Seminar Flashcards
What is the most common bony prominence for pressure injuries in supine?
Sacrum and Coccyx
What pressure ulcer risk factor is associated with Cancer?
Increased body temp.
What pressure ulcer risk factor is associated with Hypotension?
Nutritional issues
What pressure ulcer risk factor is associated with Obesity/ Low body weight?
Impaired mental status
What pressure ulcer risk assessment tool has the highest reliability?
Braden Scale
What indicates at risk for the Braden scale?
18 and higher
What is the stage of the pressure ulcer that refers to” shallow ulcer without sloughing or bruising”?
Stage 2 NPUAP
What is the usual complication of NPUAP Stage 4 pressure ulcer?
Osteomyelitis (Bone infection)
What is the gold standard for diagnosing osteomyelitis?
Bone biopsy
When should an eschar should not be removed?
When there is stable eschar (dry adherent and intact without erythema or fluctuance) which acts as a natural cover and protection.
___ ulcer is caused by sensory neuroparthy.
Diabetic ulcer
What is the etiology of venous ulcers?
Ambulatory venous hypertension
What common joint site is most commonly affected in Charcot’s joint?
Lisfranc joint/ Tarsometatarsal joint
What is the gold standard for treating diabetic ulcer?
Total contact casting
What is the most important lab value?
Serum albumin
What does low albumin mean?
Increased protein intake to a nutritionist for the pt.
What is the difference between scab and eschar?
Eschar is firmly adherent and concave whereas the scab is convex and loosely to firmly adherent.
What is the difference of the texture between eschar and scab?
Eschar = Soft to hard, smooth and leathery Scab = Rough
For PLWS what are the parameters for pressure and suction?
Pressure = 4-15 mmHg Suction = 80-100mmHg
What is a contraindication to sharp debridement?
Anticoagulant meds like Heparin/ Warfarin
What are the agents for enzymatic debridement? Enumerate its specific enzymes.
Proteolytic & Fibrinolytic
enzymes and Collagenase
Proteolytic & Fibrinolytic
enzymes = Elase, travase, Others (Papain, streptokinase, streptodornase, sutilains)
Collagenase = Santyl
What selective debridement will you choose if the amount of granulation tissue is less than the amount of necrotic tissue?
Enzymatic
What selective debridement will you choose if the amount of granulation tissue is greater than the amount of necrotic tissue?
Autolytic
What topical antibacterial agent is good for MRSA but not used for Pseudomonas?
Mupirocin 2%
What topical antibacterial agent is good broad-spectrum vs. gram negative bacteria?
Gentamicin sulphate
What is the effect of US during the inflammatory phase?
US facilitates the release of histamine from mast cells to shorten inflammatory period
What is the effect of US during the proliferative phase?
US increases the activity of fibroblasts to help you form the collagen
The application of electrical stimulation is __ days anode and ___ days cathode.
Application: 3 days cathode then 3 days anode
What is the side effect of immunosuppressive agents to wound healing?
Affects fibroblast function, collagen synthesis, & phagocytic action in the wound
What is the side effect of Antiprostaglandins to wound healing?
Decrease in blood supply (constriction)
Prednisone is both a corticosteroid and a ___.
Immunosuppressive agent
What are the topical cytotoxic agents that are bacteriostatic?
Hydrogen Peroxide and Acetic Acid
What is the indication of Sodium Hypochlorite?
Sodium Hypochlorite for Staph. Aureus
What is the formula for Dakin’s Solution?
0.4-0.5% Sodium Hypochlorite and 0.4% Boric Acid
What is the indication for Dakin’s Solution?
Staphylococci, Streptococci and Pyocyaneus microorganisms
What topical agent refers to 0.005% solution is bactericidal but not cytotoxic
Sodium Hypochlorite
What is the side effect of immunosuppressive agents to wound healing?
Affects fibroblast function, collagen synthesis, & phagocytic action in the wound
What is the side effect of Antiprostaglandins to wound healing?
Decrease in blood supply (constriction)
Prednisone is both a corticosteroid and a ___.
Immunosuppressive agent
__% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)
0.005% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)
What is the indication of Sodium Hypochlorite?
Sodium Hypochlorite for Staph. Aureus
Which substance functions to stabilize membrane structure & function, acts as a cofactor in enzyme systems, affects immune response, & inhibits bacterial growth?
Zinc
What is the difference between cellulitis and dermatitis?
Cellulitis = Infection of soft tissues with fever
Dermatitis = Inflammation of tissues without fever
What are the ff. enzymes used for?
Elase
Travase
Santyl
Elase = Venous ulcers with fibrinous exudates/ glassy edematous wounds Travase = Wounds with eschar Santyl = Stubborn necrotic collagen
What are the poorly vascularized areas that are usually affected with arterial ulcers?
Toes, dorsum of the foot, lateral malleolus and anterior tibia
What is the primary goal of treating arterial ulcers?
The primary goal is to increase the circulation to the area in question.
What is the topical agent most effective with adhered biofilms?
Surfactants (Saf Clens)
__% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)
0.005% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)
Which substance functions to provide the structural components for wound
healing; proteins?
Amino Acids
Which substance functions to stabilize membrane structure & function, acts as a cofactor in enzyme systems, affects immune response, & inhibits bacterial growth?
Zinc
What is the difference between cellulitis and dermatitis?
Cellulitis = Infection of soft tissues with fever
Dermatitis = Inflammation of tissues without fever
Enumerate 5 signs of infection.
Low grade fever Local pain Inc. local temp. New breakdown Abnormal discharge
What are the poorly vascularized areas that are usually affected with arterial insufficiency?
Toes, dorsum of the foot, lateral malleolus and anterior tibia
What is the primary goal of treating arterial ulcers?
The primary goal is to
increase the circulation to the area in question.
What is the topical agent most effective with adhered biofilms?
Surfactants
Besides histamine what else do mast cells release?
Heparin and serotonin
