Module 4 Part two Flashcards

1
Q

open or closed tissue injury

disruption of normal anatomic structure or function that results from bodily injury or a pathological process

A

wound

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2
Q

disruption or break in the skin

A

open

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3
Q

no disruption or break in the skin

A

closed

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4
Q

free of infectious and potentially infectious microbes

A

clean

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5
Q

wound with microbes

infected

A

contaminated

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6
Q

break in epidermis, dermis or underlying tissue

A

penetrating

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7
Q

superficial injury caused by rubbing and scrapping

A

abrasion

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8
Q

open wound with jagged edge

A

laceration

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9
Q

what are the signs of wound infection

A

accumulation of fluid and RBCs
loss of function
draining
wound dehiscence

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10
Q

what symptoms occur when infection wound

A
erythema
edema
heat
pain
function
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11
Q

what is the wound assessment

A

REEDA

redness, edema, ecchymosis, draining, approximation

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12
Q

what are risk factors of pressure ulcers

A

old age, contractures, diabetes, immobility, incontinence, impaired circulation, obesity, vascular disease

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13
Q

what does the braden scale measure

A

sensory perception, moisture, activity, mobility, nutrition, and friction

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14
Q

how to check for pressure ulcers

A

assess bony prominences

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15
Q

transverse depressions of nails

A

Beau’s lines

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16
Q

elevated ridges, common in elderly

A

longitudinal ridges

17
Q

white spots in the nail plate

A

leukonychia punctata

18
Q

red swelling of nail fold

A

paronychia

19
Q

what are developmental variations in newborns

A

first few hours may be red

dark skinned don’t always manifest coloration (except in nail bed and scrotal)

20
Q

developmental variations in neonatal

A

acrocyanosis, erythema toxicum, harlequin color changes, Mongolian spots, telangiectasis, physiologic jaundice, milia

21
Q

stork bite

A

telangiectasis

22
Q

pink papular rash on neonatal

A

erythema toxicum

23
Q

cyanosis of hands and feet

A

acrocyanosis

24
Q

developmental variations in pregnancy

A

striae gravidarum, linea nigra, chloasma, darkening of moles, palmar erythema

25
developmental variations in older adults
transparent skin, dry skin, wrinkling/drooping, cherry angiomas, seborrheic keratosis, senile lentigines
26
orientation
what is the year, season, date, day, month | where are we state, country, town, hospital, floor
27
registration
name three objects and patient must repeat them
28
attention and calculation
serial sevens (stop after 5)
29
recall
ask for the three objects repeated from above
30
language
1) name a pencil and watch 2) repeat the following 3) follow 3 stage command 4) read and obey the following (close your eyes) 5) write a sentence 6) copy and design a trapeze