Brainscape's Knowledge GenomeTM

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


See full index

MC II Exam 3 > Dressing Selection > Flashcards

Dressing Selection Flashcards

1
Q

Primary dressing function

A

facilitate wound healing through debridement, antimicrobial, and moisture balance maintenance

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

Secondary dressing function

A

anchor primary dressing, protect the wound from mechanical forces, manage edema

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

Dressing selection

A

primary: based on wound bed; secondary: based on patient’s activity level

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

Passive dressing function

A

absorb drainage, cover to prevent contamination

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

Interactive dressing function

A

provide antimicrobial agents, provide growth factors, promote lysis of necrotic tissue

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

Bioactive dressing function

A

stimulate the migration and mitosis of cells by the introduction of live cells or by providing collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

wet to dry dressings

A

No longer considered standard of care

Unacceptable means of mechanical
debridement; painful for the patient

Detrimental to wound healing by
destroying healthy granulation tissue with removal

Has limited use in acute- and long-term care settings (CMS Pressure Ulcer Guidelines in F-Tag 314)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

transparent films: composition

A

Thin polyurethane membrane with adhesive acrylic layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

transparent films: indications

A

Autolytic debridement
Secondary dressing
Anchor IV catheters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

impregnated gauze: composition

A

Mesh with petrolatum, with/without bismuth tribromophenate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

impregnated gauze: indications

A

Flat, dry partial thickness wounds

Secondary dressing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hydrocolloids: composition

A

Adhesive inner layer
Gel-forming absorbent layer
Occlusive or semi-occlusive outer layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hydrocolloids: indications

A

Shallow or flat wounds with minimal drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hydrogels: composition

A

Organic polymers with 30% to 90% water content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

hydrogels: indications

A

Dry wounds for autolytic debridement

Over tendon, muscle, bone to prevent desiccation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

foams: composition

A

Soft open-cell sheets of polyurethane
With or without adherent backings
With or without adhesive borders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

foams: indications

A 
Wounds with heavy exudate
Flat wounds (donor sites, skin tears, surgical incisions)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

calcium alginates: composition

A 
Calcium or calcium & sodium salts
Derived from seaweed
Processed into a dry fiber that becomes a gel when it interacts with exudate
May be hemostatic on some wounds
Absorbs 5-15 times weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

calcium alginates: indications

A

draining cavity wounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

cellulose (hydrofiber): composition

A

Sodium carboxymethyl-cellulose spun into fibers
Absorbs exudate and becomes a gel
Maintains a moist wound environment
Absorbs 25 times weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cellulose (hydrofiber): indications

A

Wounds with heavy exudate

Either flat or cavity

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

X-cell (xylos, inc): composition

A

3 layers of cellulose impregnated with normal saline

With or without PHMB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

X-cell (xylos, inc): indications

A

Flat wounds with min exudate
Painful wounds
STSG donor sites
Venous/vasculitic wounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Honey: composition

A

Carbs, protein, vitamins

Enzyme inhibine=>hydrogen peroxide and gluconolactone (antibacterial)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

honey: indications

A

Partial thickness burns
Wounds with odor
Wounds with eschar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

collagen: composition

A

Collagen harvested from bovine, porcine, or avian collagen

Processed into 100% collagen or into a collagen matrix with alginate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

collagen: indications

A

Clean, granulating wounds to facilitate cell migration to the wound bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

collagen: contraindications

A

Infected wounds
Non-viable tissue
Patients allergic to porcine or bovine products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

allograft: composition

A

Harvested cadaver skin
Acellular freeze-dried
Contains basement membrane with collagen, elastin, proteoglycans, and vascular structures
Biological scaffold for dermal/epidermal regrowth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

allograft: indications

A

burn therapy and other clean, full-thickness wounds

31
Q

living skin equivalents: composition

A

Neonatal fibroblasts in a collagen or nylon-like mesh

Apligraf, Dermagraf, Transcyte

32
Q

living skin equivalents: indications

A

Clean granulated wounds as a temporary wound to promote closure or to protect while waiting for skin graft

33
Q

topical antimicrobials purpose

A

To restore a balance between bioburden and local immune system

34
Q

types of topical antimicrobials considered “best practice”

