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Fundamentals > Skin Integrity and Wound Care > Flashcards

Skin Integrity and Wound Care Flashcards

1
Q

Skin is the largest:

A

organ

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2
Q

Skin is involved in thermoregulation through its ability to:

A

dilate and constrict blood vessels

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3
Q

The skin has a major tole in sensation by:

A

giving tactile feedback from the surrounding environment

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4
Q

The skins normally acidic pH provides:

A

a protective mechanism against pathogens

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5
Q

Epidermis

A

outermost layer of the skin, and the thinnest; regenerates ever 4-6 weeks

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6
Q

Subdivisons of the epidermis:

A 
stratum corneum
stratum lucidum 
stratum granulosum
stratum spinosum
stratum germinativum (basal layer)
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7
Q

Stratum Corneum:

A

made up of flattened dead cells

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8
Q

The middle 3 layers provide a transition from:

A

stratum corneum to stratum germinativum (which also help in reduction of friciton and shear)

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9
Q

Stratum Germinativum:

A

constantly produces new cells that are pushed up (protein keratin is synthesized here)

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10
Q

Keratin:

A

gives the skin strength and flexibility and allows the skin to repair itself

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11
Q

Melanin:

A

gives the skin its color and protects from UV light and Langerhans cells

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12
Q

Langerhans cells:

A

involved in digestion of bacteria and the immune system’s response to foreign materials

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13
Q

Dermis:

A

lying between the epidermis and the deeper subcutaneous layer

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14
Q

The epidermal and dermal layers are joined together by the:

A

basal membrane

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15
Q

Rete Ridges/Papillary Dermis:

A

provides the stick that anchors these layers of the skin together, preventing them from sliding back and forth

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16
Q

Embedded in the dermis:

A 
sebaceous glands
sweat glands
hair/nail follicles
nerves
lymphatics
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17
Q

Subcutaneous layer:

A

layer of adipose tissue; in addition to attaching the dermis to the underlying muscles and bones delivers the blood supply to the dermis, provides insulation

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18
Q

Open wound:

A

actual break in the skin’s surface

example: abrasion,. puncture/surgical wound

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19
Q

Closed wound:

A

seen with bruising, and the skin is still intact

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20
Q

Superficial wound:

A

involves only the epidermis

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21
Q

Partial thickness wound:

A

involves the epidermis and the dermis but does not extend to the subcutaneous layer

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22
Q

What do partial thinkness and superficial wounds have in common?

A

these wounds heal quickly and leave no scaring

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23
Q

Full thickness wound:

A

extends through the dermis to the subcutaneous layer and may extend farther to the muscle, bone, or other underlying structures.

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24
Q

How do full thickness wounds heal:

A

heal slowly and leave scarring; more likely to become chronic

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25
Q

Burns:

A

tissue injuries caused by heat, electricity, chemical radiation, extreme cold, or friction

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26
Q

Clean wound:

A

no infection and risk for developing infection is low

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27
Q

Clean contaminated wound:

A

similar to a clean wound, but because the surgery involves organ systems that are likely bacteria, the risk for infection is greater

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28
Q

Contaminated wounds:

A

result from a break in sterile technique during surgery; have a higher risk of infection

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29
Q

Infected wounds:

A

shows clinical signs of infection including redness, warmth, and increased drainage

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30
Q

Colonized wounds:

A

1 or more organisms are present on the surface of the wound; when a swab culture is obtained but there is not overt sign of infection in the tissue below the surface

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31
Q

Acute wound:

A

wound that progresses through the phases of wound healing in a rapid, uncomplicated manner

32
Q

Approximated:

A

the edges of a wound can be brought together

33
Q

Primary Intention:

A

heal quickly and result in minimal scar formation

34
Q

Chronic wound:

A

fails to progress to healing in a timely manner

35
Q

Secondary Intention:

A

new tissue must fill in from the bottom and the sides of the wound until the wound bed is filled with new tissues

36
Q

Tertiary Intention:

A

a delay occurs between injury and closure

37
Q

Phases of wound healing:

A

inflammation
proliferative
maturation

38
Q

Inflammatory Phase:

A

beings with the body’s initial response to wounding of the skin and last about 3 days (a the end of this phase, the wound bed is clean and ready to being the actual repair process)

39
Q

Proliferative Phase:

A

healing/repair of the defect, filling in the wound bed with granulation tissue, and resurfacing the wound with skin.

