DM neuropathy and pressure injuries wound care exam 2

Question 1

which wound most often has copious amounts of serous drainage?

Answer 1

venous

Question 2

what type of exudate will be present in a pressure injury that indicates it is infected?

Answer 2

purulent

Question 3

when does reactive hyperemia occur?

Answer 3

after periods of ischemia

Question 4

what effect does shear forces have on capillaries?

Answer 4

they distort and break them

Question 5

what dressing is appropriate for stage 1 PIs?

Answer 5

silicone-backed foam dressing

Question 6

how long does healing take in stage 1 PIs?

Answer 6

2-3 days

Question 7

an intact serum-filled blister indicates what stage of PI?

Answer 7

stage 2

Question 8

what dressing is appropriate for stage 2 PIs?

Answer 8

hydrocolloid

Question 9

how long does a stage 2 PI take to heal?

Answer 9

23 days

Question 10

how can one tell the difference between a stage 2 and stage 3 PI on the heel?

Answer 10

presence of slough. the depth wont differ too much because the thickness of the heel isn’t substantial enough

Question 11

what range indicates moderate risk for the Braden scale?

Answer 11

13-14

Question 12

what range indicates high risk for the Braden scale?

Answer 12

10-12

Question 13

what is the range of normal A1c?

Answer 13

4 to 5.6%

Question 14

what is the common location of diabetic wounds?

Answer 14

WB surfaces. Dorsal joints of the toes

Question 15

what type of exudate is common with diabetic wounds?

Answer 15

serosanguinous

Question 16

what is stage 1 of diabetic foot ulcers?

Answer 16

callus formation

Question 17

what is stage 2 of a diabetic foot ulcer?

Answer 17

subq hemorrhage

Question 18

where will there be increased pressure if a pt has pes cavus?

Answer 18

forefoot

Question 19

what are the contraindications for the total contact cast?

Answer 19

PAD, infection, ABI < 0.7

Question 20

how often should the total contact cast be changed?

Answer 20

every week but 1-2 days at first to check the skin condition

Question 21

what wound type if most difficult for autolytic debridement?

Answer 21

arterial wounds

Question 22

how long does autolytic debridement take?

Answer 22

weeks

Question 23

what is the contra-indication for autolytic debridement?

Answer 23

infection

Question 24

what are the disadvantages of using enzymatic debridement?

Answer 24

it can cause maceration. it can become deactivated by detergents, iodine, silver and mercury

Question 25

which forms of debridement are non-selective?

Answer 25

mechanical and sharp

Question 26

what forms of debridement should you always say no to?

Answer 26

wet-to-dry and whirlpool