Exam 2: Chapter 8 Flashcards

1
Q

What are the extrinsic factors that affect wound healing in acute surgical wounds

A
  1. preoperative period
  2. intraoperative period
  3. postoperative period
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2
Q

What are things to consider during the preoperative period

A

The length of hospital stay prior to surgery, preparation of the operative site, and prophylactic antibiotics

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3
Q

What are the different types of surgeries

A

clean
clean-contaminated
contaminated
dirty or infected

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4
Q

True or false:

The longer you stay in the hospital, the higher risk you have of developing an infection

A

true

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5
Q

What class of surgery is considered clean

A

class 1

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6
Q

What class of surgery is considered clean-contaminated

A

class 2

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7
Q

What class of surgery is considered contaminated

A

class 3

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8
Q

What class of surgery is considered dirty or infected

A

class 4

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9
Q

Which type of surgery is defined by nontraumatic injuries, no inflammation or break in sterile field

A

Clean or class 1

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10
Q

What types of procedures are considered clean or class 1

A

Exploratory, mastectomy, THR, or vascular surgery

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11
Q

What type of surgery is defined by involving the GI or respiratory tract

A

Clean-contaminated or class 2

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12
Q

What types of procedures are considered clean-contaminated or class 2

A

Bronchoscopy or small bowl resection

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13
Q

Which type of surgeries are defined as having a major break in sterile technique and a gross GI spillage

A

contaminated or class 3

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14
Q

What types of procedures are considered to be contaminated or class 3

A

appendicitis, cholecystectomy, diverticulitis

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15
Q

What types of surgeries are defined to have acute bacterial inflammation along with pus and devitalized tissue

A

dirty/infected or class 4

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16
Q

What types of procedures are considered to be dirty/infected or class 4

A

drainage of abscess, perforated bowel, and peritonitis

17
Q

Who is in control during the intraoperative period

A

the surgeon

18
Q

What are factors during the intraoperative period that will affect wound healing

A

Duration of the surgery, obesity, incision tension, comorbidities, type of wound closure

19
Q

What type of wound closure is used on surgical wounds

A

primary intention with sutures and staples

20
Q

True or False:

Stress of surgery activates the parasympathetic nervous system

A

False: It activates the sympathetic nervous system

21
Q

What are things to consider during the postoperative period that will affect surgical wound healing

A

vasoconstriction, hypoxia, hypothermia, pain, hypovolemia

22
Q

What are the intrinsic factors that affect wound healing in acute surgical wounds

A
age
concurrent conditions
nutritional status
oxygenation perfusion
stress and pain
23
Q

During the assessment and management of an acute surgical wound, what should we be examining

A

the location, linear measurements, observe tissue for resurfacing, closure, exudate and palpate incision for collagen deposition and health of surrounding tissue

24
Q

What are the two types of surgical dressings

A

primary and secondary

25
Q

Describe primary dressing

A

the dressing that touches the wound

26
Q

Describe secondary dressing

A

goes over the primary dressing

27
Q

True or False:

Surgical wounds go through the same healing phase as other wounds

A

true

28
Q

Surgical wounds are best evaluated using ____ since the surgery

A

time

29
Q

Postoperative days __-__ show signs of inflammation, blood exudate that changes to sanguineous, epithelia resurfaces, and exudate decreases

A

days 1-4

30
Q

Postoperative days __-__ show signs of healing ridges along entire incision, wound exudate changes to serous, exudate disappears, and suture material begins to be removed

A

Days 5-9

31
Q

Postoperative days __-__ involves the removal of remaining external suture material

A

10-14

32
Q

Postoperative days __-__ is when collagen realigns and strengthened, color of incision changes from bright pink to fading pink or silvery gray, healing ridge softens, and functional ability of scar

A

days 15 to 1-2 years

33
Q

When do I refer-
Significant increase of bloody ____
exudate that changes from serosanguineous to ____
Increased exudate after day ___
____ of healing ridge
Signs of local wound infection after day __

A
exudate
purulent
4
absence
4
34
Q

When do I refer-
Signs of ____ infection such as high temp, high WBC, and confusion
Frank wound _____
____ formation

A

systemic
dehiscence
fistula