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Integ > Midterm > Flashcards

Midterm Flashcards

1
Q

The skin is divided into what two layers?

A

-The dermis and epidermis

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2
Q

What is just deep to the dermis and allows it to move freely over internal organs?

A

-The hypodermiS

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3
Q

What are the layers of the epidermis from deep to superficial?

A

-Basale, Spinosum, Granulosum, lucidum, corneum

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4
Q

What layer of the epidermis houses active keratinocytes?

A

-The Stratum Basale

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5
Q

Which layer of the epidermis helps the skin withstand friction and shear force?

A

-Stratum Spinosum

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6
Q

What layer of the epidermis helps the skin prevent water loss?

A

-The stratum Granulosum

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7
Q

What is contained in the stratum granulosum that prevents water loss?

A

-Intercellular space comprised of lipid rich material

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8
Q

What layer of the epidermis provides protection from the environment?

A

-Stratum lucidum

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9
Q

In what areas of the body in the stratum lucidum visible?

A

-The palms and bottoms of feet

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10
Q

What layer of the epidermis do keratinocytes become corneocytes?

A

-The stratum Conreum

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11
Q

What layer of the epidermis forms an acid mantle to make the skin more resistant to infection?

A

-The stratum corneum

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12
Q

Where are melanocytes located?

A

-Between the straum basale and the stratum spinosum

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13
Q

What type of cells are located in the stratum spinosum and provide an immune response?

A

-Langerhan cells

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14
Q

What type of cells are located in the stratum basale and detect light touch and tactile sensation?

A

-Merkel cells

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15
Q

Where does blood flow run in the dermis?

A

-Just deep to the basement membrane, to be able to supply the epidermis; allowing nutrition to the active keratinocytes

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16
Q

What are the name of the shunts of blood flow that run through the dermis?

A

-ateriovenous anastmoses

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17
Q

what does the dermis contain to help carry out excess fluid?

A

-lymphocytes

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18
Q

Where do nerve running through the dermis become free nerve endings?

A

-Just before the epidermal junction

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19
Q

What is the more superficial layer of the dermis?

A

-The papillary dermis

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20
Q

What do fibroblasts in the papillary dermis create?

A

-Elastin and type I collagen

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21
Q

The collagen and elastin made in the papillary dermis are responsible for giving what characteristics to skin?

A

-Turgor and toughness

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22
Q

What do the firbroblasts in the papillary dermis create that helps aid wound closure?

A

-Hyaluronic acid

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23
Q

What is the deep layer of the dermis that is located over the subcutaneous fat?

A

-The reticular Dermis

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24
Q

What is found in the reticular dermis that detects light touch and vibration

A

-Meisner’s Corspuscle

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25
Q

What is the term for skin loss only on the epidermis?

A

-Erosion

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26
Q

What type of wounds are erosion wounds?

A

-1st degree burns and pressure sores

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27
Q

Partial thickness wounds involved what layers?

A

-The epidermis and papillary dermis (demonstrate bleeding)

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28
Q

What type of wounds are partial thickness wounds?

A

-2nd degree burns and pressure sores

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29
Q

What wounds involve the dermis, epidermis and hypodermis?

A

-Full thickness wounds

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30
Q

What is the first phase of skin healing?

A

-Hemostasis

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31
Q

How long does hemostasis last?

A

-less than 1 hour

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32
Q

What is hemostasis directed by?

A

-platelet aggregation

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33
Q

What occurs during hemostasis?

A

-The wound stops bleeding and scab begins to form

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34
Q

Clinical signs of hemostasis are similar to the inflammation stage, but what is the factor that distinguishes between the two?

A

-clot formatoin

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35
Q

What is the inflammation stage of wound healing also known as?

A

-scavenger or neogenesis

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36
Q

What does the inflammation stage of wound care mainly invole?

A

-cleaning the wound

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37
Q

What begins immediately after the injury to get rid of necrotic tissue?

A

-autolytic dedridement

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38
Q

What does the proliferation stage of wound healing entail?

A

-injured tissue being replaced by healthy cells undergoing mitosis

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39
Q

What is needed to provide nutrients to the wound and remove waste and deris?

A

-Angiogenesis

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40
Q

What is granulation tisse characterized by?

