WK5- Holistic Management of Patient's with Wounds Flashcards
What is the difference between patient adherence and compliance
compliance is a one way interaction between clinician and patient
adherence is when a patient freely chooses to follow suggested guidelines.
What is the difference between parenteral and enteral nutrition ?
parenteral: nutrition that is delivered intravenously
Enteral: nutrition delivered via feeding tube
What is the clinical manifestation of this possible deficiency: Water
Dry skin, hair, and mucous membranes
poor skin turgor
increased HR and RR
orthostatic hypotension
confusion
sunken eyeballs
What is the clinical manifestation of this possible deficiency: Protein
dull, dry hair
pallor
peripheral edema
pressure ulcers, especially multiple or repeat ulcerations
What is the clinical manifestation of this possible deficiency: Carbohydrates/Energy
decline in body weight
pallor
extremely poor dentition
What is the clinical manifestation of this possible deficiency: Fats
Emaciated
epidermal flaking
fissuring of the skin
large flakes of dandruff
What is the clinical manifestation of this possible deficiency: Vitamin A
night blindness
difficulty adapting to changes in light intensity
scleral changes and dry eyes
gingivitis
pigment changes
dry skin
What is the clinical manifestation of this possible deficiency: Vitamin C
Swollen Gums that bleed readily
transparent skin quality
weakness
delayed wound healing
can help the body absorb iron
What is the clinical manifestation of this possible deficiency: Vitamin K
petechiae
wounds bleed readily
What is the clinical manifestation of this possible deficiency: B Complex Vitamins
pallor, pale eye membranes, hyperpigmentation, redness or swelling of the mouth, mouth sores, purple discoloration of the tongue with loss of villi, swollen gums that bleed readily, confusion, muscle cramps, anemia
What is the clinical manifestation of this possible deficiency: Zinc
Decreased sense of taste
dull, dry, or thinning hair
seborrhea-like dryness and redness of the face
What is the clinical manifestation of this possible deficiency: Iron
pallor, yellow discoloration of the skin
soft, spoon shaped nails
Easily fatigued
dyspnea
anemia
What is the clinical manifestation of this possible deficiency: Copper
Thinning of hair
may have pigmentation changes
What is the clinical manifestation of this possible deficiency: Magnesium
Dehydration, neuromuscular hyperexcitability, confusion
What is the clinical manifestation of this possible deficiency: Calcium
acute: neuromuscular hyperexcitiablity, dysrhythmias
Skeletal deformities such as kyphoscoliosis, bone pain, fractures, dry scaling skin, brittle nails
What is the clinical manifestation of this possible deficiency: Phosphorus
Skeletal deformities, idiopathic fractures, bone pain
What is the clinical manifestation of this possible deficiency: Selenium
Decreased ability to fight infection
muscle pain
muscle wasting
What are the normal values for: Total lymphocyte count
> 1800 cells/mm cubed
What are the normal values for: Blood glucose
70-110 mg/dL
What are the normal values for: Platelets ?
140-400 k/uL
What are the normal values for: Hematocrit (HCT) ?
Men: 42-52%
Women: 37-47%
Critical Values: <15-20% or >60%
What are the normal values for hemoglobin ?
Men: 14-17.4 g/dL
Women: 12-16 g/dL
Critical Values: <5-7 g/dL or >20 g/dL
What are the normal values for A1C ?
<5.7%
What are the normal values for: Total White Blood Cells ?
5.0-10.0 10 to the 9th/L
Vitamin A
also called retinol
help maintain healthy skin and epithelial integrity, required for collagen synthesis, promotes granulation tissue formation, and facilitates epthelialization.
Vitamin C
also called ascorbic acid
needed to build and maintain tissues, helps the body absorb iron and is necessary for collagen synthesis.
Vitamin K
essential for blood clotting, patients on anticoagulants should not initiate vitamin K supplementation without clearance
B Complex
a group of eight water soluble vitamins required for normal immune function and energy metabolism. Aid in WBC formation, antibody formation, and resistance to infection. Facilitate fibroblast function and collagen synthesis, improving wound tensile strength.
Vitamin E
helps prevent free radical related cellular damage.
Decreases inflammatory phase of wound healing, enhances immune function, and decreases platelet adhesion.
Zinc
necessary for: collagen and protein synthesis, cell proliferation, epithelialization, and normal immune function. It is also an antioxidant.
Iron
essential component of hemoglobin, required for oxygen transport, antibody production and normal immune function.
Copper
required for hemoglobin synthesis, iron transport and absorption
Magnesium
important in bone formation, protein synthesis, repair, critical cofactor to over 300 enzyme systems.
Calcium
vital to bone formation, bone remodeling, and muscle contraction
fibrin synthesis in blood clotting
important neurotransmitter
Phosphorous
needed for bone formation, normal metabolism, fluid balance, essential in enzyme systems
Selenium
required for synthesis of up to 30 proteins and assistance of normal immune function.
What does the lab measure value and why is it important: Creatinine
creatinine measures kidney function and protein status. Normal creatinine levels are .8-1.5 mg/dL.
What does the lab measure value and why is it important: Serum Albumin
Serum albumin is a plasma protein whose decreased levels can indicate protein deficiency, malnutrition, increased hospitalization time and complications, more adverse pressure ulcer formation risk, and tissue edema.
normal is 3.5g/dL
What does the lab measure value and why is it important: Prealbumin
prealbumin is a major transport protein. Prealbum decrease levels can indicated mortality risk, though unreliable as a standard.
What does the lab measure value and why is it important: Serum Transferrin
serum transferrin is an indicator of protein status that is responsive to short term change.
What does the lab measure value and why is it important: Blood Urea Nitrogen ( BUN)
BUN is an indicator of renal function, normally between 5-25 mg/dL. Elevated BUN levels indicate a decrease in wound healing.
What does the lab measure value and why is it important: Total Lymphocyte count (TLC)
an indirect measure of nutritional status and immune function. Decreased TLC is associated with delayed wound healing, and increased mortality.
What does the lab measure value and why is it important: Blood Glucose
measures blood sugar
increased risk of ulceration, infection, and impaired wound healing.