A 
Ionic silver dressings
Available in a variety of dressings 
Cadexomer iodine
Iodosorb, Iodoflex
Polyhexamethylene biguanide 
 compound (PHMB)
XCell antimicrobial
AMD gauze
Acetic acid washes only for pseudomonas
35
Q

silver dressings wound healing actions

A

Destroy broad spectrum of bacteria by blocking cell respiration, destroying cell membrane and allowing cytoplasm to leak (respiration, replication, repair processes are disabled)
Decrease excessive matrix metalloproteinase (MMP) activity by decreasing zinc levels

36
Q

cadexomer iodine: composition

A

Macrospherical, hydrophilic, biodegradable beads of cadexomer starch with 0.9% iodine in paste or ointment

37
Q

cadexomer iodine: indications

A

Partial thickness burns

Draining wounds with bacteria present

38
Q

cadexomer iodine: contraindications

A

Patients with iodine sensitivity or allergy

39
Q

dressings to avoid

A 
Povidone iodine (Betadine)
Used as skin disinfectant
Can be cytotoxic for granulation tissue
Acetic acid
Effective against pseudomonas
Use as a wash only, not as a dressing
Dakin’s solution (infected, necrotic wounds only)
Contains sodium hypochlorite
Retards deposition of collagen
Hydrogen peroxide
Toxic to fibroblasts
No antibacterial effects
May be used to dissolve clots (Rodeheaver, Ratliff)
40
Q

dressing selection should be based on these

A 
Wound healing phase
Tissue in the wound bed 
Amount of drainage
Presence of microbes
Patient activity level
Goals for wound healing
41
Q

tools to guide dressing selection

A

The Red/Yellow/Black color system (Marion Labs)
Classification by grade, stage or depth
Wagner/UT -grade
NPUAP -stage
PTW/FTW -depth
Selection based primarily on exudate & presence of devitalized tissue
Solutions Algorithms www.guideline.gov
Selection driven by Clinical/Physiologic Need
Dressing Decision Tree (Broussard)

42
Q

inflammatory phase dressing selection

A

antimicrobials, debriding agents, absorbent fillers

43
Q

proliferative phase dressing selection

A

Fillers, foams
Hydroactive dressings
Hydrogels, biologicals

44
Q

remodeling phase dressing selection

A

silicone-backed foam, scar therapy

45
Q

DIME paradigm

A

Debridement, Inflammation/infection, Moisture balance, Edges

46
Q

DIME: Debridement

A

gels, films; enzymes

47
Q

DIME: inflammation/infection

A

antimicrobials, alginates

48
Q

DIME: Moisture

A

absorbent fillers, hydroactive dressings, hydrogels

49
Q

DIME: Edges

A

collagen, xeroform

50
Q

dressing selection based on tissue type (colors)

A 
Black (eschar)
Gels, films, enzymes
Yellow (fibrous, slough)
Enzymes, cellulose, alginates, foams
Red (granulation)
Gels, cellulose, foams, hydroactive dressings
51
Q

dressing selection: moderate to copious drainage

A

cellulose, foams, alginates

52
Q

dressing selection: minimal to moderate drainage

A

cellulose, foams, alginates, hydrocolloids, hydroactive dressings

53
Q

dressing selection: scant to minimal drainage

A

thin foams, hydrocolloids, hydroactive dressings, hydrogels

54
Q

indications for antimicrobial dressings

A

Failure to heal (may be first sign of bacteria)
Serous, purulent, or hemorrhagic exudate
Foul odor
Small areas of yellow or brown slough on wound bed
Fragile granulation tissue that bleeds easily
Surrounding skin pain, warmth, and swelling (cellulitis)
Increased size or new adjacent wounds (infected deeper structures) (Sibbald)

55
Q

goals for wound healing

A 
Wound to advance in healing phase
Full closure by secondary intention
Prepare for surgical closure
Manage drainage or odor for palliative care
Caregiver or patient to be 
   independent in changing 
   dressing
No signs of clinical infection
56
Q

secondary dressing application

A

Begin distally and progress to joint above the wound.
Wrap in spiral or figure 8 depending on the amount of edema/vascular status- Do not encircle a limb with tape -
Use conforming gauze on dry skin.
Apply tape to gauze or elastic wrap only; avoid tape on skin.
Secure dressing sufficiently for patient functional level