A

-Beefy Red appearance

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41
Q

What is the final stage of wound healing that begins after wound closure?

A

-Maturation/remodeling phase

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42
Q

What occurs in the maturation stage?

A

-A aggregation of cells that increases the strength of the wound

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43
Q

When a wound heals, how much strength does it retain from the original skin?

A

-80%

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44
Q

What is the term for the recurrence of wounds in the same area due to the decreased in tensile strength?

A

-Recidivism

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45
Q

What are the 3 classifications of wound response?

A
  • Healing by primary intenetion
  • Healing by delayed primary intention
  • Healing by secondary intention
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46
Q

What type of healing will you typically see after surgury?

A

-primary intention (miminal scaring)

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47
Q

What is the example of a wound healing by primary intention?

A

-Those that have been surgically closed and are free from bacteria or pathogens

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48
Q

Wounds the heal by primary intention typically heal by when?

A

-2 weeks

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49
Q

What are wounds healing by delayed primary intention characterized by?

A

-wounds that have some sort of problem on the inside that prevent the edges from approximating; can be debris

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50
Q

What can result due to a delayed primary intention wound?

A

-A granuloma

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51
Q

How do delayed primary intention wounds normally resolve?

A

-Surgically

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52
Q

What is the usual wound healing process for non-surgical wounds?

A

-Secondary intention (progress through all wound stages)

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53
Q

Wounds seen in the clinic will be what two types of wounds?

A

-Delayed primary intention or sedondary

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54
Q

Cells communicate in the matrix to provide a better environment for what?

A

-wound healing

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55
Q

What breaks up the wound matrix to enhance the surrounding wound bed allowing for epithelial migration?

A

-Plasminogen activators and Mixed metalloproteinases (MMPs)

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56
Q

The majority of the drainage that leaves wounds consists of what?

A

-Proteins

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57
Q

What is the ECM of the skin comprised of?

A

-Collagen, elastin, proteoglycans and GAGs

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58
Q

What type of wounds occur with inadequate healing and may take months or years to close?

A

-Chronic wounds

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59
Q

What do chronic wounds typically occur because of?

A
  • Foreign debris
  • bacterial disruptions
  • disease processes (circulatory disorders)
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60
Q

What are the most common chronic wounds?

A

-Venous insufficiency wounds

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61
Q

What 7 factors can impead healing?

A

-Infection, medications, comobities, cancer/radiation, autoimmune disorders, stress, lack of sleep

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62
Q

What can be applied to wounds that are being delayed by infection?

A

-antimicrobials

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63
Q

Fungal infections most commonly occur where?

A

-in moist environments under dressings

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64
Q

How can corticosteroids delay wound healing?

A
  • allows for a lag time for inflammatory cells and fibroblasts to occupy the area
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65
Q

What can be given to those with prolonged steroid use the allow for better wound healing?

A

-ZMAC (zinc, magnesium, Vitamin A, Vitamin C)

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66
Q

What effects to NSAIDs have on wound healing?

A

-Decrease platelet aggregation, decrease tensile strength, and decrease granulation formation during the proliferation stage

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67
Q

How does diabetes delay wound healing?

A

-it increase glucose levels and impairs leukocyte function

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68
Q

How does arterial insufficiency delay wound healing?

A

-limits the ability to remove waste and provide nutrients

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69
Q

What is a large indicator of wound healing?

A

-cardiac function

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70
Q

What type of cells are particularly effected by ionizing radiation therapy and causes decreased tensile strength of the tissue and delayed healing?

A

-Fibroblasts

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71
Q

Why does chemotherapy cause poor wound healing?

A

-it kills good wound healing cells as well as cancer cells

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72
Q

What cancer treatment can cause decrease blood flow and sensation to the extremites and may lead to further tissue degeneration?

A

-CIPN

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73
Q

What cancer treatment may cause nutrional deficits and cause poor healing?

A

-Chemoside

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74
Q

Stress causes the release of what that will impair the response to injury?

A

-epi and norepi

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75
Q

How does smoking impair healing?

A

-it causes vasoconstriction and decreases the healing response

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76
Q

What can lead to insulin resistance and high glucose levels that can inhibit healing in all phases?

