NPWT Flashcards

1
Q

What do you use to clean a wound

A
  • noncytotoxic wound cleaners (normal saline or commercial)
  • will not damage or kill fibroblasts and healing tissue
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2
Q

why is a 35ml syringe with 19-gauge angio catheter used for wound irrigation? and what pressure is being delivered for wound?

A

does not damge wound tissue. Uss low pressure of 4-15psi to avoid trauma to wound bed and to not damage healing wound

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3
Q

A pt. has a pressure ulcer X and a student nurse thinks about irrigating the wound? is this helpful or contrindicating to the clients condition?

A

contraindicating - avoid irrigating wounds when the base cannot be determined

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4
Q

what is debridement and what is its use

A

removal of non-viable, nercotic tissue:
- rids the injury of a source of infection
- enables visualization of wound bed
- provides a clean base for healing

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5
Q

which kinda debridement does a nercotic heel ulcer use?

A

none. Black eschar should not be debrides if there is no evidence of infection

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6
Q

sharp/ surgical debridement

A

Sharp or surgical debridement is the most efficient way to reach vitalized tissue at the base of a
wound.
- Used when sepsis is localized and excised.
- Scalpel, scissors or other sharp instrument is used.
- Must have the knowledge, skill and competence to perform this procedure (physicians, advanced
practice nurse).

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7
Q

autolytic debridement

A

In autolytic debridement synthetic dressings are used over a wound to allow the eschar and
fibrinous slough within the wound to be self-digested by the action of enzymes that are present in
wound fluids.
- Dressings that support moisture at the wound surface (e.g., hydrogel or hydrocolloid) maintain a moist wound bed (“moist like your eyeball”), which allows the movement of epithelial cells and facilitates wound closure.
- A wound that has excessive exudate (drainage) provides an environment that supports bacterial growth, macerates the peri wound skin, and slows the healing process.
- If exudate is excessive, an absorptive dressing (e.g., calcium alginate, hydro fibre, or foam) should be used, and volume, consistency, and odour drainage evaluated to determine whether infection may be present.

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8
Q

chemical/enzymatic debridement

A
  • Chemical or enzymatic debridement is another option. Topical enzymes induce changes in the
    substrate, resulting in the breakdown of necrotic tissue.
  • Depending on type of enzyme used, will either digest or dissolve tissue.
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9
Q

A student nurse applied topical enzymes on the wound bed and the peri wound tissue. Whats wrong with this statement

A

you dont apply that kinda debridement on the periwound

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10
Q

biological debridement

A

Biological debridement is the use of maggot therapy. Sterile maggots are used in a wound because they ingest the dead tissue and do not impede granulation.
- Wound before maggot debridement therapy. This wound, covered with a thick layer of slough, failed to respond to conventional treatment over 18 months.
- Wound following three applications of maggots. The wound is completely free of slough and rich with granulation tissue.

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11
Q

mechanical debridement

A

Mechanical debridement, or a “wet-to-dry” saline gauze dressing, is not considered appropriate, as it is nonselective in its removal of both devitalized and viable tissue.
-Wet-to-dry causes mechanical separation of eschar from the wound bed once the dressing is removed (can cause considerable pain).

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12
Q

A nurse used hydrocolloid dressing on a pt and after a week, the wound starts getting better, what must the nurse do next?

A

choose a different type of dressinf after assessing wound base characteristics

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13
Q

what is negative pressure wound therapy?

A
  • another type of dressing
  • uses a machine that applies localized negative pressure to surface and margins of the wound and pulls the base of wound and enhances healing rate
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14
Q

when is NPWT effective/used?

A

for wounds in whic rapid healing is viable and will enhance patients quality of life
- used to enhance viability of split-thickness skin grafts by placing it intaoperatively over grafe and decreases the graft’s ability to shift and evacuates fluid that builds up under the gragt

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15
Q

disadvantage of NPWT

A

expensice and are changed x3 a week (especially w this inflation goddayum)

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16
Q

vaccum assisted closure

A
  • fast+effective healing
  • reticulated opan cell foam placed directly on wound bed and drape is used to cover the dressing
  • hole is made into the drape and a painter track pad over that drape to seal the wound and is then connected to a therapy unit
  • provides uniform negative pressure to wound surface and induces physical and biological response
17
Q

what is hyperbaric oxygen therapy?

A

Is the systemic delivery of oxygen at increased atmospheric pressures.
- The patient is placed in an enclosed chamber in which 100% oxygen is administered at 1.5 to 3.0 times the normal atmospheric pressure.

18
Q

Match the following

EXUDATE LEVEL DRESSING TYPE
a. moderate- heavy 1.film dressing
b. antimicrobial 2. Hydrogel dressing
c. moderate - heavy 3. Hydrocolloid
d. Low-moderate 4. Alginate
e. Low 5. Crystalline silver
f. Low 6. foam dressing

A

a4/a6
b5
c6/c4
d3
e1/e2
f1/f2

19
Q

What are some signs that the wound has too little moisture

A
  • Base non glistening.
  • Grey in colour.
  • Dressing sticks to base.
  • Some products are still dry.
  • No breakthrough outer dressing
20
Q

some wound care principles

A
  • Base spongy
  • Base after dressing removed: floods.
  • Maceration (breakdown of tissue because of moisture)
  • Dressing changed 2-3/day.-
  • Cannot see base when using transparent fill.