CHpt 36: Wound care

Question 1

skin tear

Answer 1

break or rip in the skin that separates the epidermis from underlying tissues

Question 2

incision

Answer 2

open wound w/ clean straight edges, usually intentional from a sharp instrument

Question 3

ulcer

Answer 3

shallow,deep crater like sore of the skin or mucous membrane

Question 4

purulent drainage

Answer 4

thick,green,yellow,brown drainage

Question 5

partial-thickness wound

Answer 5

when dermis and epidermis are broken

Question 6

wound

Answer 6

break in the skin or mucous membrane

Question 7

diabetic foot ulcer

Answer 7

partial-thickness wound caused by the scraping away or rubbing of the skin

Question 8

serosanguineous drainage

Answer 8

thin,watery drainage that is blood tinged

Question 9

infected wound

Answer 9

containing large amounts of bacteria that shows signs of infection

Question 10

circulatory ulcer

Answer 10

open sore on lower legs, or feet caused by decreaed blood flow through arteries or veins

Question 11

hematoma

Answer 11

sweling that contains blood

Question 12

phlebitis

Answer 12

inflammation of a vein

Question 13

contaminated wound

Answer 13

wound with high risk of infection

Question 14

gangrene

Answer 14

condition which there’s death of tissue

Question 15

unintential wound

Answer 15

wound resulting from trauma

Question 16

arterial ulcer

Answer 16

open wound on lower legs and feet caused by poor arterial flow

Question 17

serous drainage

Answer 17

clear, watery fluid

Question 18

infected wound

Answer 18

dirty wound

Question 19

clean-contaminated wound

Answer 19

wound that occurs from surgical entry of urinary,reproductive,respiratory, gastro-intestinal system is

Question 20

chronic wound

Answer 20

wound that doesnt heal easily

Question 21

venous ulcer

Answer 21

open sore onn lower legs or feet from poor blood flow through the veins

Question 22

puncture wound

Answer 22

entry of the skin and underlying tissues may be intentional on unintentional

Question 23

intentional wound

Answer 23

wound created for therapy

Question 24

penetrating wound

Answer 24

open wound that breaks the skin and enters a body arena, organ or cavity

Question 25

dehiscence

Answer 25

seperation of wound layers

Question 26

vascular ulcer

Answer 26

aka circulatory ulcer

Question 27

edema

Answer 27

swelling caused by fluid collecting in tissues

Question 28

full-thickness wound

Answer 28

occurs when the dermis, epidermis and subcutaneous tissue are penetrated. Muscle and bone may be involved

Question 29

trauma

Answer 29

accident/violent act that injures the skin, mucous membranes, bones, and internal orgnan

Question 30

evisceration

Answer 30

seperation of the wound along w/ the protrusion of abdominal organ

Question 31

stasis ulcer

Answer 31

aka venous ulcer

Question 32

sangunienous drainGE

Answer 32

bloody drainage

Question 33

shock

Answer 33

occurs when tissues doesnt get enough oxygen

Question 34

excoriation

Answer 34

loss of epidermis by scratching or when skin rubs against skin, clothing, other materials

Question 35

ulcers of the feet are caused by…

Answer 35

decreased blood flow through arteries or veins

Question 36

a measure to prevent venous ulcers(stasis) is…

Answer 36

remind person not to sit with legs crossed

Question 37

maturation phase

Answer 37

scar gains strength. red,raised scar becomes thin and pale (day 21-3years)

Question 38

proliferative phase

Answer 38

(day 3-21) means to multiply rapidly, dcells multiply to repair the wound

Question 39

inflammatory phase

Answer 39

(3 days) bleeding stops, scab forms to protect against microbes

Question 40

during wound healing, what phase is happening when the wound is a year old

Answer 40

Maturation

Question 41

first intention (wound healing)

Answer 41

wound is closed, via glue, staples, stitches etc

Question 42

second intention(wound healing)

Answer 42

for contaminated/infected wounds. wounds are cleaned and dead tissue removed

Question 43

third intention (wound healing)

Answer 43

wound left open and closed later, combines first and second intention. Infection and poor circulation are common reasons for third intention

Question 44

whats a sign of internal hemorrhage

Answer 44

hematoma

Question 45

if you observe signs of shock or hemorrhage, you should…

Answer 45

report it to the nurse @ once

Question 46

when you are assigned to change dressings you should change your gloves when…

Answer 46

change gloves after removing old dressing

Question 47

how does a binder promote healing

Answer 47

reduce swelling, promote comfort and revent injury

Question 48

a bind should be applied w/ what amount of force…

Answer 48

firm, even pressure

Question 49

skin tears are portals for…

Answer 49

microbes

Question 50

when a person has circulatory ulcers, report any…

Answer 50

skin tears

Question 51

what two diseases are common causes of arterial ulcers

Answer 51

high BO, diabetes

Question 52

with primary healing… wound edges are held together with

Answer 52

sutures,staples,clips,glue,adhesive bandages

Question 53

when changing a dressing, what should you do if the old dressings stick to the wound

Answer 53

remove carefully

Question 54

if a person has drainage from a wound, how is it measured

Answer 54

weighing dressings by graphing them
noting the # and size of dressings
measureing amount of drainage in collection containers

Question 55

whats the purposes of transparent adhesive film dressing

Answer 55

wound keep moist

drainage