A

-alcohol consumption

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77
Q

What is the normal what blood cell count?

A

-4.5-11

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78
Q

What may lead to increased WBC count?

A

-infection or trauma

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79
Q

What does a low WBC count mean?

A

-decrease immune response to bacteria

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80
Q

What is the normal levels of hemoglobin?

A

-12-18 g/dL

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81
Q

Increased of decrease levels of hemoglobin will cause what?

A

-The inability of the wound to progress

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82
Q

What is the normal level of hematocrit?

A

-36-50%

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83
Q

What is increased hematocrit a sign of?

A

-thrombi/emboli

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84
Q

What is normal prothrombin time?

A

-2.5 seconds

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85
Q

What does increased prothrombin time cause?

A

-easy bleeding

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86
Q

What does decrease prothrombin time cuase?

A

-increased clotting

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87
Q

What is the normal HbA1C range?

A

-less than or equal to 5.7 percent

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88
Q

increase HbA1C will cause what?

A

-Delayed wound healing

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89
Q

What is the average glucose levels?

A

-less than 100 mg/dL

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90
Q

What dictates the type of wound healing?

A

-Tissue loss

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91
Q

What is the name for the Red Yellow and Black Classification system?

A

-Marion Lab Scale

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92
Q

What is the Marion Lab scale used to describe?

A

-the wound surface that correlates with the specific therapy needs

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93
Q

What are Red wounds described to be?

A

-Healthy, cleaning, healing and granulating

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94
Q

What is a yellow wound indicative of?

A

-A possible infection, or presense of necrotic tissue

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95
Q

What are black wounds characterized as?

A

-Necrotic or dead

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96
Q

What is the most widely known wound classification system used for pressure ulcers?

A

-National Pressure Ulcer Advisory Panel Pressure Ulcer Staging System

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97
Q

What does the NPUAP used to describe?

A

-The severity of the wound in order to dictate treatment protocols for reimbursement with regard to treatment products

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98
Q

What is the wagner scale used to classify?

A

-ulcers

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99
Q

What was the wagner scale originally used to diagnose and treat?

A

-the dysvascular foot

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100
Q

How does the wagnar scale describe a wound?

A

-The depth of the injury and presence of infection on a 0-6 scale

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101
Q

What is a grade 0 ulcer on the wagner scale?

A

-A pre or postulcerative site

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102
Q

How is a grade 1 ulcer on the wagner scale described?

A

-Superficial wounds through the epidermis or also the dermis, but no subcutaneous involvement

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103
Q

How is a grade 2 ulcer on the wagner scale desribed?

A

-penetrates through then tendon and capsule but the done and joint is not effected; full thickness wound

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104
Q

What is a grade 3 ulcer on the wagner scale?

A

-ulcer that affects joint and bone with abscess or osteomyelitis

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105
Q

What is a grade 4 on the wagner scale?

A

-forefoot gangrene within a digit

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106
Q

What is a grade 5 on the wagnar scale?

A

-Whole foot gangrene, requires amputation proximal to the digit

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107
Q

What is the University Texas system used to classify?

A

-Diabetic foot ulcers when a diabetic nephropathy is present

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108
Q

What 4 things does the UT scale grade?

A

-(A) wound depth; (B) infection, (C) Ischemia, (D) infection

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109
Q

What is step 1 in the wound care process?

A

-General assessment (regular PT exam)

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110
Q

What is step 2 in the wound care process?

A

-Diagnosis

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111
Q

What is step 3 of the wound care process?

A

-Prognosis and goal

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112
Q

What is step 4 of the wound care process?

A

-Re-evaluation

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113
Q

What things are important to ask the patient regarding a wound?

A

-onset, appearance, signs and symptoms, medication, and psycho-social history

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114
Q

What is part A of the diagnosis proccess of wound assessment?

A

-an in depth examination of testing for related factors and co-morbities, and focused wound examination

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115
Q

What is part B of the diagnosis of wound assessment?

A

-Forming the diagnosis from the info gathered in part A

116
Q

What should to do before asessing a wound?

A

-Clean it to give a clear picture

117
Q

What is the most commonly used method to document wound deminsions?

A

-The clock method

118
Q

How is the perpendicular method of wound deminsions performed?

