Exam 2 ulcers

Question 1

Describe a stage 1 pressure ulcer

Answer 1

Intact skin with non-blanching redness

Question 2

Describe a stage 2 pressure ulcer

Answer 2

shallow, open ulcer with red-pink wound bed

Question 3

Describe a stage 3 pressure ulcer

Answer 3

full-thickness tissue with visible cutaneous fat

Question 4

Describe a stage 4 pressure ulcer

Answer 4

full-thickness tissue loss with exposed muscle and bone

Question 5

What is the key nutritional component of ulcer healing

Answer 5

Protien, 1-1.5 g/kg/day

Question 6

Should you debride a stage 1 pressure ulcer?

Answer 6

NO

Question 7

What is the main concern of a stage 1 pressure ulcer

Answer 7

Removing the cause of the ulcer

Question 8

How do you clean a stage 2 pressure ulcer?

Answer 8

saline flush

Question 9

Should you debride a stage 2 pressure ulcer?

Answer 9

NO

Question 10

Central concern with a stage 2 ulcer

Answer 10

provide moist wound bed, keep surrounding tissue dry

Question 11

Should you debride a stage 3 pressure ulcer?

Answer 11

Yes, if eschar or slough is present

Question 12

What are ways to debride a stage 3 pressure ulcer?

Answer 12

autolytic debridement, wet-to-dry bandages, enzymatic solutions, surgery

Question 13

How to clean a stage 3 ulcer?

Answer 13

saline flush

Question 14

What is the central issue with a stage 3 pressure ulcer?

Answer 14

debride necrotic tissue, protect granulation tissue

Question 15

Should you debride a stage 4 pressure ulcer

Answer 15

yes, all necrotic tissue

Question 16

What is the central concern of a stage 4 ulcer?

Answer 16

patience, pain control, possible end of life talk

Question 17

What is the most common cause of lower extremity ulcers?

Answer 17

venous (90+%)

Question 18

Where is the most typical place for a venous pressure ulcer?

Answer 18

medial malleolus

Question 19

What is the classic sign of a venous ulcer?

Answer 19

Chronic adema will not diurese, tender upon palpation

Question 20

What is the pathophysiology of a venous ulcer?

Answer 20

Valves between low and high pressure system breaks, increasing venous pressure in superficial veins, causing them to break

Question 21

Risk factors for venous ulcers

Answer 21

Overload: CHF, obesity, Obstruction: clot, tumor, “pump” malfunction, neuro dysfunction, injury, inactivity

Question 22

what is the treatment for a venous ulcer?

Answer 22

same cleansing as a pressure ulcer, same debridement, control edema, external pressure

Question 23

What is often an underlying disease that accompanies arterial ulcers?

Answer 23

Diabetes

Question 24

What does an arterial ulcer look like?

Answer 24

circumscribed, “punched-out” ulcers, often multiple, absent pulses, claudication ( muscle pain in area with activity)

Question 25

Where do arterial ulcers usually occur?

Answer 25

least perfused areas: lateral malleolus, tibia, feet/toes

Question 26

What is the measurement for arterial ulcer risk?

Answer 26

Ankle-brachial index (ABI): Normal: 1, 0.8=claudication, 0.4= pain at rest

Question 27

What is Buerger's disease

Answer 27

thrombangiitis obliterans- a hypersensitivity to smoking. Occurs on young smokers' hands and feet, thrombophlebitis

Question 28

What test tests occlusion of ulnar artery?

Answer 28

Allen test

Question 29

Describe allen test

Answer 29

Make fist, mechanically block ulnar and radial arteries, release ulnar artery to see if hand turns pink. Positive test will indicate a block in ulnar artery

Question 30

Treatment of arterial arteries

Answer 30

NO external compression, quit smoking, revascularization, skin graft or amputation

Question 31

Should you provide external pressure to an arterial artery?

Answer 31

NO

Question 32

Where are the most common areas for a neurotropic ulcer

Answer 32

Plantar aspect of foot or toes

Question 33

What does a neurotrophic ulcer look like?

Answer 33

often callused with just a small pin prick in the middle- upon opening it's an ulcer

Question 34

What does the treatment of neurotrophic ulcers look like?

Answer 34

Protection: change footwear, total contact cast, recombinant platelet-derived growth factor, diabetes menagement

Question 35

What are some special cases that cause ulcers

Answer 35

pyoderma gangrenosum, cancer (basal cell carcinoma, squamous cell carcinoma)

Question 36

What does a pyoderma gangrenosum ulcer look like?

Answer 36

margins are serpiginous and elevated, edges are blue or purple hue, pustule or blister precedes

Question 37

What is pyoderma grangrenosum associated with?

Answer 37

inflammatory bowel, RA, leukema, other autoimmune diseases

Question 38

How do you treat pyoderma gangrenosum?

Answer 38

Steroids (oral or injection)

Question 39

What is the most common skin cancer?

Answer 39

Basal cell carcinoma

Question 40

What does a BCC ulcer look like

Answer 40

"heaped up" or rolled edges

Question 41

Where do BCC ulcers usually occur

Answer 41

sun-exposed areas

Question 42

What can cause a squamous cell carcinoma?

Answer 42

a previously benign ulcer

Question 43

What should you do with an SCC ulcer?

Answer 43

punch biopsy