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Gerontology > Module 11 > Flashcards

Module 11 Flashcards

1
Q

What are the predisposing factors for venous ulcers

A

Venous hypertension, valvular incompetence, impaired calf muscle pump function, obesity and history of DVT

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2
Q

Ulceration occurs when venous hypertension is

A

Greater than 90 mmHg

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3
Q

What are the reasons tissues become vulnerable to breakdown

A

Chronic stasis and edema

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4
Q

Distended veins in LE allow for

A

Pooling of blood

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5
Q

What is the most common cause of leg ulcers

A

Chronic venous insufficiency

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6
Q

Eczema or stasis dermatitis caused by _______ may result in _____

A

Edematous inflammatory agents, ulceration

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7
Q

Fluid that filters through the capillaries to the interstitial spaces contains

A

Dissolved proteins, electrolytes, salts, cells, and metabolic by products degrades and inactivated growth factors that come to the area during hemostasis

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8
Q

Location of venous ulcer

A

Medial aspect of distal third of lower extremity, posterior medial malleolus

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9
Q

The depth in a venous ulcer is

A

Shallow

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10
Q

The gaiter area for a venous ulcer is

A

Rich in perforated veins

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11
Q

Are venous ulcers typically painful

A

No

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12
Q

What is the most comfortable position for a venous ulcer

A

Elevating lower extremities

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13
Q

Venous ulcer wound bed will have ____ edema

A

Firm

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14
Q

Venous ulcer wound bed color

A

Beefy red, or reddish brown discoloration

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15
Q

What is the shape and margins of a venous ulcer

A

Large with irregular margin

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16
Q

Edges on a venous ulcer

A

Uneven

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17
Q

What is common on the wound base of a venous ulcer

A

Calcification

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18
Q

Exudate or drainage in a venous ulcer is frequently

A

Moderate to heavy

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19
Q

Post thrombotic syndrome may develop in _____ of all patients who experience lower extremity DVT

A

Half

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20
Q

What does CEAP stand for

A

Clinical signs, etiology can classification, anatomic distribution, physiologic dysfunction tool

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21
Q

C0 on the CEAP

A

No visible or palpable signs of venous disease

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22
Q

C1 on the CEAP

A

Reticular veins

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23
Q

C2 on the CEAP

A

Varicose veins

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24
Q

C3 on the CEAP

A

Edema

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25
Q

C4 CEAP

A

A) pigmentation and eczema b) atrophy Blanche

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26
Q

C5 CEAP

A

Healed venous ulcer

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27
Q

C6 CEAP

A

Skin changes with active ulceration

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28
Q

What are the goals in venous ulcer treatment

A

Increase venous return, decrease venous stasis and associated edema, provide compression, and address wound environment

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29
Q

Wound dressings are used to

A

Promote re epilthelialization and granulation when underlying pathophysiology has been treated

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30
Q

Occlusive compression dressings, bandages, wraps, and pneumatic sequential compression devices should not be used in the presence of

A

Sings of infection, cellulitis, or severe arterial disease

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31
Q

You should continue use of compression therapy after the wound has closed because

A

Venous ulcer can re occur

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32
Q

For treating a venous ulcer the legs should be elevated above the heart for

A

30 minutes 3-4 x per day

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33
Q

Calf muscle activity acts as a

A

Venous pump

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34
Q

Compression modalities are used to control

A

Stasis and edema

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35
Q

__ are not used when there is a wound present

A

Stockings

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36
Q

Elastic wraps are contraindicated with

A

Arterial disease, severe infection, weeping dermatitis, or friable tissue

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37
Q

Unna boot is a

A

Special gauze bandage made of cotton that contains zinc oxide paste and eases skin irritation and maintains moisture

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38
Q

Compression therapy requires ______ of pressure to counter act tissue capillary pressure

A

30-40 mmHg

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39
Q

Stockings should be replaced every

A

4-6 months

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40
Q

Intermittent pneumatic compression therapy lasts

A

One hour 5 days per week for up to 6 months

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41
Q

Intermittent pnematic compression pressure is __ at foot and ___ at thigh

A

45, 30

42
Q

The degree of compression for these indications: prevent DVT, mild edema, tired, achy legs

A

20 mmHg

43
Q

Pressure recommended for these recommendations Mild varicose veins, mild to moderate edema, long haul flights of greater than 4 hours, varicose veins during and after pregnancy

A

20-30mmHg

44
Q

Pressure recommended for these indications : venous ulcer, DVT, superficial thrombophlebitis, following venous surgery, varicose veins with severe edema, post thrombotic syndrome, mild lymph edema

A

30-40 mmHg

45
Q

Pressure recommended for these indications: severe lymph edema, severe chronic venous insufficiency

A

Greater than 40 mmHg

46
Q

Compression stocking recommendations for spider veins, early varicose veins, aching feet and legs, and slight edema

A

8-15 mmHg

47
Q

Compression stocking recommendations for varicose veins, mild edema and DVT prevention

A

Class one hosiery : 14-17 mmHg or 15-20 mmHg

48
Q

Compression stocking recommendations for moderate varicose veins, mild edema and prevention of venous ulcer recurrence

