Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology 1 > Wound Care > Flashcards

Wound Care Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

Partial thickness wound healing

A
  • steam burn, abrasion
  • Re-epithelialization and regeneration
  • nl skin function returns
  • No scar
  • Epithelial cells come from hair follicle or edge of wound
  • 10-14 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Full thickness wound healing

A
  • heal by scar tissue formation
  • lose nl tissue function
  • four phases:
    1. Inflammation
    2. Granulation/proliferation
    3. Epithelialization
    4. Maturation/remodeling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Inflammation stage of full thickness wound healing

A
  • First 7 days
  • Provide hemostasis and clear bacteria, foreign material, dead tissue
  • Can be confused with infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Granulation/proliferation stage of full thickness wound healing

A
  • Fibroblasts synthesize collagen
  • Angiogenesis infiltrates collagen
  • O2 and nutrition demands are high
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Epithelialization stage of full thickness wound healing

A
  • Overlaps with proliferative phase

- Continues from edges like partial thickness wounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Maturation/remodeling stage of full thickness wound healing

A
  • May last up to 2 years
  • Overlaps proliferation and epithelialization
  • Reorganizes matrix collagen along lines of stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Intrinsic factors that affect healing

A
  • General health
  • Age
  • Chronic disease
  • Immunosuppression
  • Sensory impairment (DM)
  • Tissue perfusion (DM)
  • Presence of necrotic tissue of foreign body (sutures)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Extrinsic factors that affect healing

A
  • Medication
  • Nutrition
  • Chemo/radiation
  • Stress
  • Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Iatrogenic factors that affect healing

A
  • Local ischemia
  • Treatment choices (irrigation material)
  • Trauma
  • Extent of injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Partial thickness burns

- describe

A
  • epidermis is burned
  • Red/pink, mildly swollen
  • Skin feels raw and tender
  • Sunburn is MC example
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Deep partial thickness burns

- describe

A
  • epidermis and dermis burned
  • Blistered, swollen, moist
  • Very painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Full thickness burn

- describe

A
  • completely through dermis
  • Destroy fat cells, nerve tissue, muscle
  • Dry, leathery, appear dark brown, black, or dry white
  • May feel no pain if nerves are burned
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Burn treatment

- overview

A
  • Depends on depth and extent of damage
  • Immediate care is important
  • Improper care → infection, slower healing, shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What topical agent is usually used to treat burns

A
  • silver!
  • Lots of silver products
  • Good option for pts with sulfa allergy
  • Newer options allow fewer dressing changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to treat blisters

  • adults
  • children
A
  • Adults intact: protect, leave intact bc provide moist dressing for wound
  • Adult broken: debride, easily infected with bacteria
  • Peds: break intact blisters and debride, will pop anyways cause kids are crazy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Burn treatment

  • cleansing
  • dressing
  • chemicals
A
  • Cleansing options: Shower, pressurized saline, pulsed lavage
  • Dressing: Non-adherent that allows drainage
  • Chemicals: Only one chemical debridement treatment remains: Santyl. Hastens the removal of slough and eschar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How are facial burns treated differently

A
  • do not use silvadene (silver): can permanently stain

- Bacitracin ointment is best

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Circumferential wounds

A
  • risk for compartment syndrome, ischemic limb

- check pulses often

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Nutrition for burn care

A
  • protein
  • clear fluids
  • multivitamin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Burn aftercare

A
  • wil be itchy!!
  • Benadryl
  • Cold pack
  • Protect at night from scratching
  • Moisturize frequently
  • Liberal sunscreen!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is most common cause of leg ulcer

A

venous insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Location of ulcers due to

  • venous insufficiency
  • arterial
A
  • venous: distal 1/3 of medial leg

- arterial: Lower leg, dorsal surface, foot, malleolus, toe joints, lateral border of foot

23
Q

Venous insufficiency ulcer

- characteristics

A
  • Irregular shape
  • Shallow
  • Mild pain (worse with standing, relieved with elevation)
  • Pink/red base
  • Edema
  • Hemosiderin stain around edge of wound (dark)
24
Q

Venous insufficiency ulcer

- RF

A
  • Prev trauma in the area
  • DVT hx
  • Pregnant
  • Obese
  • Clotting disorder
  • Fam hx
  • Occupation – stand a lot
25
Q

Venous insufficiency ulcer

- 4 steps to manage

A
  • Clean
  • Debride
  • Absorb drainage
  • Manage edema
26
Q

Venous insufficiency ulcer

- clean

A
  • Normal saline (warmed to body temp)

* If slough: wound cleanser with surfactant

27
Q

Venous insufficiency ulcer

- Debride

A
  • Chemical
  • Sharps (forceps, scissors, scalpel, curette)
  • Ultrasonic (new)
28
Q

Venous insufficiency ulcer

- Absorb drainage

A
  • 7 categories of dressing, gauze, alginates, hydrocolloids, carboxymethlycellulose, foams, ABD pads
  • Drainage is caustic to surrounding, healthy tissue
29
Q

Venous insufficiency ulcer

- Manage edema

A

• Must check ABI prior to applying compression: >1.0, verify with transcutaneous O2 before applying compression

