EXAM 2: Holistic Management of Wounds

Question 1

Compliance vs Adherence

Answer 1

Compliance: one way interaction where clinician directs the pt to follow instructions

Adherence: Patient freely chooses to follow suggested guidelines; THIS IS WHAT WE WANT

Question 2

Ways to promote adherence

Answer 2

• set mutually agreed upon, low risk solutions
• cutting down vs quit smoking
• educate on the why
• educate, DONT DICTATE
• give clear instructions
• teach back
• EMPHASIZE THAT PAST EXPERIENCE DOES NOT DICTATE FUTURE OUTCOMES
• inform of consequences of non adherence
• identify and remove barriers
• mirror to inspect feet

Question 3

Nutritional Screening

Question 4

Parenteral vs Enteral Nutrition

Answer 4

• Parenteral Nutrition: nutrition delivered intravenously
• Enteral Nutrition: nutrition delivered via feeding tube (OG, NG, Nasojejunal, Gastrstomy, Jejunostomy)
• some people need just supplemental nutrition this way, some need all nutrition this way

Question 5

Table 9-2 Clinical Manifestation of Possible Nutrient Deficiencies

Question 6

Nutrients required for homeostasis, repair, and regeneration

Answer 6

• water
• protein
• carbs
• fats
• vitamins & minerals

Question 7

what % of body comp is water

Answer 7

~ 60%

Question 8

what % of protein is nitrogen

what charge balance do we want and how to we measure

Answer 8

16%

positive balance by a nitrogen test which tracts food and pee all day and sends it to a lab that will measure PROTEIN IN AND NITROGEN OUT

Question 9

T or F: Obesity does not mean well nourished

Answer 9

TRUE
- they can have plenty of foot intake, but poor nutritional value

Question 10

Creatinine ???

Answer 10

measures kidney function and protein metabolism

• ESRD: they cannot excrete waste through kidney so waaste stays in the circulatory system

Question 11

Serum Albumin

Answer 11

• plasma protein that accounts for over half of all plasma proteins, therefore measure of protein deficiency and malnutrition
• LONG HALD LIFE so we dont look at it much for improved nutrition

Question 12

3rd Spacing

Answer 12

when fluid moves from vascular system (intraVascular space) into IntraStitial space (3rd space)

Question 13

what conditions have higher levels of serum albumin

Answer 13

• hepati cirrhosis
• heart failure
• malnutrition
• Chrons disease (IBD)

Question 14

Prealbumin

Answer 14

• nutrition marker that we use because it has a SHORT HALF LIFE

Question 15

BUN (blood urea nitrogen)

Answer 15

• by product of protein metabilism and indicator of kidney function

Question 16

high BUN = ________ wound healing

Answer 16

SLOWER

Question 17

Total Lymphocyte Count

Answer 17

INDIRECT measurement of nutritional status and immune function

Question 18

effects of elevated levels of Blood Glucose

Answer 18

increase risk of ulceration, infection, and impaired wound healing

Question 19

A1c

Answer 19

-average blood glucose levels over 3 months

KNOW THE CHART VALUES