Exam 4: Chapter 30: Assessment and Management of Patients with Vascular Disorders and Problems of Peripheral Circulation Flashcards
What is a leg ulcer?
An excavation of the skin surface that occurs when inflamed necrotic tissue sloughs off.
Patho behind leg ulcers?/
Inadequate exchange of oxygen and other nutrients in the tissue is the metabolic abnormality that underlies this development
Alternations in blood vessels at the arterial, capillary, and venous levels may affect
cellular processes and lead to the formation of ulcers
Chronic arterial disease is characterized by
intermittent claudication, which is pain caused by activity and relieved after a few minutes of rest
Patients with Arterial Ulclers may also complain of
digital or forefoot pain at rest
If arterial occlusion is acute, pain is
unrelenting and rarely relieved even with opoids
Typically, arterial ulcers are
small, circular, deep ulcerations on the tips of toes or in the web spaces between the toes
Ulcers often occur on the
medial side of the halllux, or lateral fifth toe and may be caused by a combination of ischemia and pressure
Arterial Ulcers and Edema and Pulses?
No Edema / No Pulse or Weak Pulse
Chronic Venous Insufficiency is characterized by
pain described as aching or heavy.
Venous Ulcers are in the area of
the medial or lateral malleolus and are typically large, superfiical, or lateral malleolus and are typically large, superfifical, and highly exudative
Venous Ulcers: Venous Hypertension causes
extravasation of blood, which discolors the area.
Arterial ulcer occurs where?
A clot at the very end of the foot
A ulcer from venous stasis happens around the
ankle
What Antiseptic Agents can inhibit the growth and development of most skin organisms?
Povidone-Iodine
Cadexomer Iodine
Acetic Acid
Chlorhexidine
Silver Wound Products
Once a wound is colonized with pathogens shows signs of infection, a
systemic antibiotic is necessary
What antibiotic is suaully prescribed for leg ulcers?
Oral Antibiotics usually are prescribed because topical antibiotics have not proven to be effective
Nutrition and Leg Ulcers
They need protein, and this can be tested by Albumin
Why does Compression Therapy work for Leg Ulcers?
Adequate compression therapy involves the application of external or counter pressure to the lower extremity to facilitate venous return to the heart
How long should the patient wear stockings for?
At all times except at night and to reapply the stockings in the mornin g
Debridement: To promote healing the wound is
kept clean of drainage and necrotic tissue
Debridement: Usual method is to
flush teh area with normal saline solution or clean it with a noncytotoxic wound-cleansing agent
Debridement: What is this?
Removal of nonviable tissue from wounds. Can be accomplished by several different methods.
What is Surgical Debridement:
Fastest method and can be performed by a physician or other qualified person
What is Nonselective Debridement:
Can be accomplished by applying isotonic saline dressing of fine mesh gauze to the ulcer. When dressing dries, it is removed along with debris adhereing to gauze
What is Enzymatic Debridement:
Application of enzyme ointments may be prescribed to reat the ulcer. Ointment applied to lesion.
What are Calcium Alginate Dressings useful for?
Used for debridemenet when absorption of exudate is neded. Dressings changed when exudate seeps through the cover dressing or at least every 7 days
Why are foam dressings useful?
They absorb exudate into the foam, keeping the wound moist
Wound Dressing: SEmiocclusive or Occlusive Wound Dressings prevent
evaporative water loss from the wound and retain warmth; these factors facor healing
Wound Dressing: Available options that promote the growth of granulation tissue and reepithelization include
the hydrocolloids
Hydrocolloids also provide a
barrier for protection because they adhere to the wound bed and surrounding tissue.
Wound Dressing: Foam Dressings are permeable to both
gases and water vapor due to their hydrophilic properties and are indicated for wounds with moderate exudate, granulating, or slough covered
Wound Dressing: Semipermeable film dressings may be selected because
they keep the wound moist and are impervious to bacteria while allowing some gas exchange. May not be effective treatment for deep wounds and infected wounds
Wound Dressing: GRowth Factor dressings may directly provide
a growth factor, or they may stimulate important growth substances within the wound
Wound Dressing: Calcium Alginate, Hydrofiber, and Hydroconductive dresings are used for wounds with
moderate to high amounts of exudate
Wound Dressing: Hydroconductive dressings provide
a capillary action that lifts and moves exudate away from a wound into the core of the dressing form where is disperses into second layer
Stimulated Healing: Tissue-engineered human skin equivalent is a
skin product cultured form human dermal fibroblasts and keratinocytes used in combination with therapeutic compression
Stimulated Healing: When applied, it
interacts with the patients cells within the wound to stimulate the production of growth factors
Stimulated Healing: What is PriMatrix
A bioactive and regenerative extracellular matrix that binds with the patietns own cells and growth factors