritional status of a patient?

A

nitrogen-balance study

39
Q

Physical signs of dehydration (6)

A
  • dry skin
  • cracked lips
  • decreased BP
  • increased pulse rate
  • constipation
  • concentrated urine
40
Q

Clinical signs of dehydration (5)

A
  • increased lab values
  • decreased BP
  • increased pulse rate
  • constipation
  • concentrated urine
41
Q

Pressure ulcer “Dos and Don’ts”

A

Do – skin checks, proper nutrition, position changes

Don’t – oily soaps/lotions, wrinkled sheets

42
Q

Colonization vs Infection

A

Colonization – group of organisms living together in body prior to tissue invasion not causing infection

Infection – invasion of tissues by microorganisms resulting in systemic reaction

43
Q

3 signs of infection

A
  • local and systemic symptoms
  • contamination and bacterial balance
  • clinical abnormalities
44
Q

surface swab culturing

A

cleansing wound w/o antiseptic solution

45
Q

Needle aspiration

A

needle into tissue to aspirate fluid that contains organisms

46
Q

Tissue biopsy

A

removal of tissue w/ scalpel or punch biopsy

47
Q

benefits of a moist wound bed

A
  • communication amongst cells
  • communication w/ growth factors
  • construction of collagen
  • migration of new epithelium
48
Q

steps to the healing process of wound

- What type of wounds is this done for?

A

injury - hemostasis (stopping of bleeding) - inflammation - proliferation - repair and remodeling - scar maturation

Only done for partial or full-thickness wounds

49
Q

What are the barriers to healing in a chronic wound?

A
  • Longer healing time w/ timelines based on wound site, cause of wound, and age/physical condition of patient
  • Inflammatory process persists and wound immune defense is impaired
  • Healing process stagnates and may require active wound treatment
50
Q

What are the four primary types of chronic wounds?

A
  • Pressure ulcers
  • Venous ulcers
  • Arterial ulcers
  • Diabetic ulcers
51
Q

Which type of chronic wound occurs from prolonged pressure, usually on a bony prominence?

A

pressure ulcer

52
Q

Which type of chronic wound has minimal drainage, often occurs on the toes or dorsum of the foot, and is accompanied by a weak or absent pulse?

A

arterial ulcers

53
Q

Which type of chronic wound most often occurs on the plantar surface of the foot, results from uncontrolled elevated blood glucose, and is a major cause of amputations?

A

diabetic ulcers

54
Q

Which type has heavy drainage, irregular wound borders, and often results in hemosiderin stains around the lower leg/ankle?

A

venous ulcers

55
Q

What are the secondary signs of infection? (7)

A
  • Delayed healing
  • Changes in color of wound bed
  • Friable (easily crumbled) granulation tissue
  • Absent or abnormal granulation tissue
  • Increase or abnormal order
  • Increased drainage
  • Increased pain at wound site
56
Q

active vs passive topical dressings

A

active - aid in changing biological or chemical environment in wound and may also have characteristics of passive dressings

passive - cover wound, maintain moisture balance, may protect form outside environment insults via physical barrier

57
Q

Negative Pressure Wound Therapy (NPWT)

A
  • Involves placing a dressing into wound cavity and applying a controlled sub-atmospheric pressure
  • Removes chronic edema, leading to increased localized blood flow and applied forces result in enhanced formation of granulation tissue
58
Q

What type of wound is contraindicated for negative pressure wound therapy?

A

ischemic wounds

59
Q

What is the desired wound appearance that indicates the development of granulation tissue?

A

red and beefy and should increase in size w/ each wound reevaluation

60
Q

what two colors indicate non-viable tissue?

A

Black/brown or yellow

61
Q

How do you measure ABI and what are ranges?

A

ankle systolic pressure over the brachial systolic pressure

normal: 0.9-1.3
mild: 0.7-0.89
moderate: 0.4-0.69
severe: <0.4

values over 1.3 are non-compressible vessels

62
Q

What are some hallmarks of superficial infections? (7)

A
  • non-healing
  • bright red granulation tissue
  • friable and exuberant granulation
  • new areas of breakdown and necrosis
  • increased exudate
  • bridging of soft tissue and the epithelium
  • foul odor
63
Q

What are some hallmarks of deep wound infections? (10)

A
  • pain
  • swelling, induration (growing hard/sclerosis)
  • erythema (>2 cm)
  • wound breakdown
  • increased size of satellite areas
  • undermining or tunneling
  • probing to bone
  • flu-like symptoms
  • anorexia
  • erratic glucose control
64
Q

What are the most common areas for diabetic ulcers?

A
  • plantar aspect of foot
  • over metatarsal heads
  • under heel
65
Q

Which classification system provides percent of risk of foot ulcer and amputation based on medical status?

A

diabetic foot risk classification

66
Q

Which classification system assesses ulcer depth along with presence of gangrene and loss of perfusion using six grades (0-5); does not fully address infection and ischemia.

A

Wagner Ulcer Classification

67
Q

Which classification system assesses ulcer depth, presence of infection and presence of signs of LE ischemia using a matrix of four grades combined with four stages?

A

University of Texas Wound Classification System

68
Q

Which classification system describes presence of infection and ischemia better and may help in predicting the outcome of the diabetic ulcer?

A

University of Texas Wound Classification System > Wagner Ulcer Classification System

Acute (14 decks)

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