Unit 2 Flashcards
Compliance
One-way interaction in which the clinician directs the pt to follow instruction
Adherence
Pt freely chooses to follow suggested guidelines
Emaciation
The state of being abnormally thin or weak
Parenteral nutrition
Nutrition delivered through IV
Enteral
Nutrition delivered via feeding tube
Examples of enteral nutrition
OG - orogastric
NG - nasogastric
Nasojejunal
Gastrostomy
Jejunostomy
Water is __ of body composition.
60%
A healthy individual requires __ L of water per day.
2.2-3.0 L
Pts with open wounds require __ L of water per day.
2.7-3.7 L
Why do pts on air beds require more water than pts with open wounds?
Air beds have more heat association which requires increased water intake
The body requires a __ nitrogen balance.
Positive
Vitamin A
Fat soluble
Helps maintain healthy skin & epithelial integrity
Required for collagen synthesis, promotes granulation tissue formation, and facilitates epithelialization
Vitamin C
Water soluble
Needed to build and maintain tissues; deficiencies will delay wound healing
Antioxidant - may limit damaging effects of free radicals
Vitamin K
Fat soluble
Essential for blood clotting
Vitamin E
Fat soluble
Helps prevent free radical-related cellular damage
Decreases inflammatory phase of wound healing, enhances immune function and decreases platelet adhesion
Supplementation may assist with pressure ulcer healing
Vitamin B Complex
Required for normal immune function and energy metabolism
Aid in WBC function, antibody formation, and resistance to infection
Improve wound tensile strength
What is the normal WBC count?
5.0-10.0 uL
What is the normal HCT value?
Men: 42-52%
Women: 37-47%
What is the normal hemoglobin value?
Men: 14-17.4 g/dL
Women: 12-16 g/dL
What is the normal platelet value?
140-400 k/uL
What is the normal glucose value?
70-100 mg/dL
What is the normal A1c value?
< 5.7%
What does creatinine measure?
Kidney function and protein metabolism
What does serum albumin measure?
Protein deficiency and malnutrition - long half-life
what does prealbumin measure?
Protein deficiency and malnutrition - short half-life
What is 3rd spacing?
Fluids moving from the vascular space to the interstitial space; this is NOT blood moving
Generally caused by fluid overload, kidney dysfunction, hyponatremia, heart failure (increased capillary hydrostatic pressure)
What does BUN measure?
Protein metabolism and kidney function
What does a higher BUN indicate?
Slower healing
What does CPK measure?
MI or deep tissue injury
Undermining
Erosion of tissue close to the wound edges; results in a large wound with a small opening
Tunneling
Narrow passageway within a wound bed
Common in all wound types EXCEPT venous insufficiency ulcers
Sinus Tract
Elongated cavity or abscess that drains to the body surface
Boggy wound with pus collection
Fistula
Tunnel that connects with a body cavity or organ
Maceration
Occurs when wounds are too wet, becomes white colored
Pitting Edema
1+ barely perceptible depression, < 2 mm
2+ rebounds < 15 seconds, 2-4 mm
3+ rebounds 15-30 seconds, 5-7 mm
4+ rebounds > 30 seconds, > 7 mm
Positive indicator
Improvement in wound - i.e., improved A1c and/or ABI, compliance with compression, previous healing
What wound care treatment can PTA’s NOT do?
Sharp debridement
Contact precaution PPE
Gloves and gown
What conditions require contact precautions?
VRE
MRSA
Scabies
Lice
Large non-contaminated draining wounds
Droplet precaution PPE
Gloves, gown, and mask
What conditions require droplet precautions?
Necrotizing fasciitis, certain PNA’s, influenza
Airborne precaution PPE
Gloves, gown, N-95, negative pressure room
What conditions require airborne precautions?
TB, measles
What is reverse isolation?
Wearing PPE to protect those with weakened immune system
Which conditions require reverse isolation?
AIDS, certain types of cancer
What is gram-positive staining?
Excretion of exotoxins causing extensive damage
Methicillin-Resistant Staphylococcus Aureus (MRSA)
Resistant to many abx
Spreads easily
Treated with Bactroban
Common in blood, stool, wounds
CONTACT ISOLATION
Vancomycin-Resistant Enterococci (VRE)
Common in surgical wounds and urine
Treated with Ampicillin-Amoxicillin
CONTACT ISOLATION
Biofilms
Complex communities of bacteria or fungi held together by a self-produced polymer matrix
Persist on medical devices, surfaces, and tissues causing chronic infection
Very difficult to kill - require long term IV abx
Microflora
Bacteria & fungi
Covers skin
Contamination
NORMAL
Microbes are non-replicating
Colonization
NORMAL
Replicating microbes
Critical Colonization
Bioburden reaches a critical point and begins to adversely affect host
Healthy individuals can tolerate higher amounts
What is the gold standard of wound cultures?
Tissue biopsy
Which is longer acting: creams or ointments?
Ointments (8-24 hrs)
Antiseptic
Antimicrobial that is cytotoxic
