Exam 3 Review

Question 1

Braden Scale Scores and Risk Levels

Answer 1

SEVERE = less than 9
HIGH = 10 to 12
MODERATE = 13 to 14
MILD = 15 to 18

Question 2

Dressing for Stage 1 Pressure Ulcer

Answer 2

Transparent - protect against friction, contamination, 2nd skin, provides insulation, clean moist surface

Clear Absorbent Acrylic - bacterial & shearing protection, keep wound moist, transparent membrane

Question 3

Dressing for Stage 2 Pressure Ulcer

Answer 3

Hydrocolloid - absorbs exudate, moist wound bed, facilitates healing w/o causing maceration, prevent contamination & shearing

Alginate - moist wound bed, alginate + exudate = gelatinous mass, absorbs exudate

Question 4

Dressing for Stage 3 Pressure Ulcer

Answer 4

Hydrocolloid
Clear Absorbent Acrylic
Hydrogels
Alginate
Foam Dressing

Question 5

Dressing for Stage 4 Pressure Ulcer

Answer 5

Hydrocolloid
Clear Absorbent Acrylic (used 4 packing)
Hydrogel (melt necrotic tissue)
Foams
Alginate (only if no exposed bone or tendon

Question 6

Contraindications of Transparent Dressing

Answer 6

wounds with heavy drainage

Question 7

Contraindication of Hydrocolloids

Answer 7

• wounds w/ heavy drainage because it absorbs it slowly
• infected wounds
• w/ exposed tendon and bone

Question 8

Contraindications of Hydrogels

Answer 8

infected, excessive exudate, bleeding

Question 9

Contraindications of Alginate

Answer 9

dry or full-thickness wounds

w/ exposed tendon and bone

Question 10

Contraindications of Foam

Answer 10

wounds with little or no drainage because of it’s drying effect