final exam Flashcards
if a wound is infected, what are the 2 objectives of the dressing?
antiseptic/antibiotics used
if a wound is undermined and/or tunneled you should…
lightly pack the wound
“clinical infection” is defined as
10^5 bacteria/gm of tissue
3 things that promote bacterial growth
- necrotic debris
- foreign body
- dessication of wound/eschar
the LOCAL factors impeding wound healing include .. (4)
- Pressure (ischemia within 2-6 hrs, necrosis > 6 hrs)
- Shear - responsible for wound undermining
- Friction (skin erosion)
- Moisture (issue friability)
what are 5 co-morbities that impede wound healing?
- DM - impaired inflammatory response, neuropathy, vasculature affected
- HIV - poor inflammatory response
- Cancer - chemo kills duplicating cells ie healing wound
- Arterial insufficiency (no circulation = no healing)
- venous insufficiency (congestion)
what whirlpool pressure is actually HARMFUL to granulating tissue?
> 8-15 psi
if compression therapy is overused during wound care, what can occur?
tissue ischemia
when should you use Bacteriostatic and Cytotoxic as topical agents?
ONLY for clinical infection
3 characteristics of COLONIZATION?
- on surface
- proliferating
- delayed healing
infection formula =
(# bacteria * virulence of bacteria) / host immune function
will an inflamed wound have edema and/or induration?
YES, slight swelling, firmness at wound edge
INFECTED: edema and induration are LOCALIZED with warmth
a NORMAL total lymphocyte count is..
2000-2500 lymphocytes/microL
if a pt has INCR PAIN , indicative of a — infection
local
if a pt has red streaks on their wound, it’s indicative of… what about erythema?
red streaks = systemic infection
erythema/skin discoloration = local
if a pt has an abscess, what can the PT do?
drain the abscess (CAN’T POP IT)
“severe depletion” of lymphocytes
<900 cell/microL
to determine ACUTE nutritional status, look at .. & should be —
ACUTE nutr status - serum PREalbumin >20 mg/dL
Long term = serum albumin >3.5 mg/dL
SURGICAL debridement is selective or non-selective?
NON selective – done if WIDE excision into viable tissue req
INDICATIONS for sharp debridement (5)
- extensive necrotic tissue
- advancing celulitis or sepsis
- thick adherent eschar
- adjunct to other therapies
- callous formation
if a pt has a sacral ulcer, what PT precautions should be taken?
limited spinal flexion, watch HAND PLACEMENT in xfers
IF a patient’s pain IMPROVES with elevation, you’re thinking it’s a … issue
venous (helps blood to flow back to heart so decreases venous insufficiency)