A

-Take the longest measure then measure perpindicular to that

119
Q

What is considered the 12 position with the clock method?

A

-The head

120
Q

Where is the width of the wound measured with the clock method?

A

-Perpindicular to the length, usualy at its maximum width

121
Q

What is the disruption in the attachment of the skin to underlying structures?

A

-Undermining

122
Q

What is undermining typically noticed as?

A

-dark, discolored tissues surrounding the periwound

123
Q

What should you use to note the location of undermining?

A

-Clock position

124
Q

Where can tunneling occur?

A

-Between two wound, or within the same wound

125
Q

Where can tunneling not occur?

A

-it cannot span under around the wound

126
Q

What type of non-viable tissue is describes are nercrotic and brown and black color?

A

-Ecshar

127
Q

How does eschar often appear?

A

-Flat and shiny, with a hard and dry texture

128
Q

What type of tissue is described as non-viable subcutaneous tissue that is the result of autolytic debridement?

A

-Slough

129
Q

What is the appearance of slough?

A

-Soft and yellow

130
Q

What stage of wound healing is granulation tissue seen?

A

-Proliferation

131
Q

How does viable muscle tissue in a wound present?

A

-striated and red and is painful to tactile sensation

132
Q

How does non-viable muscle in a wound present?

A

-greyish, cannot contract and is not painful

133
Q

What need to be kept moist at all times to prevent infection if is exposed in a wound?

A

-periosteum

134
Q

What must you do to rule out osteomyelitis?

A

-Perform a biopsy

135
Q

What type of wounds are tendons seen in?

A

-full thickness wounds

136
Q

How does viable tendon appear in a wond?

A

-shiny due to the paratendon sheath

137
Q

Why must exposed tendons in a wound be kept moist?

A

-to maintain the viability

138
Q

What type of viable tissue is described as shiny globules with a dull yellow appearance?

A

-Adipose

139
Q

Why is the window viability of adipose typically short?

A

-It has poor blood supply

140
Q

What type of tissue is described as granulation tissue that overides the surface

A

-Hypergranulation

141
Q

What is hypergranulation a sign of?

A

-abnormal healing

142
Q

What will hypergranulation prevent?

A

-Wound edges from approximating

143
Q

What may be used to caogulate tissue and promt proper healing?

A

-Silver nitrate

144
Q

What has been shown to decrease the incidence of hypergranulation?

A

-Foam dressings with pressure, or topical corticoids

145
Q

Why is proper documentation of drainage neccesary?

A

-to recognize the phase of healing and allow for a clear picture of healing status

146
Q

What is a scant amount of drainage?

A

-A small amount of drainage on dressing after removal

147
Q

What is minimal drainage?

A

-25% of the dressing is covered

148
Q

What is moderate dressing?

A

-50% of the dressing is covered

149
Q

What is heavy drainage?

A

-100% of the dressing is covered

150
Q

What is copious drainage?

A

-Multiple layers of the dressing are covered

151
Q

What is strike through drainage?

A

-Visible through the last layer of dressing

152
Q

What type of drainage is described a clear serum?

A

-Serous

153
Q

What type of drainage is described as bloody?

A

-sanguinous

154
Q

What type of drainage is described as bloody and clear?

A

-Serosanguinous

155
Q

what type of drainage is is described as a viscous puss?

A

-Purulent

156
Q

What is characteristic of drainage is indicative of infection?

A

-Bad odor

157
Q

If the periwound is red what would that be described?

A

-Erythema

158
Q

If the periwound is pale, what what would that be described as?

A

-Ischemic

159
Q

The brown/purple stain that is typical with venous insufficiency is known as what?

A

-Hemosiderin

160
Q

When should wound odor be assessed?

A

-After cleaning

161
Q

What type of infects has characteristically sweet odor like corn tortillas?

A

-Psueomonas

162
Q

Malignancy has what type of odors?

A

-varying

163
Q

What type of infection has a foul odor?

A

-Wet Gangrene

164
Q

Where does the arterial system begin?

A

-The ascending aorta

165
Q

What are the symptoms of Claudications?

A

-heavy legs with cramping in the calf that increases with exertion

166
Q

When will individual with PAD have pain during rest?

