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KN JD NPTE: INTEG > Wound Care > Flashcards

Wound Care Flashcards

1
Q

Most appropriate technique for acute care hospitals?

Most appropriate technique for home care, LTC facilities, outpatient, routine procedures?

A

Sterile technique

Clean technique

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2
Q

Negative-pressure wound therapy (vacuum-assisted closure)

  1. Open-cell ____ placed into wound
  2. Controlled sub atmospheric pressure (typically ___ mmHg below ambient pressure) applied
  3. Helps maintain ___ wound environment, control __, increase ___, reduce ____
A
  1. Foam dressing
  2. 125
  3. Moist, edema, localized blood flow, infectious material
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3
Q

Surgical intervention is indicated for ___ ulcer, enhancing ___ and resurfacing wound (grafts), preventing __ and ___. May be indicated for what staging of ulcers?

A 
Excising
Vascularity
Sepsis
Osteomyelitis
III, IV
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4
Q

What is hyperbaric oxygen therapy (HBO)?

A

Pt breathes 100% O2 in a sealed, full-body chamber with elevated atmospheric pressure (between 2-2.5 ATA)

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5
Q

What does HBO therapy do?

A

Hyperoxygenation reverses tissue hypoxia and facilitates would healing due to enhanced solubility of O2 in the blood

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6
Q

Who is HBO therapy contraindicated for?

A
  1. Untreated pneumothorax

2. Some antineoplastic medications (doxorubicin, disulfiram, cisplatin, mafenide acetate)

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7
Q

Cleanse the wound how often?

A

Initially and at each dressing change

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8
Q

Normal saline (0.9% NaCl) is recommended for what?

A

Most ulcers; nontoxic effect in wounds

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9
Q

Cleansing topical agents contain ____ that lower surface tension. Limited use due to ?

A

Surfactants

Possibly toxic to healing tissues

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10
Q

Dakin’s solution, acetic acid solution, hydrogen peroxide, sodium hypochlorite solution

A

Cleansing topical agents

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11
Q

Minimize mechanical force of cleaning by using what?

A

Gauze, cloth, sponge

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12
Q

Irrigation: recommended pressure?

A

4-15psi

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13
Q

What is-
Delivery of irrigating solution under pressure that is produced by electrically powered device.
What is another type that assists in removal of wound debris?

A

Pulsed lavage

Pulsed lavage with vacuum (PLWV)

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14
Q

Use of whirlpool therapy— supported for wound care? Why/why not?

A

NOT- contamination, infection, higher unregulated pressures can damage granulation tissue, limbs placed in dependent position

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15
Q

What types of washes shouldn’t you use on skin? Why?

A

Harsh soaps, alcohol-asked products, harsh antiseptic agents —> may erode skin

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16
Q

Removal of necrotic or infected tissue that may interfere with wound healing

A

Wound debridement

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17
Q

Wound debridement reduces ___ concentration in wound, improves ___

A

Bacterial

Wound healing

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18
Q

What are some topical agents used to manage non-healing or infected wounds?

A
  1. Antiseptics and wound cleanser (Dakin’s solution, acetic acid)
  2. Antimicrobials (antifungals, antibacterial-Bacitracin/Neosporin) 3. Anesthesia and analgesia agents (topical lidocaine)
  3. Enzymatic debridement (Santyl)
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19
Q

Ideal wound dressings maintain ___ environment, control for ___, facilitate gaseous exchange, ___, prevent contamination, and are ___ to the wound.

