Wound Flashcards
Site of wounds in arterial insufficiency
lat malleolus
dorsum of foot
toes
Trophic changes in arterial insufficiency
Abnormal hair growth
Decreased LE hair
Dry skin
Clinical presentation of a pt c venous insufficiency
Swelling of U/L or bilat LE
LE pain that is relieved by elevation
Early S/Sx of Arterial insufficiency
Decreased hair on toes
Characteristics of arterial wounds
(-) granulation
necrotic
pale
Temperature of extremity upon palpation in pts c Arterial insufficiency
Cool
Late S/Sx of Arterial insufficiency
Gangrene
Treatment for Lymphatic dse
Complete Decongestive Therapy (Phase 1 and 2)
Trophic changes in a pt c venous dse
Hemosiderin staining
Lipodermatosclerosis
Primary areas of pressure ulcers
Sacrum
Coccyx
GT
OT
Calcaneus
Lateral Malleolus
The temperature of extremity upon palpation in a pt c venous dse
Warm
Status of LE upon elevation in a pt c Arterial dse
Pallor
Steps for MLD
Decongest first
Milk distal to proximal
S/Sx of venous insufficiency
itching, aching, heavy limb
Status of LE upon dependency in a pt c Arterial dse
Rubor
Treatment for Arterial wounds
Debridement
Skin grafts
Amputation
Site of wounds in venous dse
Proximal to medial malleolus
Stages of pressure ulcers
Blanchable Erythema
Superficial abrasion, blisters, and shallow craters
Full thickness loss
Dyvascular S/Sx of neuropathies
Ischemia resulting to impaired healing time
Impaired O2 transportation
Poor wound healing
Cause of Pressure/Decubitus Ulcers
Unrelieved pressure to the dermis
Pressure sores/ulcers are common among
Immobilized individuals
Clinical presentation of a pt c lymphatic impairment
Swelling distal to or adjacent to the area c impaired lymphatic drainage
Gold standard intervention for venous dse
Compression therapy
Tissue under the wound edge becomes eroded, resulting in a pocket beneath the skin
Undermining
Clinical presentation of neuropathies
Ulcers in WB surfaces of the foot
Anesthetic, round, over bony prominences
Pathogenesis of pressure ulcers
Pressure occludes blood vessels leading to decreased blood flow towards it and resulting in cell death and necrosis
Motor S/Sx of neuropathies
Loss of intrinsic muscles
Hammer claw toes
Foot drop d/t loss of nerve supply
Characteristics of an Exudate
Creamy, yellowish
Moderate to very thick
Sensory S/Sx of neuropathies
No pain pressure and temperature sense
Increased risk for skin breakdown
Wound formation d/t
Any dse involving peripheral, cranial, and/or autonomic nerves
Neurpathies
Passageways underneath the skin surface that extend from a wound and can take twists and turns
Tunneling
Autonomic S/Sx of neuropathies
decreased or absent sweat and oil production resulting to dry and inelasstic skin
Heavy callus formation
Characteristics of a Transudate
Clear
Thin
Watery