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Integumentary > Week 4: Pressure Ulcers > Flashcards

Week 4: Pressure Ulcers Flashcards

1
Q

What is a localized area of tissue necrosis that develops when soft tissue is compressed between a firm surface and underlying bony prominence?

A

Pressure ulcer

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2
Q

What is the greatest risk for pressure ulcers?

A

IMMOBILITY

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3
Q

Which populations are at most risk for pressure ulcers?

A

individuals with spinal cord injuries, hospitalized patients, individuals in long-term care facilities

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4
Q

What is the capillary closing pressure?

A

13-32 mmHG

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5
Q

Pressure ulcers are a result of:

A

inverse pressure-time relationship, individual hemodynamic factors, and body location

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6
Q

____ is more sensitive to pressure than _____

A

Muscle, skin

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7
Q

What is a localized area of blanchable erythema?

A

reactive hyperemia

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8
Q

What predisposes skin to PU by causing maceration, increasing shear, and increasing friction forces?

A

moisture

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9
Q

What is a force parallel to soft tissue?

A

shear

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10
Q

What is two surfaces moving across one another

A

friction

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11
Q

What shape is produced by shear forces?

A

teardrop

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12
Q

What is the second most common risk factor?

A

malnutrition

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13
Q

more than _____ of patients with PUs are over 70 years old.

A

half

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14
Q

Scar tissue only attains up to ____% of the strength of the original tissue

A

80%

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15
Q

What are the most widely used screening tools for screening of pressure ulcers?

A

Braden Scale for Predicting Pressure Sore Risk
Norton Risk Assessment Scale
Gosnell Pressure Sore Risk Assessment

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16
Q

What are different ways of classifying pressure ulcers?

A

Integumentary Preferred Practice Patterns
Shea Staging System
International NPUAP/EPUAP Pressure Ulcer Classification System

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17
Q

What are the benefits of the International NPUAP/EPUAP PU Classification System?

A
  • Promotes uniform understanding of the depth of tissues involved
  • Excellent reliability
  • Clinicians must stage pressure ulcers for Medicare reimbursement
  • Determines type of support surface to be used
  • Can be used for research studies
18
Q

What tissues are involved in a stage 1 PU?

A

may be superficial or may the the first sign of deeper tissue involvement

19
Q

What tissues are involved in a stage 2 PU?

A

partial thickness (epidermis and/or dermis)

20
Q

What tissues are involved in a stage 3 PU?

A

full thickness (epidermis, dermis, and subcutaneous)… bone or tendon not visible

21
Q

What tissues are involved in a stage 4 PU?

A

full thickness with underlying deep tissue exposed

22
Q

Practice pattern for Stage II PU?

A

C

23
Q

Practice pattern for Stage III PU?

A

D

24
Q

What tissues are involved in unstageable ulcers?

A

full thickness (III or IV)

25
Q

What are certain PUs unstageable?

A

base obscured by eschar or slough

26
Q

What are some limitations of the NPUAP/EPUAP PU Classification System?

A

Stage I is not an ulcer by definition, clinicians may erroneously reverse stage a pressure ulcer, significant revision of prior system (takes time to adapt)

27
Q

What is the 5PT method of characterizing pressure ulcers?

A

Pain, Position, Presentation, Periwound, Pulses, Temperature

28
Q

What are the areas at most risk when a patient is lying supine?

A

Posterior heel, sacrum/coccyx, spinous process, medial humeral epicondyle, scapula, occiput

29
Q

What are the areas at most risk when a patient is lying sidelying?

A

Malleolus, medial and lateral femoral condyles, greater trochanter, lateral humeral epicondyle, ear

30
Q

What are the areas at most risk when a patient is lying prone?

A

Anterior tibia, anterior knee, ASIS

31
Q

What are the areas at most risk when a patient is seated?

A

Sacrum/coccyx, ischial tuberosity, greater trochanter

32
Q

95% of pressure ulcers are located over:

A

sacrum, greater troch, ischial tub, posterior calcaneous, lateral malleolus

33
Q

Temperature is increased in areas of _______ and decreased in areas of ______.

A

reactive hyperemia, ischemia

34
Q

What are the major observational scales of pressure ulcers?

A

Sessing, Bates-Kensen Wound Assesment Tool (WBAT), Pressure Ulcer Scale of Healing (PUSH)

35
Q

How long does a Stage I PU take to heal?

A

1-3 weeks

36
Q

How long does a Stage II PU take to heal?

A

days to weeks

37
Q

How long does a Stage III or IV PU take to heal?

A

average of 8-13 weeks

38
Q

Ulcers that do not decrease in size within ____ weeks should be reassessed for alternative/adjunctive interventions.

A

2 weeks

39
Q

What should be done with sounds that fail to progress in a timely manner and that show signs/symptoms of infection?

A

culture

40
Q

What should be done with wounds that have exposed bone or with deep wounds with purulent or malodorous drainage?

A

assess for osteomyelitis

Integumentary (12 decks)

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