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PTA - Intro to Rehab > PTA Acute Care - Wound Care > Flashcards

PTA Acute Care - Wound Care Flashcards

1
Q

list the bony prominences at risk for pressure

A 
ear
occiput
acromion process
scapula
olecranon
thoracic vertebrae
lumbar vertebrae
sacrum
coccyx
greater trochanter
ischial tuberosity
lateral malleolus
medial malleolus
calcaneus
metatarsals
lateral knee
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2
Q

what are the 4 different Debridement procedures?

A

Mechanial
Enzymatic
Autolytic
Sharp

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3
Q

what is the difference between Infection and Contamination?

A

Infection
- presence of organisms that the patient’s defenses cannot control and localize

Contamination
- presence of organisms that the patient’s defenses can control and localize

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4
Q

What is the difference between Sterile and Clean?

A

Sterile
- surgical gloves and sterile surface

Clean
- regular gloves and clean surface

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5
Q

What are the principles of wound management?

A
  • debridement
  • control infection
  • fill dead space
  • absorb excess exudates
  • maintain moist wound bed
  • promote granulation
  • cover the wound
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6
Q

what is an Eschar?

A

a necrotic cap

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7
Q

how does a wound heal?

A

from the bottom up

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8
Q

what are the Classifications of Pressure Ulcers?

A

Stage I - nonblanchable erythema (red does not go away)
Stage II - partial thickness skin loss (blister, abrasion)
Stage III - full thickness skin loss involving necrosis (deep crater)
Stage IV - full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, tendon, etc

if totally covered with eschar wound is Unclassifiable

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9
Q

what is the difference between Acute and Chronic?

A

Acute

  • result of surgery or trauma
  • healing factors are working

Chronic

  • no healing factors are working
  • (but can be converted to acute through debridement)
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10
Q

what Nutritional Deficiencies may impair wound healing?

A

inadequate amounts of:

  • vitamins
  • proteins !! most important
  • ascorbic acid
  • carbohydrates
  • fats
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11
Q

what is Wound Sepsis?

A
  • a potentially life threatening complication of an infection
  • occurs when chemicals released into the blood stream to fight the infection trigger inflammatory responses throughout the body
  • -> can trigger a cascade of changes that can cause organ system failure
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12
Q

what organisms are implicated in infections?

A

staph

bacteria

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13
Q

How does wound infection impair wound healing?

A

Causes:

  • Inefficient cellular activity
  • Decreased oxygen in the wound bed; insufficient oxygen to support the regeneration of tissue
  • Increased rate of cell necrosis
  • Risk of wound sepsis, osteomyelitis, gangrene
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14
Q

Know the five major phases of wound healing

A 
Inflammation
Proliferation
Granulation
Reepithelialization
Remodeling (Matrix Formation)

yep, yep, already know these

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15
Q

what are the available options for Wound Cleansing?

A
  • Nonforceful Irrigation - spray cleanser such as saline
  • Pulsed lavage – for mechanical debridement; can treat wound itself and doesn’t affect surrounding tissues; can be done anywhere; no maceration of surrounding tissue
  • Whirlpool – good for burn wounds, but may need limb in deep position for long time which could cause swelling
  • Topical solutions/commercial cleansers - be careful, maybe too harsh
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16
Q

common topical treatments for wound infections:

A 
Antiseptics
* Dakin's - for odor
* Acetic Acid - to inhibit infection
* Hydrogen Peroxide - nonselective debridement
Antibacterials
* Silvadene - for burn
* Neosporin
* Bacitracin
Analgesics
17
Q

what is another name for Microenvironmental Dressing?

A

occlusive or semi-occlusive

p 581

18
Q

list some pros and cons for conventional Gauze dressing:

A

Pros

  • can be impregnated with useful things like zinc, antimicrobials or petrolatum
  • readily available
  • can be used alone or with other dressing
  • can be used on infected or non-infected wounds

Cons

  • leaves fibers
  • can be adherent
  • highly permeable
  • needs frequent changes
  • increased infection rate
  • prolonged use decreases cost effectiveness
19
Q

What is a Wet-to-Dry dressing

A 
a Nonselective Debridement
Wet gauze 
- applied to the wound bed
- allowed to dry on the wound
Removal of the dry dressing 
- débrides the wound
- pulls away any cellular material that has adhered to the gauze
- removes necrotic tissue (yay), but also rich endogenous fluids, fibrin, and other cells critical to wound healing (non-selective, boo)
20
Q

differentiate between the different types of wounds

A
  • Trauma wounds
  • Surgical wounds
  • Arterial insufficiency wounds
    • round with defined edges
    • on lower leg
  • Venous insufficiency wounds
    • Most common with vascular
    • weepy and gross
      causes
  • Pressure wounds
    • Applying too much pressure to an area for too long; inability to move frequently
  • Neuropathic/ Diabetic Ulcers
    • Cutaneous insensitivity: not aware of pressure or cuts
    • often on bottom of foot
21
Q

wound care for burn patient

A

how to progress?

22
Q

what are the different categories of dressings we are studying?

A
  • Transparent Films
    • Hydrogels
    • Hyrocolloids
    • Foam dressings
    • Alginates
    • Gauze
23
Q

considerations when choosing dressing:

A
  • Infection: absent or present; prevent or treat
  • Necrosis: remove or not; autolytic or mechanical
  • Drainage: dry (no drainage), adequate (moist) or excessive (too wet); restore, retain, or remove
  • Granulation tissue: present or absent; protect, facili-tate formation
  • Epithelialization: present or absent; facilitate formation
  • Periwound area: intact, at risk or macerated; protector absorb
  • Incontinence: present or absent; protect or absorb
  • Cavities and tunneling: present or absent; fill andprotect
  • Friction: present, some risk, significant risk; cushion,protect, or prevent
  • Odor: minimal or needs reduction; ignore or addodor-reducing dressings
24
Q

what are indications for use of Gauze dressing?

A

any wound!

  • wet to wet
  • wet to moist
  • wet to dry
25
Q

what are the primary factors needed to promote healing?

A 
** Nutrition !!
good bandage
good blood supply
moisture
pressure relief
debridment

PTA - Intro to Rehab (12 decks)

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