57
Q

flat wound dressing application

A

Select dressing appropriate for wound bed.
Select dressing that extends beyond any involved periwound skin.
Apply dressing so that it touches all of the wound bed.
Avoid any dead space between dressing and wound surface.
Apply secondary dressing so that it is adhered at any folds or crevices.
For ‘at risk’ skin, consider a barrier film-let dry before taping/applying dressing

58
Q

dressing removal

A

Take the skin off the tape, not the tape off the skin.
Roll/Pull parallel to the skin.
Roll/Pull in the direction of the hair.
Use adhesive tape remover/saline soaked sponge.
Avoid alcohol products on inflamed skin
Minimize Discomfort and Skin damage

59
Q

fragile skin

A

Avoid any adhesives on fragile or insensate skin (including patients with diabetic neuropathy.)
For ‘at risk’ skin, consider a barrier film/lotions/creams
Avoid adhesive transparent films.
Avoid holding extremities to move patient.

60
Q

dangers of picking wrong dressing

A 
Delay healing
Increase pain
Cause dessication or maceration
Increase cost of care
Decrease quality of life
61
Q

5 goals of topical care

A 
Optimization of the moist environment
Wound stabilization, manipulation, pressure reduction & edema control
Activation of wound environment
Bioburden control, infection prevention
Quality of life improvement
62
Q

Macerated wound margins - goals and product to use

A 
goal: protect wound margins; product: Non-sensitizing Moisture barriers:
Zinc oxide
Dimethicone
Petrolatum
Dressing Barriers:
Films
Hydrocolloids
NPWT*
63
Q

moderate to heavy drainage - goals and products

A 
goal: absorb drainage; products: Alginates
Hydrofibers
Foams
Absorptives
NPWT*
Pouching
64
Q

non to minimally draining wounds - goals and products

A 
goal: maintain moisture; products: Hyrdogels
Hydrogel gauze
Saline gauze
Film dressings
Hydrocolloid
Non-adherent
65
Q

dry or dessicated wounds - goals and products

A

goal: hydrate wound; products: Hydrogel gauze
Hydrogel
Saline gauze

66
Q

cavernous, undermined, tunneled wound goals and products

A 
goal: fill "dead" or negative space; products: Gauze Packing
Gauze packing strips
Hydrofiber strips
Alginate Rope
Hydrogel gauze
Hydrocolloid paste
Cavity Strand (Polymer)
NPWT*
67
Q

edema - goals and products

A 
goal: reduction and control; products: Compression 
Bandaging
Dynamic
Static
Segmental pumps
Graduated compression stockings
68
Q

unrelieved pressure - goals and products

A 
goal: pressure reduction/relief; products: Offload foot/heel
     “Football” dressing
      Specialty devices
Support surfaces
Overlay
Replacement       Mattress
Cushions
69
Q

granulated static/stalled wound - goals & products

A 
goal: biologic support; products: Growth factors
Apligraf
Dermagraft
Oasis/Matristem
Allograft
70
Q

failure to heal - goals & products

A 
goal: enhance tissue growth; products: MMP inhibitors
 Hyaluronic acid
Maltodextrin
Collagen 
NPWT*
Polyhydorgenated ionogen
Oxidized regenerated cellulose
Trolamine sodium alginate
71
Q

necrotic - goals & products

A 
goal: remove non-vital tissue; products: Debridement
Autolytic-eg, hydrocolloid
Mechanical- eg gauze
Larval 
Enzymatic- collagenase
72
Q

malodor/quality of life -goals & products

A 
goal: odor control; products: Activated Charcoal
Iodosorb/Iodoflex
Silver Dressings
Gentian Violet/Methylene 
         blue PVA foam
Metronidazole
Maltodextrin NF
Dilute Antiseptic solutions
73
Q

pain/quality of life goal & products

A 
goal: pain reduction/control; products: Siliconized dressings
Hydrogels
Impregnated gauze
Non-adherent contact layers & 
        dressings 
Compression bandages
Topical analgesics (eg Lidoderm®)

MC II Exam 3 (8 decks)

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