Chapter 32

Question 0

What are some procedures you would use surgical asepsis?

Answer 0

Inserting a urinary catheter, sterile dressing change, preparing injectable medications

Question 1

True or false

Those who are immunosuppressive more often than not become infected by organism harbored in their own body

Answer 1

True

Question 2

True or false

A sterile item should be covered if it is not used immediately

Answer 2

True

Question 3

How long are solutions considered sterile after being opened ?

Answer 3

24 hours

Question 4

Wound classification

Answer 4

Partial thickness: all or a portion of the dermis is intact

Full thickness: the entire dermis, sweat glands and hair follicles are severed

Complex: The dermis and underlying subcutaneous fat tissue or damaged or destroyed

Question 5

Primary intention

Answer 5

Intentional wounds with minimal tissue loss such as those made by surgical incision with sutured approximated edges usually heal by primary intention

Question 6

Secondary intention

Answer 6

Wounds healed by secondary intention have edges that are not well approximated. Large open wounds from Burns or major trauma which require more tissue replacement and are often contaminated commonly heal by secondary intention

Question 7

Tertiary intention

Answer 7

Wounds healed by tertiary intention are those ones left open for several days to allow edema or infection to resolve or exudate to drain and then are closed

Question 8

What are the 4 phases of the wound healing process

Answer 8

1. Hemostasis
2. Inflammation
3. Proliferation
4. Maturation

Question 9

When does hemostasis occur?

Answer 9

Hemostasis occurs immediately after the initial injury. Involved blood vessels constrict and blood clotting begins. Exudate forms, this causes swelling and pain

Question 10

What is the inflammatory phase?

Answer 10

The inflammatory phase follows hemostasis and last about 4 to 6 days. WBCs, primarily Leukocytes and macrophages move to the wound. Macrophages not only ingest debris it also released growth factors that are necessary for growth of new cells and blood vessels

Question 11

What is the proliferation stage?

Answer 11

The proliferation phase is also known as the fibroblastic, regenerative, or connective tissue phase. The proliferation phase last for several weeks. New tissue called granulation tissue is formed.

Question 12

What is the maturation phase?

Answer 12

The final stage of healing begins about three weeks after injury possibly continuing for months or years. This is when a scar forms

Question 13

What is desiccation?

Answer 13

Dehydration

Question 14

What is maceration?

Answer 14

Over hydration

Question 15

What plays an important part in the proliferation of cells?

Answer 15

Zinc

Question 16

What vitamins are essential for epitheliazation and collagen synthesis?

Answer 16

Vitamin A and C

Question 17

What is dehiscence?

Answer 17

Dehiscence is the partial or total separation of wound layers as a result of excessive stress on wounds that are not healed

Question 18

What is the most serious complication of dehiscence?

Answer 18

Evisceration

Question 19

What is the first thing you do if dehiscence occurs?

Answer 19

Cover the wound area with sterile towels moistened with sterile 0.9% sodium chloride solution

Question 20

What is a fistula ?

Answer 20

I fistula is an abnormal passage from an internal organ to the outside of the body or from one internal organ to another

Question 21

What is a pressure ulcer?

Answer 21

The pressure ulcer is a world with the localized area of tissue necrosis

Question 22

What two mechanisms contribute to pressure ulcer development?

Answer 22

1. External pressure that compresses blood vessels

2. Friction and sheering forces that tear and injure blood vessels

Question 23

Friction vs. Shearing

Answer 23

Friction occurs when two surfaces rubbing up against each other

Sheer results when one layer of tissue slide over another layer

Question 24

Stage I and stage II

Answer 24

Stage I: intact skin with non-blanchable redness

Stage II: partial thickness loss of dermis presenting as a shallow open ulcer

Question 25

Stage III and stage IV

Answer 25

Stage III: full thickness tissue loss, subcutaneous fat may be visible

Stage IV: full thickness tissue loss with exposed bone, tendon, or muscle

Question 26

Braden scale

Answer 26

No risk: 19-23
Mild risk: 15-18
Moderate risk: 13-14
High risk: 10-12
Very high : 9 or lower

Question 27

Negative pressure wound therapy

Answer 27

Negative pressure wound therapy promotes wound healing and wound closure through the application of uniform negative pressure on the wound bed, reduction in bacteria in the wound, and remove all of excess wound fluid, while providing a moist and healing environment