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508 > Wound Care > Flashcards

Wound Care Flashcards

1
Q

Characteristics of the epidermis

A

outer epithelial layer
protective barrier
avascular
prevents dehydration of underlying tissue

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2
Q

Characteristics of the dermis

A

highly vascular

strong and elastic due to collagen and elastin

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3
Q

What does the dermis contain

A

hair follicles
sebaceous glands
nerve endings
receptors for pain, touch, cold, heat

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4
Q

Characteristics of the subcutaneous layer

A

below dermis
adipose tissue
connective tissue-fascia

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5
Q

What does thhe subcutaneous tissue do

A

provide insulation, support, cushioning

protects underlying tissue

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6
Q

what is a partial thickness wound

A

through the epidermis into dermis

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7
Q

What are the phases of normal wound healing

A

inflammatory
proliferative
maturation/remodeling

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8
Q

what does the inflammatory pahse do

A

prepares wound for healing and cleans debris

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9
Q

What does the proliferative phase do

A

rebuilds the damaged structures and provides strength to the wound

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10
Q

what does the maturation/proliferative stage do

A

modifies the immature scar to a mature scar

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11
Q

What occurs during the inflammation phase

A

control bleeding and combat infection

signal cells necessary for repair and regeneration

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12
Q

How long does inflammation last

A

acute: 24-48 hours
subacute: up to 6 days

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13
Q

Cardinal signals of the inflammatory phase

A 
swelling 
redness
warmth
pain
decreased function
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14
Q

What are the 4 events that occur in the proliferative phase

A

angiogenesis
granulation tissue formation
wound contraction
epithelialization

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15
Q

what is angiogenesis

A

formation of new blood vessels

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16
Q

what is granulation tissue formation

A

temporary connective tissue that goes across and fills the wound

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17
Q

What is wound contraction

A

edges of wound grow closer together

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18
Q

what is epithelialization

A

epithelial cells that go across temporary granulation

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19
Q

what is the purpose of the proliferative phase

A

resurfacing of the wound bed

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20
Q

What does the tissue look like in the proliferative phase

A

red, beefy, fragile

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21
Q

how long does the proliferative phase last

A

2-24 days

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22
Q

How long is the maturation/remodeling phase

A

21 days on

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23
Q

what happens in the maturation/remodeling phase

A

changes in the bulk, form, and strength of scar

granulation tissue must be strengthened and reorganized to fit surrounding tissue

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24
Q

When does the greatest change occur in the maturation/remodeling phase

A

6-12 mo

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25
Q

What are the 3 methods of wound closure

A

primary
secondary
delayed primary

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26
Q

What is primary wound closure

A 
edges touch (what you think of with surgical wound)
can use staple glue stitches
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27
Q

What is secondary wound closure

A

wound edges dont touch

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28
Q

what is delayed primary wound closure

A

wound edges can be touching but wait to close

29
Q

What is eschar

A

dry darker black dead tissue

30
Q

What is skin

A

largest organ in the body

interphase b/t body and env.

31
Q

What is slough

A

moist, green-yellow, slimy dead tissue

32
Q

what is desiccation

A

look dry, including edges

33
Q

what is maceration

A

too moist/wet

makes tissue fragile

34
Q

What is undermining

A

use q tip to go underneath edges of wound b/c it extends past edges

35
Q

What is tunneling

A

stick something under skin b/t 2 wounds

36
Q

What is exudate

A

Thicker liquid b/c more protein in it

yellow, cream

37
Q

what is transudate

A

generally blister

clear watery fluid

38
Q

what is periwound

A

edge of wound

where edge of wound stops and healthy skin begins

39
Q

Factors affecting wound healing

A

wound characteristics
local factors
systemic factors

40
Q

Wound characteristics affecting healing

A 
mechanism of onset 
time since onset
location
dimensions 
wound hydration
necrotic tissue or foreign bodies
infection
41
Q

local factors affecting wound healing

A

circulation (diabetes, cold, fear, pain, peripheral vascular diseases)
sensation (perihperal neuropathy, stroke)
mechanical stress (pressure ulcer)

42
Q

systemic factors affecting wound healing

A 
Age
inadequate nutrition
comorbidities 
meds
behavioral risk taking
43
Q

Types of wounds

A 
Arterial insufficiency
Veous insufficiency 
pressure ulcers
neuropathic ulcers
burns 
trauma
44
Q

What is the pain like in arterial wound insufficiency

A

severe

increased with elevation (b/c decrease circulation more)

45
Q

What is the location of arterial insufficiency

A

Mostly LE (distal toes, dorsum of foot, lat malleous, ant, leg, areas of trauma)

46
Q

What is an arterial insufficiency wound like

A 
Base pale
poor granulation 
round regular margins 
little to no bleeding,drainage
necrotic tissue
47
Q

What is the appearance of an arterial insufficiency wound

A

Thin, shiny, ddry skin, hair loss, cool skin

48
Q

What are pulses like in arterial insufficiency wounds

A

decreased or absent pedal pulse

49
Q

Factors leading to arterial insuffiency ulcers

A 
Smoking
diabetes
hypertension
advanced age
trauma
hypolymphedma
50
Q

what is the pain like in venous insufficiency wounds

A

mild to moderate

decreased w/ elevation/compression

51
Q

What is the location or venous insifficiency wounds

A

Medila lower leg, medial malleous, areas of trauma

52
Q

what is the wound like in venous insufficiency

A

Red wound bed
good granulation
irregular margins
copious drainage

53
Q

What is the appearance of a venous insufficiency

A

edema

normal to warm skin temp

54
Q

What is the pulse like in venous insufficiency

A

normal

55
Q

Where are the most common places for pressure ulcers

A

bony prominences (sacrum, greater trochanter, heels)

56
Q

Where are common locations for neuropathic ulcers

A

heel, ball of foot, big toe

57
Q

What are burns classified by

A

Type and depth

58
Q

What are the goals of wound care

A 
protection 
reduce strain on nearby tissue 
protect periwound
reduce pathogenic microorganisms in and around wound
speed up healing process
reduce/decrease scar tissue
59
Q

What to document and assess in wound care

A 
Location 
size
undermining/tunneling
wound bed 
edges
drainage 
odor 
surrounding skin 
wound healing
60
Q

What are the two methods of debridement

A

selective

nonselective

61
Q

What are form of selective debridement

A

sharps
autolytic
enzymatic
biologic

62
Q

what is autolytic

A

use bodys own enzymes to get rid of tissue

63
Q

What is enzymatic

A

put topical enzyme on wound

64
Q

What is biologic debridement

A

use maggots

65
Q

What are nonselective forms of debridement

A

mechanical-scrubbing, whirlpool

Surgical

66
Q

Universal precautions for wound care

A

use gloves
use appropriate disposal containers
use a sterile field when debriding a wound

67
Q

Modalities for wound care

A 
Whirlpool
e stim
ultrasound
hyperbaric o2
pulsatile lavage
vac
compression
68
Q

What type of env do wounds heal faster

A

moist

508 (10 decks)

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