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Skin/MSk > Exam 2 ulcers > Flashcards

Exam 2 ulcers Flashcards

1
Q

Describe a stage 1 pressure ulcer

A

Intact skin with non-blanching redness

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2
Q

Describe a stage 2 pressure ulcer

A

shallow, open ulcer with red-pink wound bed

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3
Q

Describe a stage 3 pressure ulcer

A

full-thickness tissue with visible cutaneous fat

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4
Q

Describe a stage 4 pressure ulcer

A

full-thickness tissue loss with exposed muscle and bone

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5
Q

What is the key nutritional component of ulcer healing

A

Protien, 1-1.5 g/kg/day

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6
Q

Should you debride a stage 1 pressure ulcer?

A

NO

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7
Q

What is the main concern of a stage 1 pressure ulcer

A

Removing the cause of the ulcer

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8
Q

How do you clean a stage 2 pressure ulcer?

A

saline flush

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9
Q

Should you debride a stage 2 pressure ulcer?

A

NO

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10
Q

Central concern with a stage 2 ulcer

A

provide moist wound bed, keep surrounding tissue dry

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11
Q

Should you debride a stage 3 pressure ulcer?

A

Yes, if eschar or slough is present

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12
Q

What are ways to debride a stage 3 pressure ulcer?

A

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

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13
Q

How to clean a stage 3 ulcer?

A

saline flush

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14
Q

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

A

debride necrotic tissue, protect granulation tissue

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15
Q

Should you debride a stage 4 pressure ulcer

A

yes, all necrotic tissue

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16
Q

What is the central concern of a stage 4 ulcer?

A

patience, pain control, possible end of life talk

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17
Q

What is the most common cause of lower extremity ulcers?

A

venous (90+%)

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18
Q

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

A

medial malleolus

19
Q

What is the classic sign of a venous ulcer?

A

Chronic adema will not diurese, tender upon palpation

20
Q

What is the pathophysiology of a venous ulcer?

A

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

21
Q

Risk factors for venous ulcers

A

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

22
Q

what is the treatment for a venous ulcer?

A

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

23
Q

What is often an underlying disease that accompanies arterial ulcers?

A

Diabetes

24
Q

What does an arterial ulcer look like?

A

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

25
Q

Where do arterial ulcers usually occur?

A

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

26
Q

What is the measurement for arterial ulcer risk?

A

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

27
Q

What is Buerger’s disease

A

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

28
Q

What test tests occlusion of ulnar artery?

A

Allen test

29
Q

Describe allen test

A

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

30
Q

Treatment of arterial arteries

A

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

31
Q

Should you provide external pressure to an arterial artery?

A

NO

32
Q

Where are the most common areas for a neurotropic ulcer

A

Plantar aspect of foot or toes

33
Q

What does a neurotrophic ulcer look like?

A

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

34
Q

What does the treatment of neurotrophic ulcers look like?

A

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

35
Q

What are some special cases that cause ulcers

A

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

36
Q

What does a pyoderma gangrenosum ulcer look like?

A

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

37
Q

What is pyoderma grangrenosum associated with?

A

inflammatory bowel, RA, leukema, other autoimmune diseases

38
Q

How do you treat pyoderma gangrenosum?

A

Steroids (oral or injection)

39
Q

What is the most common skin cancer?

A

Basal cell carcinoma

40
Q

What does a BCC ulcer look like

A

“heaped up” or rolled edges

41
Q

Where do BCC ulcers usually occur

A

sun-exposed areas

42
Q

What can cause a squamous cell carcinoma?

A

a previously benign ulcer

43
Q

What should you do with an SCC ulcer?

A

punch biopsy

Skin/MSk (31 decks)

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