Skin ulcers

Question 1

T/F: pulses are normal with venous ulcer presence.

Answer 1

true

Question 2

T/F: Venous ulcers aren’t painful at all.

Answer 2

true, none to aching pain in dependent position

Question 3

Darker pigmentation indicates what kind of ulcer, venous or arterial?

Answer 3

venous

Question 4

T/F: Edema is present with venous ulcers.

Answer 4

true

Question 5

What are the causes of venous and arterial ulcers?

Answer 5

venous: valvular incompetance, venous hypertension
arterial: arteriosclerosis obliterans, artheroembolism

Question 6

T/F: Venous ulcers have good granulation.

Answer 6

true

Question 7

T/F: Venous ulcers are usually deep.

Answer 7

false, usually shallow

- arterial are deep

Question 8

T/F: Venous ulcers usually have a moderate amount of exudate.

Answer 8

true

- arterial have none

Question 9

T/F: Gangrene may be present with venous ulcers.

Answer 9

false, may be present for arterial ulcers

Question 10

T/F: Venous ulcers may have possible cyanosis upon dependency.

Answer 10

true

- arterial have dusky rubor on dependency

Question 11

T/F: Arterial ulcers usually have edema.

Answer 11

false, venous ulcers usually have edema

Question 12

When is compression therapy for venous ulcers contraindicated?

Answer 12

with an ABI

Question 13

Where are arterial ulcers commonly found?

Answer 13

anywhere on lower leg, but more common on small toes, feet, bony areas of trauma like the shin

Question 14

T/F: Pulses are present usually with diabetic ulcers.

Answer 14

true and false; can be present or absent

Question 15

Why does a pressure ulcer develop?

Answer 15

not moving results in hypoxic ischemia and damage to underlying tissue

Question 16

Describe the stages of pressure ulcers.

Answer 16

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

Question 17

What is silver nitrate?

Answer 17

a topical antimicrobial agent

Question 18

What liquid is recommended to clean most ulcers?

Answer 18

normal saline

Question 19

What type of mechanical wound cleansing is done?

Answer 19

irrigation (via squeeze bottle, pulsed lavage)
minimal mechanical force (gauze, cloth)

NOT whirlpool therapy

Question 20

Why is debridement done?

Answer 20

decreases spread of infection (cellulitis, sepsis)

also allows examination of wound, decreased bacterial concentration in wound

Question 21

T/F: Ideal dressings maintain a dry environment.

Answer 21

false; maintain a moist environment (quicker healing, less pain) and control excessive exudate, while insulating and protecting from contamination

Question 22

Why a moist environment instead of dry for a wound dressing?

Answer 22

promotes faster and less painful healing

promotes autolytic debridement

Question 23

Why use a silver dressing?

Answer 23

b/c it contains an antimicrobial agent

Question 24

What is used for edema management? (not just compression stuff)

Answer 24

elevation
ankle pumps/exercise
compression wraps
paste bandages (unna boot with zinc)
compression stockings/pumps

Question 25

What type of current is used for estim for wound healing? (3)

Answer 25

1) direct current with continuous waveform application
2) high voltage pulsed current
3) pulsed biphasic current

Question 26

What level of albumin indicates malnutrition?

Answer 26

<3.5mm/dl

normal = 3.5-5.5

Question 27

T/F: hydration is a huge concern for patients with wounds.

Answer 27

true - they need 3 or more liters of water a day to help promote healing