Wound Care

Question 1

Maceration

Answer 1

Exessive moisture causing skin breakdown (Dressing NOT absorbing exudate or keeping wound too moist)

Sometimes can be corrected by more frequent dressing changes

Question 2

Slough

Answer 2

Yellow crusting surface that does not wash off

Question 3

Eschar

Answer 3

Black build up that must be removed by wound care/surgical nurse

Question 4

Deprivement

Answer 4

the procees of removing dead tissue from a wound

Question 5

When is a wound swab obtained?

Answer 5

After the wound is cleaned

Question 6

Well approximated incision

Answer 6

BOth edges of the incision are touching each other along the entire cut

Question 7

How do nurses remove suctures?

Answer 7

Removing every second one, in case the wound has not fully healed, so that it doesn’t fall apart

Question 8

Dee-hiss-ance

Answer 8

When an incision seperates

Question 9

What items must you gather to perform a simple dressing change?

Answer 9

Sterile dressing tray
Clean clothes
Sterile normal saline or cleaning solution
A new sterile dressing

Question 10

Major purposes of dressing?

Answer 10

Protects wound from microorganism contamination.
.

b.
Promotes thermal insulation of the wound surface.

c.
Provides a moist environment for the wound bed,
.

d.
Protects patient from seeing the wound (if perceived as unpleasant).
.

e.
Physically supports the wound site.
.

f.
Aids in hemostasis.

g.
Absorbs drainage and supports auto-lytic debridement.

Question 11

Purpose of gauze net in relation to dressing

Answer 11

Secures large dressing that are often located in difficult areas to tape.

Question 12

Ties

Answer 12

Used when frequent dressing changes are required.

Question 13

Tape

Answer 13

The nurse ensures that the periwound skin is not excoriated or at risk of breakdown.

Question 14

Secondary Intention.

Answer 14

In this type of wound healing there is loss of tissue which must be filled with scar tissue. Chance of infection is greater.

Question 15

Primary intention

Answer 15

The skin edges are approximated or closed and the risk of infection is low. There is little tissue repair required

Question 16

The proliferation phase of wound healing last

Answer 16

3-24

Question 17

Indicators of wound infection

Answer 17

Elevated temperature

Feeling unwell.

Discomfort in the incision site.

Redness in the incision site.

Question 18

which statement below represents the most important aspects of either a clean or sterile approach.

Answer 18

Ensure as clean a field as possible with the use of sterile dressing packs, sterile scissors, forceps,dressings and gloves.

Question 19

A description of a hydro-colloid dressing is:

Answer 19

Pre-moistened gauze placed over a granulating wound

Question 20

Before changing a dressing the nurse should:

Answer 20

Discuss the plan to change the dressing with the patient, assess the need for analgesia, and provide it, if necessary.

Question 21

serosanguinous