  • Vasopneumatic pump to move fluid caudally
  • External bandages
  • Multi-layer compression dressings
  • Circumferential measurements before and after to assess effectiveness
30
Q

Because healing a wound doesn’t treat venous insufficiency, what must occur to prevent recurrence of wound

A

maintain reduction of edema

31
Q

How to reduce edema for venous insufficiency

A
  • Forever wear support hose or circaids.
  • Leg elevation 2 hr a day, 20-30 min at a time, leg higher than heart, NOT bed rest
  • Exercise that activates calf muscles (use compression)
  • NO smoking
  • Don’t’ cross legs
  • Feet and leg hygiene
  • Avoid trauma
  • Nutrition, low sodium
  • Inspect legs/feet daily
32
Q

Arterial ulcers

- characteristics

A
  • Pain, esp at rest
  • Foot is cold or cool
  • Weak, absent pulses
  • Absence of hair growth
  • Skin is shiny, dry, pale
  • Thickened toenails
  • Necrotic ulcers with min drainage
  • ABI <0.5
  • Pallor with leg elevation
  • Rubor of dependency (white when elevated, red when down)
  • Hx: HTN, smoking, claudication
33
Q

Arterial ulcers

- risk factors

A
  • Card hx
  • HTN
  • High cholesterol
  • Smoking
  • DM
  • Fam Hx
34
Q

Arterial ulcers

- eval of arterial flow

A
  • Pulses: dorsalis pedis, posterior tibial, popliteal, femoral
  • ABI: <0.8 → arterial compromise
  • Transcutaneous O2 <30 mmhg → no healing potential
  • Refer to vascular surgeon or cardiologist
35
Q

What should NEVER be done to an arterial ulcer

A

debridement, will lead to further necrosis

36
Q

Arterial ulcer

- treatment

A 
- PT to increase circulation
• Hot pack to femoral triangle
• Rooke boots, bed cradles, and other protective gear and positioning
• Antimicrobials: 
• Electric stimulation
- STOP smoking!!
- If gangrene keep dry
- Wound on leg, encourage exercise to increase blood flow
37
Q

Negative pressure therapy

A
  • Wound vac
  • Can be used on all kinds of wounds
  • Wound must be fairly clean
  • Cut foam slightly smaller than wound, do not overpack
38
Q

Biological wound treatment

A
  • Oasis
  • Porcine small intestinal submucosa. Provides matrix for collagen to use as a framework.
  • Do not remove, keep adding to it if it works
  • Might produce inflammatory response but that is ok (it’s not infected)
39
Q

Cultures for wound management

A
  • Punch biopsy is best but swab is adequate

- Used to base topical treatment options

40
Q

Hyperbaric oxygen

A

is another type of wound treatment

41
Q

Topical commonly used

A
  • Clobetasol
  • Cyclosporin or dexamethasone
  • Gentamycin
42
Q

Why are pressure injuries important (business aspect)

A
  • Stage III and IV are hospital acquired, won’t be paid to treat
  • Inspect FULL body of patient when admitted to ensure none present. If present, document size and location
43
Q

What can be confused with pressure injuries

A
  • DM foot ulcers
  • Skin tears and lacerations
  • Maceration dt diarrhea or infection
  • Arterial or venous leg ulcers
44
Q

Pressure injuries

- risk factors

A
  • Pressure
  • Moisture
  • Friction
  • Shear
  • Hypotension (poor perfusion)
  • Lengthy immobilization
  • Poor nutrition
45
Q

Pressure injuries

- Common locations

A 
bony prominences:
• Occiput
• Sacrum
• Ischium
• Heels
• Trochanter
• Knee
• Ankle
46
Q

Describe stage 1 pressure injury

A

Non-blanchable erythema of intact skin

47
Q

Describe stage 2 pressure injury

A
  • Partial-thickness loss of skin with exposed dermis
  • Wound bed is viable, moist, pink/red
  • May be intact or ruptured serum-filled blister
48
Q

Describe stage 3 pressure injury

A
  • Full-thickness loss of skin
  • Adipose is visible, granulation and rolled wound edges are often present
  • Slough or eschar may be visible
  • Depth depends on location
  • No exposure of fascia, muscle, tendon, ligament, cartilage, bone
49
Q

Describe stage 4 pressure injury

A
  • Full-thickness skin and tissue loss
  • Exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, bone
  • Slough and eschar may be visible
50
Q

Describe unstageable pressure injury

A
  • Can’t evaluate dt presence of eschar or slough

* If can’t see base of wound, is unstageable

51
Q

Describe deep tissue pressure injury

A

Often seen in patients who have “been down” for a long time, injury is still evolving, not sure how bad it will be

52
Q

Describe pressure injury d/t medical device

A
  • New category

* Tubes, drains, cannula, etc.

53
Q

Describe facility acquired pressure injury

A
  • Usually sacrum (also heels and occiput)
  • Can occur in children
  • Many pts have scI, spinal orthotics
  • Perineal dermatitis or excoriation dt diarrhea is NOT a pressure injury but does place pt at increased risk for one

Dermatology 1 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions