Exam 2 Flashcards
Chapter 6:
Management of Infection
Abcess
Localized collection of pus within body tissues
Aerobes
Bacteria that require oxygen to survive
Anaerobes
Bacteria that cannot survive in an oxygen rich environment
Antibacterial
Type of antimicrobial that is effective against bacteria
Antibiotics
Oral or intravenously delivered substance that destroyed or inhibits the growth of microorganisms
Antifungal
Type of antimicrobial that destroys yeast and molds
Antimicrobial
Substance that destroys or inhibits the growth of microorganisms
Antiseptic
Antimicrobial designed to reduce bacterial contamination on intact skin
Bactericidal
Antimicrobial agent that is capable of killing bacteria
Bacteriostatic
Antimicrobial agent that inhibits bacterial cell growth
Biofilms
Communities of microorganisms that are attached to a wound surface and encased with glycocalyx
Clean technique
Infection control procedure designed to reduce the number of microbes present and decrease the risk of infection
Colonization
Normal presence of a small number of microbes (less than 10^3 organisms/gram of tissue)
Complement system
A cascade of proteins produced by the body that enhance the body’s defense against pathologies
Contamination
Presence or anticipated presence of blood, wound fluid or other potentially infectious waste
Critical colonization
Point at which increasing would bioburden begins to adversely affect wound healing
Disinfect
To clean a surface with a antimicrobial
Fluid aspiration
Method of identifying wound infection in which a physician uses a needle to remove 1.0 mL of fluid from the wound area for analysis
Gram-negative
Method of identifying microorganisms , gram negative are not stained by crystal violet but are stained by safranin
Gram-positive
Method of identifying microorganisms, gram positive organisms are stained by crystal violet
Infection
Invasion and multiplication of microogranisms within body tissues, wound culture reveals greater than 10^5 microbes per gram of tissue
MRSA
Methicillin-resistant Staphylococcus aureus
Nosocomial Infection
An infection that is acquired while hospitalized
Resistant
A bacteria that cannot be killed by a certain antimicrobial
Sensitive
If a bacteria can be killed by a certain antimicrobial
Standard Precautions
Type of infection control that includes universal precautions, hand washing, and personal protective equipment
Sterile technique
Methods of infection control that uses only sterile equipments
Sterilization
Procedure that destroys all microbes from the area of interest
Swab Cultures
Methods to identify and quantify microbes present in a wound
Tissue Biopsy
Procedure in which a physician removes a sample of living tissue from the wound to identify infection
Universal Precautions
Type of infection control in which all blood and body fluids are considered to be contaminated
VRE
Vacomycin-resistant Enterococci
Chapter 7
Dressing Selection and Bandaging
Alginate
Absorptive wound dressing made from brown seaweed
Biologic dressings
Wound dressings derived from natural tissues
Biosynthetic dressings
Wound dressings derived from natural tissues and nonnatural tissues
Composite dressings
Multilayer dressings made from a combination of wound dressing categories
Gauze
Traditional wound dressing, woven or non woven, available in sheets, rolls, and packing strips
Granuloma
Chronic inflammation around a foreign body
Hydrocolloids
Moisture retentive occlusive wound dressing consisting of gelatin, pectin, and carboxymethylcellulose hydrophilic particles with an adhesive backing
Hydrogels
Moisture retentive would dressing that is 80-99% water or glycerin based, available in sheets and as an amorphus gel
Impregnated gauze
Mesh gauze with a topical agent such as an amorphus hydrogel or petrolatum incorporated into it
Moisture barriers
Substance used to protect the periwound and intact skin from excessive moisture. Some moisture barriers are also safe for use on rashes and broken skin
Moisture retentive dressings
Specialized synthetic or organic wound dressing
Moisture vapor transmission rate
The rate at which gas is able to escape through a moisture retentive dressing
Moisturizers
Substance used to relieve and prevent dry skin
Occlusion
The ability of a dressing to prevent transmission of moisture vapor and gases from the wound bed
Primary dressing
Wound covering that comes into direct contact with the wound bed
Secondary dressing
Wound dressing placed over the primary dressing that provides increased protection, cushioning, absorption and or occlusion
Semipermeable film
Moisture retentive wound dressing consisting of a transparent polyurethane sheet with an adhesive backing, impermeable to bacteria and water
Semipermeable foam
Moisture retentive wound dressing consisting of a polyurethane foam with or without an adhesive backing
Skin sealants
Product used on intact periwound to protect the skin from excessive moisture and or adhesives
Skin substitutes
Products used for temporary or extended skin coverage
Tissue adhesives
Also known as skin glue, over the counter alternative to sutures and staples for primary wound closure
Chapter 10
Arterial Insufficiency Ulcers
Ankle-Brachial Index
Indirect measure of peripheral perfusion, calculated as the systolic pressure of the ankle divided by the systolic pressure of the brachium. Normally .9-1.1
Arterial Insufficiency
Decreased arterial blood supply, most commonly due to arteriosclerosis
Arteriography
Invasive procedure in which radioactive dye is used to assess blood flow
Arteriosclerosis
General term for thickening and hardening of arterial walls
Artherosclerosis
Systemic, degenerative process in which the arterial lumen is gradually encroached upon by plaque formation
Capillary refill
Indicator of surface blood flow, normally less than 3 seconds
Doppler ultrasound
Instrument used to assess arterial or venous flow
Duplex scanning
Noninvasive medical test to assess peripheral blood flow, velocity and turbulence
Gangrene
Dead tissues that is dry, dark, cold and contracted, must be surgically removed
Intermittent Claudication
Activity specific discomfort due to local ischemia
Intimal Layer
Inner layer of arteries and veins composed of single endothelial cell layer
Ischemic rest pain
Burning pain due to arterial insufficiency that occurs at rest
Ischemic ulcers
Arterial insufficiency ulcer
Plethysmography
Noninvasive medical test to assess peripheral blood flow
Rubor of dependency
Test to assess arterial blood flow
Segmental pressure measurements
Serial blood pressure measurements used to localize an area of decreased arterial blood flow
Toe pressures
Test to assess digit perfusion
Transcutaneous oxygen monitoring (TCOM or TcPO2)
Test measuring tissue oxygen content
Tunica externa
Protective outer layer of arteries and veins, formerly called adventitia
Tunica media
Middle layer of arteries and veins composed of smooth muscle along with some collagen and elastin fibers
Venous filling time
Test to assess peripheral blood flow
Chapter 11
Venous Insufficiency Ulcers
Calf muscle pump
Pressure changes within the venous system in which muscle contraction forces blood proximally
Cellulitis
Inflammation of connective tissue; infection in or close to, the skin
Compression garment
Custom or off the shelf compression sleeve for venous insufficiency, lymphedema, or burn scare mgmt
Deep veins
Located within muscles, roughly parallel arterial system
Dermatitis
Inflammation of the skin associated with itching, redness, and open lesions
Fibrin cuff theory
Theory that venous insufficiency ulcers are due to the development of fibrin cuffs around the capillaries
Hemosiderin deposition
Occurs when the byproduct of the breakdown of red blood cells is forced into the interstitium by venous hypertension
Homan’s sign
Assessment technique historically used to identify a deep vein thrombosis that has been since found to be inaccurate
Laplace’s law
Formula describing the determinants of the amount of compression exerted by a bandage
Ligation
Tying off, perforating veins may be ligated to reduce hypertension in the superficial veins
Lipodermatosclerosis
Hyperpigamentation and accompanying erythema, induration and plaque-like structural changes due to long-standing venous insufficiency
Multilayer compression bandage
Compression bandage composed of many layers used for the treatment of venous insufficiency ulcers and or lymphedema
Paste bandage
Nonelastic compression bandage, such as unna’s boot
Percutaneous ablation of perforators (PAPS)
Endoscopic surgery for chronic venous insufficiency
Perforating veins
Veins that pierce the fascia to connect to deep and superficial venous system
Pruritus
Severe itching
Respiratory pump
Pressure changes within the venous system in which inspiration and expiration force blood toward the heart
Sclerotherapy
Injection of an agent to fibrose dysfunctional veins
SEPS procedure
Endoscopic surgery for chronic venous insufficiency
Short-stretch compression wrap
Compression wrap with low resting pressure and little distensibility
Superficial veins
Veins located within the subcutaneous tissue, assist with temperature regulation
Trendelenburg test
Test to identify vein incompetence
Tubular bandage
Off the shelf sleeves to provide compression
Varicosity
Dilated vein. In addition to increased lumen size, varicosities typically entail increased vessel length and tortuosity
Vasopneumatic compression device
Pneumatic device consisting of a bilayered sleeve to provide compression
Vein stripping
Surgical resection of veins
Venography
Invasive procedure in which radioactive dye is used to assess venous blood flow
Venous hypertension
Increased backward pressure within the venous system
Venous stasis ulcer
Ulcer caused by venous insufficiency
White blood cell trapping theory
Theory that venous insufficiency ulcers are due to activated white blood cells within the interstitium
Chapter 11
Pressure Ulcers
Air-fluidized pressure-relieving device
Dynamic pressure relieving support surface
Alternating pressure-relieving device
Dynamic pressure relieving support surface
Bottoming out
Occurs when there is less than 3/4 to 1 inch of support material between the patient and support surface
Capillary closing pressure
Amount of external pressure that must be applied to prohibit capillary blood flow, generally 13-32 mmHg
Dynamic support surface
Electric device that uses currents of air or fluid to redistribute pressure across the body
Fluid-filled pressure-reducing device
Static pressure reducing support surface made of air, water or gel
Foam pressure-reducing device
Static pressure reducing support surface appropriate for patients with low risk for ulcer development
Friction
When two surfaces move across one another
Hand check
Method to assess for bottoming out by placing outstretched hand palm up between the support surface and patient
International NPUAP/EPUAP Pressure Ulcer Classification System
Classification system for pressure ulcers updated in 2009
Ischemia reperfusion injury
Repeated bouts of localized tissue ischemia from pressure or peripheral arterial disease and reperfusion that may cause gradual, progressive tissue damage
Low-air-loss-pressure-relieving device
Dynamic pressure relieving support surface
Chapter 13
Neuropathic Ulcers
Autonomic neuropathy
Dysfunction of the autonomic nervous system that may result from uncontrolled diabetes
Charcot foot
Neuropathic fracture/dislocation found in patients with diabetes, most commonly resulting in a rocker bottom foot deformity
Incision and drainage
Procedure in which an abscess is surgically opened and thoroughly irrigated
Motor neuropathy
Dysfunction of the motor nerves leading to atrophy, weakness and or paralysis
Neuropathic ulceration
Ulcer due to insensitivity; previously referred to as a diabetic ulcer
Padded ankle-foot orthoses
Method of treating neuropathic ulcers, removable brace that reduces plantar pressure and immobilizes the ankle and foot
Sensory neuropathy
Dysfunction of sensory nerves leading to an altered or decreased sensation
Total contact cast
Modified short leg cast used to treat uninfected grade 1 or 2 plantar neuropathic ulcers
Wagner classification system
Classification system for neuropathic ulcers
Walking splint
Bivalved total contact cast used to treat neuropathic ulcers
