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Integumentary > Practical #1 > Flashcards

Practical #1 Flashcards

1
Q

What are some causes of arterial insufficiency?

A 
Trauma
Acute embolism
Diabetes mellitus
Rheumatoid arthritis
Thromboangiitis (Buerger’s disease)
Arteriosclerosis
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2
Q

Most common places for arterial wounds:

A

Wounds between toes, on tips of toes, dorsal aspect of foot, over phalangeal heads, adjacent to lateral malleolous/ tibia or where subject to trauma , such as shin, distal calf

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3
Q

What arterial wounds look like:

A

Dry wounds with black/gray necrotic tissue and erythematous halo
Thin dry skin, absence of hair, shiny, smooth, cool

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4
Q

Borders of arterial wounds:

A

Well defined borders “punched out” smooth edges

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5
Q

Associated illnesses with arterial insufficiency ulcers

A 
Coronary disease 
CHF
COPD
Hypertension
Diabetes mellitus
End-stage renal disease
Hypercholesterolemia
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6
Q

Risk factors contributing to AI ulcers

A 
hyperlipidemia and elevated LDL
Systemic process
Smoking
Diabetes
Hypertension
Trauma
Advanced Age
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7
Q

Tests and Measures for AI

A 
Pulses
Capillary Refill
Rubor of Dependency
Venous Filling Time
Ankle-Brachial Index
Doppler Ultrasound
TBI- Toe pressures
TCPO2- Transcutaneous oxygen 
Plethysmography
Duplex scanning
Arteriography
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8
Q

Common causes of venous insufficiency

A

Common causes of venous insufficiency

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9
Q

Risk factors contributing to VI ulcers

A 
Vein dysfunction
Calf muscle pump failure
Trauma
Previous VI ulcer
Advanced Age
Diabetes
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10
Q

PT Tests and Measures for VI

A

Clinical Assessment for DVT
Ankle-Brachial Index
Trendelenburg Test
Venous Filling Time

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11
Q

C0

A

asyptomatic

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12
Q

C1

A

telangiactasias or spider veins <3mm

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13
Q

C2

A

varicose veins>/= 3mm

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14
Q

C3

A

leg edema

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15
Q

C4

A

skin and subcutaneou tissue change

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16
Q

C4A

A

hemosideran deposition

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17
Q

C4B

A

lipodermatosclerosis

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18
Q

C5

A

healed venous ulcer

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19
Q

C6

A

current venous ulcer

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20
Q

Venous signs:

A

Eschar or slough, wet, yellow fibrous
Moderate to heavy exudate
Tortuous veins
Edematous leg

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21
Q

Wound edges in VI:

A

Shallow wounds

Irregular wound edges

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22
Q

Location of VI insufficiency:

A

Superior to Malleoli, usually medial

Surrounding skin dry and scaly

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23
Q

ABI results >1 (.1.3)

A

Calcified vessels if diabetic- requires further evaluation. Do not exceed 250 mmHg, is non-compressible and may damage artery

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24
Q

ABI 1-.95:

A

No significant Arterial Disease

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25
Q

ABI .95-.8:

A

Mild disease- Compression with caution

26
Q

ABI: .8-.5:

A

claudication- compression contraindicated (usually symptomatic with claudication @.7)

27
Q

ABI less than .6

A

debridement contraindicated by ANY means. Inadequate circulation, exposing debrided tissue to infection

28
Q

ABI less than .5

A

compression contraindicated –resting pain .5-.4

29
Q

ABI less than or equal to .3:

A

tissue loss

30
Q

Risk Factors Contributing

to Pressure Ulcers

A 
Shear
Excessive moisture
Impaired mobility
Malnutrition
Impaired sensation
Advanced age
History of pressure ulcer
31
Q

Stage I PU:

A

Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area.
Area may be painful, warmer, cooler, firmer, softer than surrounding tissue

32
Q

Tissues involved in stage I:

A

May be superficial

May be first sign of deeper tissue involvement

33
Q

Stage II PU:

A

Superficial ulcer
Shallow crater without slough or bruising
May be ruptured or intact blister

34
Q

Tissues Involved in Stage II:

A

Partial thickness (epidermis, dermis, or both)

35
Q

Stage III PU:

A

Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.

