Skin ulcers Flashcards
T/F: pulses are normal with venous ulcer presence.
true
T/F: Venous ulcers aren’t painful at all.
true, none to aching pain in dependent position
Darker pigmentation indicates what kind of ulcer, venous or arterial?
venous
T/F: Edema is present with venous ulcers.
true
What are the causes of venous and arterial ulcers?
venous: valvular incompetance, venous hypertension
arterial: arteriosclerosis obliterans, artheroembolism
T/F: Venous ulcers have good granulation.
true
T/F: Venous ulcers are usually deep.
false, usually shallow
- arterial are deep
T/F: Venous ulcers usually have a moderate amount of exudate.
true
- arterial have none
T/F: Gangrene may be present with venous ulcers.
false, may be present for arterial ulcers
T/F: Venous ulcers may have possible cyanosis upon dependency.
true
- arterial have dusky rubor on dependency
T/F: Arterial ulcers usually have edema.
false, venous ulcers usually have edema
When is compression therapy for venous ulcers contraindicated?
with an ABI
Where are arterial ulcers commonly found?
anywhere on lower leg, but more common on small toes, feet, bony areas of trauma like the shin
T/F: Pulses are present usually with diabetic ulcers.
true and false; can be present or absent
Why does a pressure ulcer develop?
not moving results in hypoxic ischemia and damage to underlying tissue
Describe the stages of pressure ulcers.
1) nonblanchable erythema of intact skin
2) partial thickness skin loss, looks like abrasion, blister, or shallow crater
3) full thickness skin loss, damage to subcuntaenous tissue; deep crater
4) full thickness skin loss with extensive tissue necrosis, damage tom muscle, bone, etc; undermining present
What is silver nitrate?
a topical antimicrobial agent
What liquid is recommended to clean most ulcers?
normal saline
What type of mechanical wound cleansing is done?
irrigation (via squeeze bottle, pulsed lavage)
minimal mechanical force (gauze, cloth)
NOT whirlpool therapy
Why is debridement done?
decreases spread of infection (cellulitis, sepsis)
also allows examination of wound, decreased bacterial concentration in wound
T/F: Ideal dressings maintain a dry environment.
false; maintain a moist environment (quicker healing, less pain) and control excessive exudate, while insulating and protecting from contamination
Why a moist environment instead of dry for a wound dressing?
promotes faster and less painful healing
promotes autolytic debridement
Why use a silver dressing?
b/c it contains an antimicrobial agent
What is used for edema management? (not just compression stuff)
elevation ankle pumps/exercise compression wraps paste bandages (unna boot with zinc) compression stockings/pumps
What type of current is used for estim for wound healing? (3)
1) direct current with continuous waveform application
2) high voltage pulsed current
3) pulsed biphasic current
What level of albumin indicates malnutrition?
<3.5mm/dl
normal = 3.5-5.5
T/F: hydration is a huge concern for patients with wounds.
true - they need 3 or more liters of water a day to help promote healing
