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Wound Basics Flashcards

1
Q

Wound Documentation

A

-give location
-measurement
-shape
-appearance
-drainage

cheese on pizza

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2
Q

Systems Review

A

Cardio: vitals, edema
MSK: posture, ROM, Strength
NeuroMSK: transfers, gaits ensation
GI: nutrition
Urogenital: continence and fre
Integ: color, scars, hair, nails

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3
Q

Wound Edges Documentation

A

-describe with terms, include viability

pizza crust

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4
Q

Periwound

A

-space around the wound
-describe its health

pizza box

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5
Q

Wound Location

A

-describe body part its located on and orientation
-number the wounds if multiple

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6
Q

Wound Measurement

A

Test longest and widest and calculate area
-support by lit, but might be inacurate

Clock Method
-12 relative to head and 6 relative to butt
-consistent
- L 12-6, W 9-3

Tracing Methods
-paper to trace the wound
-count boxes

Volumetric
-contamination

Photo
-HIPPA

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7
Q

Sinus Tract

A

-extends under skin surface but doesn not lead to anything
-drainage

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8
Q

Tunnel

A

-caused by destructtion of fascia
-has a destination (organ, joint, wound)

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9
Q

Undermining

A

-erosion under the wound edges

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10
Q

Granulation Tissue

A

-good, shows healing/blood supply
-bright red

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11
Q

Friable Tissue

A

-pink
-poor circulation/infection
-will not heal

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12
Q

Slough

A

-not viable tissue
-snot like
-yellow or brown
-WBC and bacteria

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13
Q

Eschar

A

-black or brown and leathery
-tissue death
-soft or hard
-usually on full thickness injuries

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14
Q

Drainage Color

A

Serous: clean/yellow/watery

Serosanguinous: pink

Sanguinous: red/blood

Purluent: yellow/tan/creamy
-infection

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15
Q

Drainage Amount

A

-None, min, mod, max

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16
Q

Epibole

A

-curved in wound edges
-signs of chronic wound

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17
Q

Hyperkeratosis

A

-build up of keratin on edge of wound and periwound

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18
Q

Maceration

A

-whiteness of wound edges and periwound
-skin has too much fluid
-waterlogged and is weaker

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19
Q

Turgor

A

-skin with less hydration
-will stay elevated after pinch

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20
Q

Erythema

A

-redness
-inflammation

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21
Q

Hemosiderin Stain

A

-blood stains skin
-chronic wound

22
Q

Pitting Edema Grading

A

+1 to +4
1. small depression
2. identifiable, rebound in <15s
3. repoinds in 15-30s
4. >30s

23
Q

Pulses

A

0-4+
-normal is 2+

24
Q

Skin

A

-largest organ
-1/3 of cardiac output

Epidermis: 5 layers
-avascular with hair, gland, nails
-barrier, regulates fluid, sensation, thermoreg, excretion, vit d
-renew in 45-75 days

Dermis: 2 layers
-vascular, lymphatics and epidermal appendages
-supports and nourishes epi, infection control, sensation

Subcutaneous:
-fat and fascia
-highly vascular

25
Epidermal Cells
Keratinocytes: re-eithepithekialization Melanocytes Merkel Cells: mechanoreceptors, light touch Langerhan's: immune from bone marrow
26
Dermal Cells
Fibroblasts: main cells of dermis, produce elastic and collagen, responsible for graulation tissue Macrophages WBC Mast Cells: mediators of inflammation, histamines
27
Superficial Wound
-epidermis only -abrasion, 1st degree burn
28
Partial Thickness Wound
-epidermis and dermis -blister, 2nd degree burn, stage II PI
29
Full Thickness Wound
-all 3 layers -full thickness burn, stage III or IV PI
30
Inflammatory Phase Cells
Platelets Cytokines: signal protein Growth Factors Polymorphonuclear Neutrophils Macrohages Mast Cells
31
Maturatiton of Remodeling
-new collagen (type 1) is put down for strength -old collagen (type III) is broken down -scar is only 80% as strong, 2nd gen scar is 64%
32
pH
4-6.5 -damage to corneum increases pH -washing often increases pH -urine or sweat decreases pH
33
Wound Closure
Primary: wound is cleana nd physically closes Secondary: wound left open and closes on its own Delayed Primary Closure: wound is initially left open but after is closed Abnormal: -scarring -Dehiscence: wound closes is opened -Hypogranulation: fails to granulate and fill in -Hypergranulation: granulation outside of wound
34
Chronic Wound
-stuck in inflammatory healing phase -have senescent cells -lower tissue inhibitors -dont respond to growth facots
35
Factors Affecting Healing
-wound dimensions, temp (decrease temp= decrease healing), hydration (want it hydrated), infection, circulation, stress, comorbidities, meds, nutrition, MOI, location, age, pt adherence
36
Protein for Wound Healing
-increase risk of PI -impaires collagen, granulation, angiogenesis, poor o2 perfusion
37
Carbs for Wound Healing
-energy for repair -energy needs increase with a wound
38
Fats for Wound Healing
-backup energy source -caries vitamins -thermoreg and cell membranes
39
Vitamin A
-collagen syn, granulation tissue, epithelization -can reverse damage of long term corticosteriod -can put in wound bed
40
Vitamin C
-build and maintain tissues, absorb iron, synthesize collagen -anttioxidant Deficiency: -altered capillaries, decreased wound strength -increased dehiscence
41
Vitamin K
-blood clotting Deficiency: -lengthen inflammatory phase
42
Zinc
-collagen and protein synth -epithelization -immune
43
Iron
-hemoglobinn binding o2 -antibody
44
Copper
-hemoglobin synthesis -iron absorption
45
Magnesium
Deficiency -HTN and vasoconstriction
46
Calcium
-fibrin synth for blood clotting
47
Lean Body Mass
10% loss: impaired immunity 20% loss: impaired healing and skin 30% loss: no healing, new wounds 40% loss: death
48
Labs
Creatine: kidney function Albumin: protein deficiency Prealbumin: recent changes in protein Serum Transferrin: protein status C-Reactive: inflammation BUN: decreased healing Glucose: risk of ulcer, infection, imapired healing
49
Measuring Depth
-dont average measurements -eschar may give misconception of debth
50
Myofibroblasts
-wound contraction

Integumentary (9 decks)

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