A

Moist
Excess exudate
Insulate
Non-traumatic

20
Q

moist environment facilities ___ debridement and promotes faster wound healing with less pain

A

Autolytic

21
Q

Sorbsan, Kaltostat

A

Alginates

22
Q

Biocclusive, OpSite, Tegaderm

A

Transparent film

23
Q

LYOfoam, Flexzan

A

Foam

24
Q

Vigilon, Carryson, Second Skin, Clearsite

A

Hydrogels

25
Q

DuoDerm, Crusaderm, 3M Tegasorb

A

Hydrocolloid

26
Q

Kerlix, 4x4s, Nugauze, Telfa

A

Standard gauze, non-impregnated

27
Q

Silver-, iodine-, Vaseline/petroleum- … Adaptic, Xeroform

A

Impregnated gauze

28
Q

Silver dressings are common ____ agent found in foams, films, alginates, hydrocolloids, hydrogels

A

Antimicrobials

29
Q

Specialty dressings: wound matrix dressings provide ___ for cellular deposit. Typically collagen or hyluronan based

A

Scaffold

30
Q

2 methods for edema management

A

Leg elevation and exercise, compression therapy

31
Q

E-stim for wound healing is used for ?

  1. ____ waveform, ___current.
  2. ___ voltage ___ current.
  3. ___ ____ current.
A

For improving circulation, facilitating debridement, enhancing tissue repair.

  1. Continuous, direct
  2. High, pulsed
  3. Pulsed biphasic
32
Q

Delayed wound healing is associated with ___ and ___.

A

Malnutrition and poor hydration

33
Q

What is the normal albumin level? What level = malnutrition?

A

Normal: 3.5-5.5 mg/dL

<3.5 = malnutrition

34
Q

BMI of ___ with ___ has increased risk for pressure ulcer

A

21 or under, weight loss

35
Q

Individuals with wounds require approx ___ or more L of H2O a day

A

3L+

36
Q

Patients on air-fluidized beds require greater ___. How much?

A

Hydration

40-60ml/Kg/day

37
Q

Provide adequate nutrition: frequent ___ calorie/high ___ meals; energy intake (____kcal/kg/body weight) and protein (____ gm/kg/body weight)

A

High
Protein
25-35
1.5-2.5

38
Q

Patients with ___ and ___ require even higher nutritional intake

A

Trauma stress

Burns

39
Q

7 ways to prevent/reduce skin injury

A
  1. Daily, comprehensive skin inspection
  2. Therapeutic positioning to relieve pressure/allow tissue reperfusion
  3. Techniques to ensure skin protection- avoid friction/shear/abrasion
  4. Pressure-relieving devices (PRDs)
  5. Avoid restrictive clothing
  6. Avoid maceration injury
  7. Patient and caregiver education
40
Q

In bed: pressure relief by turning/repositioning every ___ during acute and rehab phases.

A

2 hrs

41
Q

In wheelchair: pushups every ___ for pressure relief

A

15 min

42
Q

Use techniques to ensure skin protection:

  1. ___, not dragging
  2. Use of turning and ___, trapeze, manual, or electric __.
  3. Use of cornstarch, lubricants, pad protectors, thin film dressings, or ___ dressing over friction risk sites
  4. Use of ___ for sliding W/C transfers
A
  1. Lifting
  2. Draw sheets, lifts
  3. Hydrocolloid
  4. Transfer board
43
Q

Static pressure relieving devices (PRD): use if patient can assume variety of positions. What are some examples?

A
  1. Foam/air/gel mattress overlay
  2. Water-filled mattress
  3. Pillows or foam wedges
  4. Protective padding (heel relief boots)
44
Q

Dynamic pressure relieving devices (PRD): use if pt cannot assume variety of positions. examples?

A
  1. Alternating pressure air mattress

2. Fluidized air/high-air-loss bed

45
Q

Seating supports (PRD): for chair-bound or w/c bound pts. Examples?

A
  1. Cushions made out of foam, gel, air, combination
46
Q

How does pt avoid maceration injury?

A
  1. Prevent moisture accumulation and temp elevation where skin contacts support surface
  2. Incontinence management strategies
47
Q

Pt/caregiver education for skin protection:

  1. Mechanisms of pressure ulcer development
  2. Daily ___
  3. Avoidance of ___
  4. ___, weight shifts, lifts
  5. Safety during self-care
  6. Safety with use of devices and equipment
  7. Importance of ongoing activity/exercise program
A
  1. Skin checks and hygiene
  2. Prolonged positioning
  3. Repositioning

KN JD NPTE: INTEG (15 decks)

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