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Integ > FINAL REVIEW > Flashcards

FINAL REVIEW Flashcards

1
Q

Arterial ulcers are usually present where?

Pulse is usually _____

A

Lateral malleolus

Absent

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2
Q

Venous ulcers are usually present where?

Pulse is usually ______

A

Medial malleolus

Present

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3
Q

What is used if ankle brachial index (ABI) is unreliable due to plaque build up

A

TBI Toe Brachial Index

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4
Q

How is ABI calculated?

A

Ankle systolic / arm systolic

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5
Q

ABI under 0.5 means…

A

Impaired healing

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6
Q

ABI of less than ____ is contraindicated for compression

A

0.7

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7
Q

What kind of bandages are preferred for compression?

A

Short Stretch Bandages

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8
Q

Compression garmets are used mainly for…

A

Maintenance

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9
Q

What is considered strong compression?

Medium?

A

Strong = 30-40mmHG

Medium = 15-30mmHG

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10
Q

How can diuretics affect lymphedema

A

Make it worse due to excess protein

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11
Q

What is stemmer sign

A

Pinch dorsum of toe to test for lymphedema

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12
Q

What kind of bite is most common?

What kind of bite is most infectious?

A

Dog

Human

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13
Q

What kind of spider bite requires wound care?

A

Brown recluse

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14
Q

Myofibrogen does what?

Fibrogen does what?

A

Closed wound edges

Makes granulation tissue

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15
Q

How are lymphatic channels divided into the body (2 major ones)

A

The R arm and head, and then everything else

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16
Q

If you debride a wound and it becomes larger w/ more necrotic tissue by the next day, what are you suspecting

A

Pyoderma gangrenosum

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17
Q

Most pressure injuries occur where

A

Sacrum and Heels

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18
Q

How fast can a pressure injury occur??

A

Under 2 hours

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19
Q

Where are pressure injuries most common in children?

A

Occiput

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20
Q

It can take ______ days for a pressure injury to become apparent

A

2-7

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21
Q

What is a HAPI?

A

Hospital Acquired Pressure injury

Hospitals have 48 hours to document existing pressure injuries, anything new they have to pay for

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22
Q

What’s the 1# cause of pressure injuries in pediatrics

A

Medical Device Pressure Injury MDRPI

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23
Q

Incontinence increases pressure injury risk ______

A

X5

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24
Q

Pressure injury is most likely to occur ______ into hospitalization

A

First 3 weeks

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25
Q

What is the number 1 and number 2 risk factor for pressure injuries

A

1# decreased mobility

2# nutrition

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26
Q

Braden scale does what?

A

Predicts PI risk, under 13 = high risk

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27
Q

Norton Scale does what??

A

Predicts PI risk, under 16= risk
Under 13= high risk

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28
Q

Inter professional education reduces PI by ____%

What 3 aspects?

A

90%

Skin Checks

Mobility

Incontinence management

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29
Q

What blood test indicates PI risk?

A

Serum Albumin,

1 gram under normal increases PI risk by x4

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30
Q

Can you downstage pressure injuries?

A

No

A stage 4 Is always a stage 4 until its healed

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31
Q

Nonblanchable erythema of intact skin

A

Stage 1 pressure injury

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32
Q

Partial thickness w/ exposed dermis

A

Stage 2 pressure injury

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33
Q

Full thickness skin loss ( may have undermining or tunneling)

A

Stage 3 pressure injury

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34
Q

Exposed bone muscle or tendon

A

Stage 4 pressure injury

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35
Q

Slough or Eschar obscures depth

A

Unstagable pressure injury

(Either a stage 3 or stage 4 underneath)

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36
Q

Maroon or deep purple color on a pressure injury means what?

A

Deep tissue PI

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37
Q

What is the Pressure Ulcer Scale for Healing (PUSH)

A

Higher score = worse wound

Can composite score for multiple PIs

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38
Q

Pressure relieving devices vs pressure reducing

A

Pressure relieving: reduces pressure below 23psi (The pressure of capillaries)

Pressure reducing ( 32- 23 psi)

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39
Q

T or F, pressure injuries heal faster than other wounds

A

F they heal slower

40
Q

Half of all burn victims are _____

Most burns occur where

A

Children

Kitchen and bathroom

41
Q

What’s the most common kind of burn

A

Thermal

42
Q

Asphalt can cause a ________ burn

What kind of this burn is most severe?

A

Chemical

Alkaline (stronger burn than acidic)

43
Q

What kind of electrical burn is worse, AC or DC

A

AC

44
Q

Burn of only the epidermis

A

Superficial burn

45
Q

Burn of some of the dermis (with blisters)

A

Superficial partial thickness

46
Q

Burn with mottled white and red appearance, epidermis and dermis affected

A

Deep partial thickness burn

47
Q

Burn with subcutaneous tissue exposed

Usually little pain

Mottled white gray black appearance

A

Full thickness burn AKA 3rd degree

48
Q

Burn with charred or mummified appearance

A

Subdermal burn (4th degree)

49
Q

What method of estimating TBSA in a burn is fastest and effective?