A

-when laying horizontally or when they are propped up

167
Q

What are 7 risk factors for arterial wounds?

A

-Artherosclerosis, Smoking, Obesity, Diabetes Mellitus, Hypertension, Hypercholesteremia, Family History, Nutrtition

168
Q

What test uses a doppler and BP cuff to calculate the systolic pressures and compare to normal values?

A

-ABI

169
Q

What is an expansion of the ABI and require pressures taken at various points along the limb to better localize the ischemia?

A

-Segmental plethysmography

170
Q

What combines ABI and SP and uses ultrasound to show details of the specific vessels that may be occluded?

A

-Arterial duplex loans

171
Q

What test allows for the measurement of oxygen delivery to the site to be measured and has been show to help determine the amount of ischemia in the limb?

A

-Transcutaneous oxygen measures

172
Q

What does Magnetic Resonance Radiography Angiography help visualize?

A

-The vessels and ischemia

173
Q

What is the Ankle Brachial Index?

A

-the ratio of brachial Systolic BP to Ankle Systolic BP

174
Q

When you obtain the BPs on the LEs, what side should you use?

A

-The one with the highest value, or one with a wound on it

175
Q

What UE value should you use?

A

-The highest

176
Q

An ABI >1.3 means what?

A

-False Elevation; heavy vessel calcification

177
Q

What is normal ABI?

A

-1.0-1.29

178
Q

What is considered borderline ABI?

A

-.091-1.0

179
Q

What ABI value indicated mild PAD?

A

-.7-.9

180
Q

What ABI values indicates moderate PAD?

A

-0.4-0.69

181
Q

What ABI value is considered severe PAD?

A

-<0.4

182
Q

What is the rubor of dependency test?

A

-Screens for artery insufficiency or ischemia

183
Q

How do you perform the Rubor Dependency Test?

A

-Start with patient in supine, then elevate legs to 30 Degrees; wait for palor to be observed; then drape legs off the edge of table

184
Q

What are normal results For the Rubor Dependency test?

A

-When you drape leg off table, it should return to a pinkish color

185
Q

What are abnormal results for the rubor test?

A

-The foot will appear bright red

186
Q

What causes the abnormal response in rubor test?

A

-Rapid dilation of the arteries to try to reprofuse the extremity quickly

187
Q

How do arterial insufficiency wounds present?

A

-Small round and regular borders- like a punch hole

188
Q

How does the wound bed appear with a vascular insufficiency wound?

A

-usually is pale due to imapired blood flow (dont heal)

189
Q

Where do vascular insufficiency wounds normally occur first?

A

-on the digits

190
Q

When do vascular insufficiency wounds become painful?

A

-when blood flow is gravity assisted

191
Q

What might occur if a vascular insufficiency wound exposes bone?

A

-osteolyelitis

192
Q

What is vital in treating arterial insufficiency wounds?

A

-Protection and ensuring blood flow

193
Q

What type of therapy has been shown to increase blood flow and and help heal arterial insufficiency wounds?

A

-infrared lights

194
Q

If an arterial insufficiency wound is stable with eschar and does not appear to have infection what should you not do?

A

-debride it

195
Q

How does a stable wound present?

A

-hard to touch, no drainage and no redness

196
Q

How do veins differ from arteries?

A

-they do not contain as much smooth muscle or elstin; allows them to withstand greater volumes of fluid

197
Q

What occurs if there is a pathology in the venous system?

A

-Edema

198
Q

What results from leaky valves?

A

-Variscosities

199
Q

How do hemosiderin stains develope?

A

-Leaky valves leak blood into interstitial spaces and die, once they die the release hemoglobin into the fluid and turns a dark brown

200
Q

Venous insufficiency normally causes edema where?

A

-in the lower leg

201
Q

Edema expanding outside of the lower leg is normally caused by what?

A

-lymphadema

202
Q

What position is normally used to assess increased venous distention?

A

-Standing

203
Q

What test measures refill time by performing ankle pumps using a diode?

A

-photothysmography

204
Q

What invansive procedure calls for a needle to be stuck into the pedal vein and measures pressure at rest and after exercise?

A

-Ambulatory venous pressure

205
Q

Where do venous insufficiency normally occur?

