Wound Care Flashcards
1
Q
What are the layers of the integumentary system
A
- epidermis
- dermis
- subcutaneous
2
Q
What are the functions of the skin?
A
- protection
- sensation
- secretion
- thermoregulation
3
Q
What are the 4 phases of wound healing?
A
- Haemostasis
- vasoconstriction, platelet plug, clotting cascade - Inflammation
- increased blood flow - proliferation
- growth of epithelial cells for repair
- granulation, fibroblasts - Maturation
- scar cell tissue
4
Q
What is a Primary intention wound?
A
- clean surgical incision
- edges pulled together by stapes, glue or sutures
5
Q
What is a Secondary intention wound?
A
- extensive tissue loss
- laceration heals through granulation and epithelisation
6
Q
What are some factors affecting wound healing?
A
- nutrition & hydration
- co-morbidities
- age
- previous injuries
- medications
- infections
7
Q
What are some common skin changes when aging?
A
- loss of subcutaneous tissue
- decrease of thermoregulation
- loss of turgor
- loss of sensation
- reduced immune response
8
Q
What are you looking for during a skin inspection?
A
- pressure injuries
- colour changes
- temperature
- moisture
- turgor
9
Q
What are some signs of a pressure injury?
A
- non-blanchable skin
- redness
- firmness
- skin breakdown
- localised heat
10
Q
What questions do you ask during a wound assessment?
A
- Wound history?
- Cause?
- Wound size?
- Wound edges?
- Location?
- Clinical appearance?
- Pain
- Surrounding skin look like?
11
Q
What are some classifications of tissue loss?
A
- superficial (epidermis)
- partial thickness loss (epidermis and dermis)
- full thickness loss (all three layers)
12
Q
List the descriptions of wound exudate (leakage)
A
- Serous (clear)
- Haemoserous (slightly blood stained)
- Sanguineous (heavy blood stained)
- Purulent (contains pus)
13
Q
3 important steps for a Skin Assessment?
A
- prepare equipment
- gather relevant info
- observe and feel skin
14
Q
Steps to maintain skin integrity?
A
- assess regularly
- quality hygiene care
- dry thoroughly
- loose clothing
15
Q
What is Asepsis?
A
- Keeping thing sterile
- the absence of pathogens and microorganisms
- prevent contamination of wounds