A

Rule of 9s

Note: don’t use palmar method

50
Q

What are the 3 zones for a burn

A

Zone of coagulation - center

Zone of stasis- compromised perfusion

Zone of hyperemia- erythema.around the burn

51
Q

What happens to cardiac output after a burn

A

Decreases by 50%

52
Q

_______ accounts for 50% of deaths in first 12 hours after a burn

A

Smoke inhalation

53
Q

Up to 75% of all burn deaths are related to _____

A

Infection

54
Q

What happens to basal metabolic rate after a burn?

A

Doubles or triples

55
Q

What stage of healing do scars occur

A

Remodeling phase

Compression wraps can prevent scar from forming

56
Q

______ skin is x15 more likely to have hypertrophic scaring

A

Darker

57
Q

Keloid scar vs hypertrophic

A

Keloid scar extends outside of the wound bed , hypertrophic does not

58
Q

____ days for burn scar contracture

_____ days for tendon sheath contractures

_____ for adaptive muscle shortening

______ for ligamentous/joint capsule restriction

A

1-4 days

5-21 days

2-3 weeks

1-3 months

59
Q

Most joints must be put in _____to prevent contracture

A

Extension

60
Q

MCP position to prevent contracture

A

Flexion

61
Q

Thumb and finger position to prevent contracture

A

Abduction

62
Q

Arm position to prevent contracture?

A

Flexion abd and ER

63
Q

What is an escharotomy

A

They cut incisions into burn tissue to prevent constriction, improves distal circulation

64
Q

Xenograft is from ____

Allograft is from ____

Autograft is from ___

Biosynthic?

A

Animal

Cadaver

Self

Man-Made

65
Q

Mesh vs full thickness skin graft?

A

Full thickness is more aesthetic and better for face and hands

66
Q

Skin receives how much of resting cardiac output?

A

1/3

67
Q

How many layers is the dermis

How many layers is the epidermis?

A

2

5

68
Q

Main cell of re-epitheliazaiton is what?

A

Keratinocyte

69
Q

What cell makes up 90% of the epidermis

A

Keratinocyte

70
Q

Is the epidermis vascular or avascular?

What about the dermis?

A

Epidermis- avascular

Dermis - vascular

71
Q

What are the 4 phases of wound healing?

A

Hemostasis -> inflammation -> proliferation -> maturation/remodeling

72
Q

What is the first cell to an injury site?

What does it do

A

PMN (Polymorphic nuclear neutrophils)

Secrete inflammatory mediators

73
Q

What cells produce histamine

A

Mast cells

74
Q

What are the 4 stages of proliferation

A

Angiogenesis -> granulation tissue formation -> wound contraction -> epithelialization

75
Q

New collagen is type ____ old collagen is type ____

How strong is new collagen?

A

New collage : type 1

Old collagen: type 3

Only 80% as strong, if injured twice only 64% as strong, keeps on being only 80% as strong as before

76
Q

Primary vs secondary wound closure?

A

Primary.- w/ stitches

Secondary- wound closes on its own

77
Q

Wound w/ no progress in 2-6 weeks or not healed in a month according to Medicare

A

Chronic wound

78
Q

Skin is normally between what PH?

A

4-6.5

Note: this is called the acid mantle

79
Q

Chronic wounds have higher levels of what cells?

A

MMP

80
Q

Why don’t you want to change dressing too many times on a wound

A

Too many temperature changes delay wound healing

81
Q

Should you let wounds air out?

A

No

82
Q

What are the 5 indicators of infection? Which one is best?

A

Rubor, Calor, Dolor, Tumor, Functio Laesa

Dolor is best indicator

83
Q

Instead of the word compliance, use the word _____ when describing patient participation

A

Adherence

84
Q

What vitamin helps with collagen synthesis and helps w/ corticosteroid use?

A

Vitamin A

85
Q

What vitamin is essential for blood clotting?

A

K

86
Q

What are the 3 fat soluble vitamins

A

A E K

87
Q

What are the 3 fat soluble vitamins

A

A E K

88
Q

Why is prealbumin a better lab than albumin for indicating wound healing

A

Isolates more recent nutrition history

89
Q

Debridement converts a chronic wound into what?

A

Back to the acute stage

90
Q

What are the 4 selective debridement types?

What is the gold standard

A

Sharp, automatic, enzymatic, biological

Sharp

91
Q

What are the 4 selective debridement types?

What is the gold standard

A

Sharp, automatic, enzymatic, biological

Sharp

92
Q

What should you not debride?

A

Dry stable heel ulcer without edema

Granulation tissue

Anything you can’t identify

93
Q

Cross hatching helps w/ what kind of debridement?

A

Autolytic

94
Q

What is the only FDA approved enzymatic debridement

Is it appropriate for infection?

What can deactivate it?

How thick do you apply it?

A

Collagenase (santyl)

No

Silver and heavy metals

2mm (nickel thickness)

95
Q

Contamination vs colonization vs critical colonization vs infection

A

Contamination - normal bacteria

Colonization- bacteria are dividing, but no risk to host

Critical colonization- detrimental to host, but not enough for an immune response

Infection- host response

96
Q

A biofilm forms during what?

Can you test for it with a tissue biopsy?

What do you need to do?

A

Critical colonization

No

Debride

97
Q

What are the ONLY wounds that you stage

A

Pressure injuries

Integ (14 decks)

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