A
  • in the gaiter area of the medial lower leg
206
Q

How do venous insufficiency wounds normally occur?

A

-insidously and are preceded by initial skin changes

207
Q

How do venous insufficiency wounds normally present?

A

-shallow with little to no eschar formation

208
Q

How will the periwound look like with a venous insufficiency wound?

A

-thickened skin or varicosities and hemosiderin staining

209
Q

What will be present in a venous insufficiency wound if there is not arterial insufficiency?

A

-Drainage

210
Q

What is the gold standard for treating venous insufficiency wounds?

A

-Compression

211
Q

What type of patient should you not use compression on?

A

-CHF

212
Q

For ambulatory patients with a venous insufficiency wound, what type of wrapping should you use?

A

-Figure 8 (provides twice as much compression)

213
Q

What was an issue with the unna boot to treat venous insufficiency wounds?

A

-it does not change size onces edema goes down

214
Q

What is the preferred compression technique for venous insufficiency wounds?

A

-4 layer compression

215
Q

What is the 1st layer of the 4 layer compression?

A

-soft rolling of padding to build up the LE to assure a conical shape

216
Q

What is the 2nd layer of the 4 layer compression?

A

-A non-eleastic layer providing the first layer of compression

217
Q

What layer of the 4 layer compression provides the figure 8 pattern?

A

-The 3rd

218
Q

What is the 4th layer of the 4 layer compression?

A

-adheres the wrapping together

219
Q

How often must a 4 layer compression dressing be changed?

A

-3-7 days

220
Q

What is the removal of dead, damaged or devitalized tissue from a wound bed?

A

-Debridement

221
Q

What is the foundation behind debridement?

A

-to encourage wound healing in order to prevent infection, reduce chronic inflammation process when necrotic tissue is in the wound bed and promote growth in order to jumpstart the wound healing process in the acute stage

222
Q

When should you debride a wound?

A

-to remove necrotic tissue if it is warranted, the perform maintenance throughout the healing process

223
Q

What does necrotic tissue look like?

A

-brown/black eschar or yellow slough

224
Q

What should the INR be at to perform debridement?

A

-2.5 (higher would cause more bleeding)

225
Q

What is a precaution to debridement?

A

-blood thinners

226
Q

What is a good indicator or wound prognosis?

A

-Pain

227
Q

What should you always perform before debridement?

A

-if the ABI is low, you must refer

228
Q

Those with ABIs less than what is contraindicated for debridement?

A

-.4

229
Q

What type of wounds will need a vascular consult prior to debridement?

A

-Dry gangrene or dry ischemic wounds

230
Q

What needs to be treated before debridement can occur?

A

-infection (fever)

231
Q

What bacterial skin infection is characterized by severely inflamed, painful limbs, with heavy odor and drainage?

A

-Cellulitis (must treat with antibiotics before debridement)

232
Q

What must you do if there is is exposed bone, tendon or any prosthetic device?

A

-Refer out to determine viability of the structure

233
Q

Should you debride a wound with stable eschar and no signs of infection?

A

-NO

234
Q

Where is stable eschar likely to present?

A

-on the heel

235
Q

What type of debridement uses the bodies natural healing mechanism to debride non-viable tissue?

A

-Autolytic

236
Q

How must the wound be prepared for autolytic debridement?

A

-need to be cleaned, and kept at the proper moisture

237
Q

What can you do to eschar to promote healing from the inside out?

A

-Cross hatch it

238
Q

What are some advantages for autolytic debridement?

A

-It is selective, improves rapidly and can be combined with other debridement types

239
Q

What disadvatages come with autolytic debridement?

A

-may have to educated caregiver repeatedly, slower than sharp, and increased risk of infection

240
Q

What type of debridement uses a collagenase to selectively break up non-viable tissue?

A

-Enzymatic

241
Q

What is the common enzyme used to perform debridement?

A

-Santyl

242
Q

What must you perform before enzymatic debridement?

A

-Clean it with a neutral pH cleaner

243
Q

What type of debridement refers to some outside scource for debridement?

A

-mechanical

244
Q

What type of dressings can be place on a wound, for non0viable tissue to attach to, to then be removed?

A

-wet to dry dressings

245
Q

Why should you moisten the wet to dry dressing before remove?