36
Q

Tissues involved in Stage III PU:

A 
Full thickness (epidermis, dermis, subcutaneous tissue)
Bone/tendon not visible
37
Q

Stage IV PU:

A

Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.
Deep ulcer with extensive necrosis

38
Q

Tissues involved in Stage IV PU:

A

Full thickness

Underlying deep tissue exposed

39
Q

Unstageable PU:

A

Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed.

40
Q

Tissues involved in unstageable PU:

A

Full thickness

Will be category III or IV

41
Q

Superficial Burns

A

First-degree burns”/Integumentary Pattern B
Dry, bright red, or pink skin that blanches upon pressure
No dermal vessel damage

42
Q

Types of superficial burns:

A

Sunburn, minor flash burn

Erythema, significant pain, lack of blisters, sunburn

43
Q

Superficial Partial-Thickness Burns

A

Superficial second-degree burns”/Integumentary Pattern C
Painful, moist, weeping, blistered skin with local erythema and edema
Blanches to pressure with immediate capillary refill

44
Q

Examples of Superficial Partial-Thickness Burns

A

Brief contact burns, flash burns, brief contact with dilute chemicals

45
Q

Deep Partial-Thickness Burns

A

Deep second-degree burns”/Integumentary Pattern C
Mottled areas of red with white eschar, blistering possible, may have areas of insensitivity/reduced sensation
Blanches to pressure with slow capillary refill
Scarring, pigment changes, contractures possible

46
Q

Examples of Deep Partial-Thickness Burns

A

Severe sunburn, scald, flash burn, brief contact with dilute chemicals

47
Q

Full-Thickness Burns

A

Third-degree burns”/Integumentary Pattern D
Initially look red then become mottled white/black, dry, leathery eschar, very painful
Burned areas insensate to light touch
Scarring and contractures likely
Most require surgical debridement and grafting

48
Q

What layers affected with full-thickness burn:

A

Epidermis, Dermis, and complete destruction to subcutaneous fat

49
Q

Subdermal Burns

A

Fourth-degree burns”/Integumentary Pattern E
Charred, mummified appearance
Exposed deep tissues
Burned areas insensate to light touch
May have permanent nerve damage
Require surgery (fasciotomy, escharotomy, grafting) and possible amputation

50
Q

NU Wound edges:

A

even, well defined, with and without undermining

51
Q

Diabetic Risk Factors Contributing Delayed Healing and Neuropathic Ulcers

A 
Vascular disease
Neuropathy
Mechanical stress
Abnormal foot function and inadequate footwear
Impaired healing and immune response
Poor vision
52
Q

PT Tests and Measures

for Neuropathic Ulcers

A

Circulation

Sensory integrity

53
Q

Grade 0 Wagner:

A

No open lesions

May have deformity or cellulitis

54
Q

Grade 1 Wagner:

A

Superficial ulcer

55
Q

Grade 2 Wagner:

A

Deep ulcer to tendon, capsule, bone

56
Q

Grade 3 Wagner:

A

Deep ulcer with abcess, osteomyelitis, or joint sepsis

57
Q

Grade 4 Wagner:

A

Localized gangrene

58
Q

Grade 5 Wagner:

A

Gangrene of the entire foot

59
Q

NU Position

A

Plantar foot
Plantar aspect of metatarsal heads
Plantar aspect of midfoot if Charcot deformity
May occur under calluses
May occur in areas of pressure/friction from inappropriate footwear

60
Q

NU Presentation

A

Round, punched-out lesions
Callused rim
Minimal drainage unless infected
Eschar or necrotic material uncommon unless infected

Integumentary (18 decks)

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