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Integumentary > Electrotherapeutic modalities > Flashcards

Electrotherapeutic modalities Flashcards

1
Q

Use of fluid to remove loosely adherent cellular debris, bacteria, wound exudate, dressing residue, and residual topical agents
-Facilitates debridement, assists with maintaining a moist environment, and enhances wound healing

A

Wound irrigation

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2
Q

Wound Irrigation Indications

A

Acceptable intervention for all types of wounds

Indicated for healing, granular wounds

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3
Q

Wound Irrigation contraindications

A

Not indicated for active, profuse-bleeding wounds

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4
Q

Wound Irrigation Method

A
  • Wound should be irrigated on IE and with each dressing change.
  • 4-15 psi
  • May be performed with soaked gauze, water-pik, syringe, pulsed lavage, whirlpool
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5
Q

Whirlpools: Form of _______mechanical debridement

A

nonselective

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6
Q

Whirlpool: 7 main purposes

A 
Debrides.
Softens necrotic/eschar.
Hydrates wound bed.
Promotes healing/circulation.
Decreases patient pain.
Eases ROM for burn injuries.
Helps soak off adherent dressings.
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7
Q

Indications:
Use on infected wounds.
Use on nondraining wounds to rehydrate wound bed with eschar, adherent necrotic tissue, or thick exudate.

A

Whirlpool

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8
Q

Whirlpool: Contraindications

A

-Can prevent wound closure.
-Dependent positioning and warm water = ^ edema.
NOT for:
-ulcers due to venous insufficiency, edema, or lymphedema
-wounds with profuse bleeding
-confused, combative, seizures.
-multiple wounds.
-Tunneling wounds, undermining, and wound in areas of skin folds.

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9
Q

Whirlpool: Immersion technique

A

Water 92-98 deg. 10-20min
twice daily to 3x/week.
Discontinue when wound is clean and granular.

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10
Q

Whirlpool: Showering technique

A

Affected area is positioned over the empty whirlpool and sprayed with water.

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11
Q

Whirlpool: use of chemical additives

A

(Chlorazene, betadine, bleach) -risks of delayed wound healing.
Don’t Use on chemical wounds.
Don’t use on young, elderly, and those with sensitivities to agents.
ONLY recommended in isolated cases

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12
Q
  • Involves regular, automatic interruption of fluid flow with handheld device to regulate irrigation pressure.
  • Applies (-)pressure to wound bed.
A

Pulsed Lavage with Concurrent Suction

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13
Q

Pulsed Lavage with Concurrent Suction: Indications

A

Cleansing or debriding wounds due to arterial or venous insufficiency, diabetes, pressure, small burns, surgery, or trauma
-tunneling or undermining wounds

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14
Q

NOT for:

  • exposed arteries, tendons, nerves, capsules, or bones.
  • body cavities, facial wounds, recent grafts or surgical procedures, or actively bleeding wounds
  • latex sensitivities or allergies

CAUTION on patients taking anticoagulants, insensate patients, and deep tunneling wounds
Irrigation with greater than 15 psi is contraindicated

A

Pulsed Lavage with Concurrent Suction: Contraindications

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15
Q

Pulsed Lavage with concurrent suction: Treatment freq varies between ___for severely infected or necrotic wounds or wounds with heavy exudate and ___times per week for granular wounds

A

BID

3x/week

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16
Q

E-stim: 7 ways it facilitates wound healing

A
  • Restores the current of injury which is thought to speed healing
  • Causes galvanotaxis
  • Stimulates cell proliferation
  • Increases blood flow
  • Increases bactericidal
  • Reduces edema
  • Facilitates autolytic debridement – use (-)
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17
Q

E-stim: indications

A
  • Adjunct for chronic wounds.

