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CM2 Exam 2 > Wounds- Schoenwald > Flashcards

Wounds- Schoenwald Flashcards

1
Q

What is the word for when a wound looks wet and soggy?

A

Macerated

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2
Q

Result from pressure or repetitive pressure at same anatomical location

A

Pressure ulcers (also called bedsores or decubitus ulcers)

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3
Q

Where do pressure ulcers typically occur on the body?

A

Develop at areas of bony prominences.

Ankles, elbows, tailbone

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4
Q

What stage ulcer is this?

Nonblanchable erythema of intact skin

A

Stage 1

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5
Q

What stage ulcer is this?

Partial thickness skin loss with exposed dermis

A

Stage 2

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6
Q

What stage ulcer is this?

Full thickness skin loss

A

Stage 3

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7
Q

What stage ulcer is this?

Full thickness skin and tissue loss

A

Stage 4

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8
Q

What stage ulcer is this?

Obscured full thickness skin and tissue loss

A

Unstageable

Could be obscured by esgar (scab)

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9
Q

What stage ulcer is this?

Persistent, non-blanchable deep red, maroon, purple

A

Deep tissue pressure injury

lesion that isn’t open but you know deep tissue injury from color

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10
Q

What is the treatment for a pressure ulcer?

A

Relieve/remove pressure

Air beds, padded seat covers, sheep skin boots

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11
Q

This type of dressing is good for exudate absorption

A

Alginates (made from seaweed)

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12
Q

This type of dressing is good at retaining moisture, absorption

A

Foams

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13
Q

This type of dressing is good at retaining moisture, debride

A

Gauzes

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14
Q

This type of dressing is good at occlusion (keeping an IV in place)

A

Hydrocolloids

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15
Q

This type of dressing is good for obliterate dead space, absorb

A

Wound fillers

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16
Q

_________ delays wound healing

A

SMOKING

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17
Q

What organism is responsible for an ulcer that is macerated because of soaking feet? (Think diabetic foot ulcer)

A

Pseudomonas

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18
Q

What two organisms are responsible for cellulitis without an open skin wound?

A

B hemolytic strep and Staph aureus

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19
Q

This type of organism category STINKS because it produces sulfide gas

A

Anaerobes

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20
Q

How much protein should a patient be taking for wound healing?

A

1.25 to 1.5 grams/kg in a healthy patient

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21
Q

What supplements can be helpful in wound healing?

A

Zinc and vitamin D

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22
Q

Risk factors for venous ulcerations (stasis)?

A
  • varicose veins
  • DVT
  • chronic venous insufficiency
  • poor calf muscle function
  • obesity
23
Q

Where is a common place for venous ulceration to occur?

A

gaiter area of the leg (calf from below knee to above ankle)

24
Q

What are common signs of venous ulcers?

A
  • Edema often present
  • Hemosiderin staining
  • Hair loss of extremity
  • Weeping and itching of skin often present
25
Q

What is a huge part of treatment for venous stasis ulcers to control edema?

A

Compression therapy- compression stockings

26
Q

You should AVOID compression stockings when __________ flow is compromised

A

arterial

27
Q

How much compression pressure should you wrap a venous ulcer in?

A

40-60 mmHg

28
Q

You have a wet wound… what type of dressing should you use?

A

Alginate and foam

29
Q

This type of ulcer is due to decrease in arterial blood supply to lower extremity

A

Arterial ulcer

30
Q

Who are at risk for arterial ulcers?

A

PVD, diabetes, sickle cell

31
Q

Arterial ulcers result in tissue ________ and damage/ulcer formation

A

hypoxemia

32
Q

Arterial ulcers have a ___________ capillary refill time

A

Reduced

33
Q

Arterial ulcer may also have reduced __________ _____

A

palpable pulses

34
Q

What are some characteristics of an arterial ulcer?

A
  • Painful
  • Ulcer appears punched out with well demarcated edges
  • Pale, often necrotic base
  • Surrounding skin dusky or shiny, hairless
35
Q

You should not decide if an ulcer is venous or arterial based on what?

A

the appearance of hair whether hairless or not

36
Q

Is a venous or arterial ulcer more painful?

A

Arterial

37
Q

Are medications used to treat arterial ulcers?

A

No but could get relief from meds like Plavix to keep blood flowing

38
Q

How do you treat an arterial ulcer?

A

Try to restore arterial function if possible with surgery usually

39
Q

This type of ulcer has a “punched out” appearance

A

arterial

40
Q

This type of ulcer is usually associated with limb edema and has a high level of exudate

A

Venous

41
Q

Mainstay treatment for venous ulcer?

A

Compresison

42
Q

This test is helpful in determining extent of peripheral vascular disease?

A

ABI

43
Q

How is an ABI performed?

A

Performed by measuring systolic blood pressure in both brachial arteries and
both dorsal arteries

44
Q

During an ABI, a patient should be at ________ and _______ for how many minutes?

A

At rest and supine for 10 min

45
Q

What is the acceptable range for an ABI?

A

0.9-1.4

46
Q

An ABI greater than _____ means a noncompressable calcification of vessels

A

1.4

47
Q

An ABI below what number would need a referral to a vascular specialist?

A

ABI below 0.8

48
Q

What ABI is indicative of severe arterial disease?

A

Less than 0.5

49
Q

What ABI value is considered diagnostic of PAD?

A

below 0.9

50
Q

How does a negative pressure wound therapy- wound vac enhance wound healing?

A
  • Reducing edema
  • Increasing rate of granulation tissue formation
  • stimulation of circulation
51
Q

What are contraindications for a wound vac placement? Meaning when would you NOT use a wound vac?

A
  • Malignancy of wound
  • Untreated osteomyelitis
  • Placement of dressings in contact with exposed blood vessels, organs or nerves
  • Nonenteric or unexplored fistulas
52
Q

What are two growth factors in artifical skin grafting?

A
  • Apligraft (using skin from circumsized foreskin)

- Dermagraft

53
Q

Treatment of wounds?

A
  • Enzymatic- chemical agents but taken off the market
  • Mechanical- wet to dry dressings, gauze (peroxide debridement controversial)
  • Sharp- surgical removal

CM2 Exam 2 (8 decks)

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