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Flashcards in Exam 2 ulcers Deck (43):
1

Describe a stage 1 pressure ulcer

Intact skin with non-blanching redness

2

Describe a stage 2 pressure ulcer

shallow, open ulcer with red-pink wound bed

3

Describe a stage 3 pressure ulcer

full-thickness tissue with visible cutaneous fat

4

Describe a stage 4 pressure ulcer

full-thickness tissue loss with exposed muscle and bone

5

What is the key nutritional component of ulcer healing

Protien, 1-1.5 g/kg/day

6

Should you debride a stage 1 pressure ulcer?

NO

7

What is the main concern of a stage 1 pressure ulcer

Removing the cause of the ulcer

8

How do you clean a stage 2 pressure ulcer?

saline flush

9

Should you debride a stage 2 pressure ulcer?

NO

10

Central concern with a stage 2 ulcer

provide moist wound bed, keep surrounding tissue dry

11

Should you debride a stage 3 pressure ulcer?

Yes, if eschar or slough is present

12

What are ways to debride a stage 3 pressure ulcer?

autolytic debridement, wet-to-dry bandages, enzymatic solutions, surgery

13

How to clean a stage 3 ulcer?

saline flush

14

What is the central issue with a stage 3 pressure ulcer?

debride necrotic tissue, protect granulation tissue

15

Should you debride a stage 4 pressure ulcer

yes, all necrotic tissue

16

What is the central concern of a stage 4 ulcer?

patience, pain control, possible end of life talk

17

What is the most common cause of lower extremity ulcers?

venous (90+%)

18

Where is the most typical place for a venous pressure ulcer?

medial malleolus

19

What is the classic sign of a venous ulcer?

Chronic adema will not diurese, tender upon palpation

20

What is the pathophysiology of a venous ulcer?

Valves between low and high pressure system breaks, increasing venous pressure in superficial veins, causing them to break

21

Risk factors for venous ulcers

Overload: CHF, obesity, Obstruction: clot, tumor, "pump" malfunction, neuro dysfunction, injury, inactivity

22

what is the treatment for a venous ulcer?

same cleansing as a pressure ulcer, same debridement, control edema, external pressure

23

What is often an underlying disease that accompanies arterial ulcers?

Diabetes

24

What does an arterial ulcer look like?

circumscribed, "punched-out" ulcers, often multiple, absent pulses, claudication ( muscle pain in area with activity)

25

Where do arterial ulcers usually occur?

least perfused areas: lateral malleolus, tibia, feet/toes

26

What is the measurement for arterial ulcer risk?

Ankle-brachial index (ABI): Normal: 1, 0.8=claudication, 0.4= pain at rest

27

What is Buerger's disease

thrombangiitis obliterans- a hypersensitivity to smoking. Occurs on young smokers' hands and feet, thrombophlebitis

28

What test tests occlusion of ulnar artery?

Allen test

29

Describe allen test

Make fist, mechanically block ulnar and radial arteries, release ulnar artery to see if hand turns pink. Positive test will indicate a block in ulnar artery

30

Treatment of arterial arteries

NO external compression, quit smoking, revascularization, skin graft or amputation

31

Should you provide external pressure to an arterial artery?

NO

32

Where are the most common areas for a neurotropic ulcer

Plantar aspect of foot or toes

33

What does a neurotrophic ulcer look like?

often callused with just a small pin prick in the middle- upon opening it's an ulcer

34

What does the treatment of neurotrophic ulcers look like?

Protection: change footwear, total contact cast, recombinant platelet-derived growth factor, diabetes menagement

35

What are some special cases that cause ulcers

pyoderma gangrenosum, cancer (basal cell carcinoma, squamous cell carcinoma)

36

What does a pyoderma gangrenosum ulcer look like?

margins are serpiginous and elevated, edges are blue or purple hue, pustule or blister precedes

37

What is pyoderma grangrenosum associated with?

inflammatory bowel, RA, leukema, other autoimmune diseases

38

How do you treat pyoderma gangrenosum?

Steroids (oral or injection)

39

What is the most common skin cancer?

Basal cell carcinoma

40

What does a BCC ulcer look like

"heaped up" or rolled edges

41

Where do BCC ulcers usually occur

sun-exposed areas

42

What can cause a squamous cell carcinoma?

a previously benign ulcer

43

What should you do with an SCC ulcer?

punch biopsy