- Ulcers, traumatic and surgical wounds, and burns

18
Q

E-stim-Contraindications

A

Not for:

  • simple wounds
  • osteomyelitis
  • active bleeding
  • sensory neuropathy
19
Q

____Technique
After performing any debridement and irrigation, a saline- or hydrogel moistened gauze is placed within the wound bed and covered with ___electrode.
-The return electrode is placed in any convenient location, __cm proximally….or can be opposite side of extremity

A

Direct; (Applied directly to wound bed)
Carbon electrode
15-20cm

20
Q
  • sufficient evidence to support use for chronic. -Enhances all three phases of wound healing
  • cell membrane permeability due to the nonthermal processes
  • low frequency (25–40 kHz) in combination with saline mist (Mist Therapy).
A

Ultrasound

21
Q

Ultrasound: Indications

A
  • Chronic wounds that are clean or infected.

- Pressure wounds, venous insufficiency, acute trauma, and recent surgery

22
Q

Ultrasound: Contraindications

A
  • Presence of osteomyelitis, active bleeding, severe arterial insufficiency, and acute DVT
  • Should not be used on untreated infections.
  • In large amounts of necrosis, deliver treatment to intact periwound
  • NOT indicated for simple wounds
23
Q

US: Direct Technique

A
  • Apply directly to wound bed (use hydrogel sheet or bacteriostatic gel pads.)
  • Deep wounds-amorphous hydrogel or saline.
  • Applied over wound, periwound, and scar
24
Q

US: Periwound Technique

A
  • Applied to periwound-facilitate wound healing
  • May be beneficial for chronic leg ulcers and tunneling, necrotic, or painful wounds
  • Leave wound dressing in place which lowers risk of contamination
25
Q

US: Immersion Technique

A
  • Moving sound head is 0.5 to 1.0 cm from wound surface
  • Good for painful wounds, wounds at bony areas.
  • Disadvantages: need for dependent positioning, potential of contamination from sound head, maceration, hyperhydration.
  • Intensity should be increased by 50%
26
Q

____
It is thought to produce changes at the protein and cellular level.
Assists with wound debridement and cleansing.
Has FDA approval.
Probe is held on or above wound bed for ___seconds per cm2, with a minimum of 4 minutes for wounds less than __cm2

A

Low frequency US with saline mist

15-20 secs.
15

27
Q
  • Enhances healing in chronic, slow-healing, and acute wounds
  • Increases local blood flow, capillary filling, and lymphatic flow.
  • May approximate wound edges and facilitate contraction and closure.
A

NPWT (wound VAC)

28
Q

NPWT: Indications

A

chronic wounds and post-surgical wounds/grafts.

29
Q

NPWT: Contraindications

A

NOT for: dry wounds, necrotic wounds, wounds in body cavities, over malignancies, in presence of exposed blood vessels or untreated osteomyelitis
Caution should be used with patients on anticoagulants or wounds with active bleeding
Should not be applied immediately after an I & D

30
Q

__foam: used to increase granulation and wound contraction
__foam: increases epithelialization
Use of ___with padding of periwound area to prevent excessive pressure from tubing

A

Black
White
Skin sealant

31
Q

Hyperbaric Oxygen (HBO)

A

controversial
Best candidates: neuropathic foot ulcers
TCOM.

32
Q

HBO contraindications

A

DVT’s, CHF, COPD, pregnancy, arterial insufficiency.

NOT for simple wounds

33
Q

Dehydration will elevate serum albumin levels

A

Serum Albumin

34
Q

Prealbumin

A

Unlike albumin, levels are not affected by patient hydration.
Normal values 16–40 mg/dL

35
Q

Creatine

A

0.8-1.5

Malnutrition decreases levels

36
Q

Serum Albumin

A

3.5-5.5

low serum=pressure ulcer

37
Q

Serum Transferrin

A

<170 indicates malnutrition

38
Q

BUN

A

5-25

elevated levels=dec wound healing

39
Q

Total Lymphocyte count

A

Dec TLC= delayed wound healing and inc mortality

40
Q

Blood glucose

A

70-110

Inc levels= risk of ulceration and impaired wound healing

Integumentary (4 decks)

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