Compression Therapy: General & Bandages

Question 1

abnormalities = interstitial edema

all could be due to what -

Answer 1

1. unregulated BP
2. plasma proteins imbalance
3. lymphatic flow obstruction
4. venous insufficiency

Question 2

localized edema

Answer 2

associated with conditions such as venous insufficiency, lymphatic blockage, and prolonged dependency, localized inflammation

Question 3

where does localized edema occur

Answer 3

discrete areas of body

Question 4

systemic or general edema

Answer 4

associated with systemic conditions such as CHF, hypoalbuminemia, kidney dysfunction

Question 5

systemic or general edema occurs where

Answer 5

more broad, non-discerning edmatous pattern

Question 6

consequences of edema

Answer 6

decreased ROM
functional limitations
decreased somatosensory input (fall risk)
pain
increased collagen leading to fibrosis
ultimately may lead to contracture, increased risk of infx, amputation

Question 7

when assessing edema, what does softer thickening tend to be associated with

Answer 7

new onset, acute symptoms

Question 8

pitting edema

Answer 8

thick and slow moving

indentation remains following removal of pressure source

Question 9

pitting edema scale 
1+
2+
3+
4+

Answer 9

1+: barely detectable depression when finger is depressed into the skin
2+ slight indentation, 15sec rebound
3+ deeper indentation, 30sec rebound
4+ >30sec rebound

Question 10

volumetric measurement for assessing edema

Answer 10

measure water displaced in a marker volume container which will easily accomodate the extremity, partially filling the container with water and immersing the extremity to a known anatomical landmark

Question 11

linear measurement for assessing edema

Answer 11

tape measure

- key is to keep them the same each time they are measured, and compare involved to uninvolved

Question 12

what is edema reduction is effected by what

Answer 12

1. improved venous and lymphatic circulation
2. physical barried to limit the size and shape of the tissue
3. increased tissue temp

Question 13

compression uses

Answer 13

1. improve fluid balance, increased venous & lymph return, reducng vascular or lymphatic edema
2. DVT prevention
3. shaping of limb
4. proven to facilitate healing
5. manual massage/drainage = mechanical compression
6. sometimes daily use

Question 14

goald and indications for compression therapy

Answer 14

1. amputation - molding limb
2. decrease chronic edema
3. lymphedema management
4. stasis ulcer
5. venous insufficiency
6. subacute injuries

Question 15

contraindications

Answer 15

• trauma/fx
• acute DVT
• completely obstructed lymph or venous return
• arteria disease/insufficiency
• arterial revascularization
• acute pulmonary edema
• loss of sensation
• edema with cardiac or renal impairment
• impaired cognition
• infxn in treatment area
• hypoproteinemia

Question 16

precautions

Answer 16

• decreased sensation
• malignancy
• uncontrolled HTN
• over area of superficial peripheral n.

Question 17

static compression

Answer 17

exerting a continous or constant force

Question 18

intermittent compression

Answer 18

exerting a varying force over time

milking mechanism from distal to proximal

Question 19

what is applied when elastic properties of the bandage are stretched in application

Answer 19

resting pressure

it remains whether patient moves or remains still (ace bandages)

Question 20

highly extensible bandages

Answer 20

provide high resting pressures when stretched with application, but typically provide very low working pressure
- apply daily

Question 21

relatively inelastic bandages

Answer 21

provide low resting pressure but high working pressure

Question 22

pros of highly elastic bandages

Answer 22

inexpensive
readily available
easily removed
patient/care giver can be trained to install

Question 23

cons of highly elastic bandages

Answer 23

• corrent and incorrect application
• may slide down the extremity
• difficult to apply even tension
• quickly loose their elastic properties
• requires pt to be able to reach area to be wrapped/unwrapped if they do not have a caregiver to help

Question 24

low stretch bandage pros

Answer 24

apply to extremity PRN to control edema

• higher working pressure generated, rather than resting pressure
• still relatively inexpensive
• easily removed
• pt/care giver can be trained to install
• more fool-proof for application of compressive forces

Question 25

low stretch bandage cons

Answer 25

• not as effective at removing edema as highly elastic bandages
• less comfortable
• corrent/incorrect application
• requires pt to be able to reach area to be wrapped/unwrapped
• less readily available

Question 26

semi-rigid bandages

Answer 26

apply every 4-7 days to extremity after edema has been removed by other means

Question 27

semi-rigid bandages pros

Answer 27

useful for less compliant patients, remains in place

eliminates daily dressing changes

Question 28

semi-rigid bandages cons

Answer 28

must be protected from environment
long term applications allows for pressure areas if not correctly applied
patient may be unable to remove easily if discomfort occurs

Question 29

precautions for bandages

Answer 29

propensity to be discharging to facility, unfamiliar with use of multi-layer dressing
frail skin
bony prominences

Question 30

contraindications for bandages

Answer 30

• pt with arterial disease
• pt inability to remove bandage
• allergy to component
• active wound infxn
• active cellulitis