A

-To limit the amount of granulation tissue that is taken with the dressing

246
Q

What type of debridement uses pulses of water to gently clean the wound or debride it?

A

-Pulse Lavage

247
Q

What range of PSI should be used for Pulse Lavage?

A
  • 4-9 PSI
248
Q

What PSI should you avoid to prevent tissue injury?

A

-15

249
Q

What is the mos rapid form of debridement?

A

-Sharp

250
Q

What are the disadvantages to sharp debridement?

A

-Pain, increased potentiol for complications

251
Q

What should you checl before performing autolytic debridement?

A

-Lab values

252
Q

What is the first step in managing excess bleeding?

A

-applying hard pressure for 10-15 minutes

253
Q

What can you do to slow the rate of perfusion and prevent bleeding?

A

-Elevate the limb about the heart

254
Q

What surgical procedure can be performed to stop excessive bleeding?

A

-Electro-caudery

255
Q

What Is licalized damage to the skin and underying soft tissue usually over a boney prominence or related to a medical or other surface

A

-A pressure wound

256
Q

How can a pressure wound present?

A

-as intact skin or an open ulcer

257
Q

What is the authoritaive voice for pressure injuries?

A

-The NPUAP (National PRessure Ulcer Advisory Panel

258
Q

What diagnosis has an increased liklihood of pressure injury?

A

-SCI, acute pediatrics, CVD and neonatal patients

259
Q

What is the average cost to treat a full thickness pressure injury?

A

-$70,000

260
Q

How can impaired lymphatic flow cause pressure injuries?

A

-causes the accumulation of metabolic waste products

261
Q

How can repurfusion cause a pressure injury?

A

-by an inflammatory response due to return of blood to an ishemic area

262
Q

What are the 4 proposed MOIs for pressure injuries?

A

-Ischemic, Reperfusion, Impaired lymphatic flow, and deformation of underlying tissue

263
Q

How long does it take to for hyperemia to be observed with constant pressure?

A

-30 minutes

264
Q

What are the clinical signs of hyperemia?

A

-Redness in the area up to 1 hour after the pressure is removed

265
Q

How long does it take for tissue ischemia to occur under constant pressure?

A

-2-6 hours

266
Q

What is a sign of tissue ischemia?

A

-Erythema; A dark red/purple color

267
Q

How long does it take for necrosis to occur under constant pressure?

A

-6 hours

268
Q

What is the final clinical step observed with pressure injuries?

A

-Ulceration

269
Q

How long does it take for ulceration to occur?

A

-About 2 weeks

270
Q

What type of wounds can you use the NPUAP scale to stage?

A

-ONLY pressure wounds

271
Q

What is stage I of the NPUAP scale?

A

-nonblanchable erythema of intact skin

272
Q

What is stage II of the NPUAP Scale?

A

-Partial thickness, with the dermis exposed; no signs of necrosis

273
Q

How will a stage II pressure injury present?

A

-as an open shallow wound that is pinkish in color

274
Q

What is a stage III pressure injury?

A

-Full thickness wound, no bone/tendon/fascia exposed with evidence of necrosis

275
Q

What is a stage IV pressure injury?

A

-Full thickness with underlying structures exposed and necrosis

276
Q

What is an unstagable pressure injury?

A

-When the wound cannot be staged prior to debridement

277
Q

What is a suspected deep tissue injury?

A

-persistant, nonblanchable erythema and may be boddy of soft

278
Q

What is a mucousal membrane pressure injury?

A

-Pressure injury on a mucous membrane with a history of medical device use

279
Q

How do you stage a muscous membrane pressure wound?

A

-you cant

280
Q

Stage I pressure ulcers account for what percent of pressure injuries in the geriatric population?

A

-47%

281
Q

What are the risk factors for pressure injuries?

A

-Immobility, inactivity, sensory loss, shear friction force

282
Q

What pressure injury risk assessment tool uses subscales of consistant physical condition, mental state, activity, mobility, and incontinence

A

-The norton scale

283
Q

What is considered low risk on the norton scale?

A

-17 to 20

284
Q

What is considered high risk for the norton scale?

A

-14 to 10

285
Q

What is considered very high risk on the norton scale?

A

-Less than 10

Integ (1 decks)

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