40
Q

Granulation tissue:

A

new tissues created to fill the wound

41
Q

Angiogenesis:

A

development of new blood vessels that are needed to support the new tissue, collagen synthesis, wound contraction, and epithelialization

42
Q

Fistula:

A

abnormal connections between two internal organs or between an internal organ through the skin, outside of the body q

43
Q

Pressure Injury:

A

localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure, or pressure in combo with shear

44
Q

Capillary closing pressure/critical closing pressure:

A

minimum pressure required to collapse a capillary

45
Q

Low levels of pressure over long periods of time can be:

A

as damaging to the skin and underlying tissue as high levels of pressure over a short period of time

46
Q

Maceration:

A

excessive moisture causes softening of the skin

47
Q

Stage I pressure ulcer:

A

intact, nonblistered skin with nonblanchable erythema or persistent redness, in the ares that has been exposed to pressure.

48
Q

Stage II pressure ulcer:

A

partial thickness would that involves the epidermis and/or dermis but does not extend below the level of the dermis

49
Q

Maturation Phase:

A

(remodeling phase) can last up to a year; collagen continues to be deposited and remodeled and scar tissue is formed and strengthens

50
Q

Scar Tissue:

A

a vascular mass of collagen that give strength to the repaired wound
(strength of the scar is never equal to that of unwounded tissues; it only reached about 80% of its previous tensile strength)

51
Q

Factors affecting wound healing:

A 
oxygenation and tissue perfusion
diabetes
nutrition
age 
infection
52
Q

Dehiscence:

A

partial or complete separation of the tissue layers during the healing process

53
Q

Evisceration:

A

total separation of the tissue layers allowing the protrusion of visceral organs through the insision

54
Q

Teach patient to splint the incision with a pillow or blanket or to use an abdominal binder while:

A

coughing, deep breathing, and movement

55
Q

Serous drainage:

A

clear, watery fluid

56
Q

Serosanguineous drainage:

A

pink to pale red and contains a mix of serous fluid, and red bloody fluid

57
Q

Sanguineous fluid:

A

indicated bleeding and is bright red

58
Q

Change a patient’s position at least:

A

every 2 hours

59
Q

Debridement:

A

removal of necrotic tissue

60
Q

Hospital acquired pressure ulcers are:

A

NOT reimbursed

61
Q

Abnormal reactive hyperemia:

A

the redness in Stage I and is due to excessive vasodilation caused by pressure

62
Q

Purulent drianage:

A

thick and indicates infection; can be yellowish, greenish, or beige

63
Q

Hydrocolloids:

A

adhesive dressings that provide a moist wound environment and their absorbent capabilities prevent the wound bed and surround tissue from becoming to wet.
(not recommended for wounds suspected of being infected)

64
Q

Stage III Pressure Ulcer:

A

full thickness wounds that extend into the subcutaneous tissue but do not extend through the fascia to muscle, bone, or connective tissue

65
Q

Undermining:

A

area of tissue loss present under intact skin usually along the edges of the wound, forming a “lip” around the wound

66
Q

Tunnel or sinus tract:

A

narrower passage way extending outward from the edge of the wound

67
Q

Stage IV pressure ulcer:

A

deeper than stage III and involves exposure of muscle, bone, or connective tissue

68
Q

Osteomyelitis:

A

infection of the bone

69
Q

Unstageable pressure ulcer:

A

full thickness wound in which the amount of necrotic tissue in the wound bed makes it impossible to assess the depth of the wound or the involvement of underlying structures

70
Q

Suspected deep tissue injury:

A

area of intact skin that is purple or a blood filled blister

71
Q

Gels:

A

add moisture to a wound thus creating a most environment and allowing autolytic debridement and wound healing to occur. (don’t absorb little wound drainage and thus are inappropriate for a highly exudative wound

72
Q

Foams:

A

pull fluid away from the wound bed yet maintain a most wound environment, used for wounds producing moderate to heavy amounts of exudate and should not be used for wounds with only a small amount of drainage (do not relieve pressure)`

73
Q

Transparent films:

A

stick to the periwound skin but not to the actual wound bed- not appropriate for wounds with more than a minimal amount of drainage. the films prevent bacteria and fluids from enter the wound but allow oxygen and water vapor to move through the dressing. they imitate that action of a blister by keeping the body’s own wound fluid next to the wound bed, maintaining a moist environment

74
Q

Gauze:

A

isn’t effective as a barrier against infection removal often results in pain and damage to the wound bed, fibers can be left, also has an inability to maintain a most wound environment required for healing for healing, gauze is preferable for allowing the wound to become dry useful in cover dressings, and for absorbing exudate from a healing draining wound

75
Q

Alignates:

A

useful in highly exudative wounds should be avoided in dry wounds, have the ability to stop bleeding

Fundamentals (12 decks)

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