A

Class two hosiery, 18-24 mmHg or 20-30 mmHg

49
Q

Compression stocking recommendations for severe varicose veins, lymph edema, treatment after phlebitis, and to prevent and treat venous ulcers

A

Class 3 hosiery, 35-49 mmHg

50
Q

Anti embolism stockings after surgery have what pressure

A

16-18 mmHg

51
Q

Type 2 DM develops primarily due to progressive

A

B cell failure

52
Q

An increase in insulin resistance causes a

A

Rise in blood glucose levels

53
Q

Another name for type one and a half diabetes

A

Latent autoimmune diabetes in adults

54
Q

Risk of cad and cvs increase ___ with diabetes

A

4 times

55
Q

Older adults over the age of ___ have the greatest risk of developing diabetes

A

74

56
Q

Charcot foot is a

A

Progressive destructive arthropathy present in an area of sensory loss due to peripheral neuropathy

57
Q

Auto of neuropathy accompanies

A

Motor and sensation neuropathy

58
Q

The Wagner wound classification system has a grading scale of

A

0-5

59
Q

Grade 0 Wagner wound

A

No open lesion but may have deformity or cellulitis

60
Q

Wagner wound grade 1

A

Superficial ulcer, partial or full thickness

61
Q

Wagner wound grade 2

A

Ulcer extends to ligament, tendon, Joint capsule, or deep fascia without access, osteomyelitis, or joint sepsis

62
Q

Wagner wound grade 3

A

Deep ulcer with abscess, osteomyelitis or joint sepsis, infection

63
Q

Grade 4 Wagner wound

A

Gangrene localized to forefoot or heel

64
Q

Wagner wound grade 5

A

Extensive gangrene

65
Q

For a diabetic foot screen examine protective sensation

A

Use monofilaments 5.07 or 10 g semmes Weinstein

66
Q

Testing arterial insufficiency for diabetic foot ulcers, what two tests

A

Ankle brachial index or toe brachial index

67
Q

ABI and TBI values.

A

Normal is 1.0-1.2, mild is .8-1.0

68
Q

Refer to a physician If there is

A

Less than .5 arterial insufficiency

69
Q

ABI compares

A

Systolic BP in brachial artery with the dorsalis pedal or posterior tibial artery

70
Q

Where is the systolic BP measured On the ankle

A

2.5 cm proximal to ankle malleolus

71
Q

Calculate ABI by

A

Ankle SBP/ brachial SBP

72
Q

Pressure of greater than ___ mmHg causes capillary closing

A

32

73
Q

The pressure ulcer score for healing (push) tracks healing of stages _ to _

A

2 to 4

74
Q

0 on PUSH means ulcer has

A

Closed

75
Q

PUsH scores range from

A

0 to 17

76
Q

Pressure sore status tool ranges from

A

13 to 65

77
Q

Lower numbers on the pressure sore status tool means

A

Improvement

78
Q

Scale that predicts not assesses healing

A

Sessing scale

79
Q

Stage 1 pressure ulcer is

A

Non blanchanle erythema, initial development

80
Q

Stage 2 pressure ulcer

A

Skin blisters or forms of an open sore, area around the sore may be red and irritated

81
Q

Stage 3 pressure ulcer

A

Skin develops an open, sunken hole or crater, damage to tissue below the skin

82
Q

Stage 4 pressure ulcer

A

Extends through deep fascia into underlying structures (muscle, bone, tendons and joints )

83
Q

Pressure ulcers are unstageable when

A

Tissue at base of ulcer is covered by dead skin (yellow, tan, green or brown )

84
Q

Most common cause of arteriosclerosis obliterans is

A

Arterial insufficiency ulcers

85
Q

Fontaine classification of arterial insufficiency ulcers stage 1

A

Asymptomatic

86
Q

Fontaine classification of arterial insufficiency ulcers stage 2

A

Intermittent Claudication

87
Q

2a Fontaine classification

A

Pain free Claudication waking over 200 m

88
Q

2b fontaine classification

A

Pain free, Claudication walking less than 200 m

89
Q

Stage 3 Fontaine

A

Claudication with pain at rest

90
Q

Stage 4 Fontaine

A

Necrosis, gangrene leading to possible amputation

91
Q

Exercise prescription for PAD

A

Walking at intensity that elicits Claudication symptoms within 3-5 minutes pain score of 1

92
Q

For PAD walking, continue walking until pain is a score of _ and stop until pain goes away

A

2

93
Q

Repeated the rest walk cycle for PAD walking for ___ minutes

A

35

94
Q

Increase PAD walking program by _ minutes up to __ minutes, _ to _ times per week for _ weeks

A

5, 50, 3, 5, 12

95
Q

Criteria to progress walking to higher work rate in PAD

A

Patient can walk without having to stop for 8 minutes

96
Q

Claudication pain rating scale

A

1: minimal discomfort, 2: moderate pain, 3: intense pain, 4: unbearable pain

97
Q

Common locations of malignant melanomas

A

Trunk and LE

98
Q

ABCDE for skin cancer

A

Asymmetrical border, brow or black, diameter greater than 6 mm and elevated or enlarged

99
Q

Basal cell cancers are

A

More common and slow growing

100
Q

Squamous cell cancers are

A

More invasive and malignant

Gerontology (12 decks)

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