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NPTE > Integumentary - other systems > Flashcards

Integumentary - other systems Flashcards

(52 cards)

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1
Q

Alginates Dressings

A

High absorption, high permeability, non occlusive,

  • requires secondary dressing
  • Acts as hemostat, creates hydrophilic gel

For FULL THICKNESS or PARTIAL
DRAINING WOUNDS Pressure or VI ulcers
Infected wounds
ABSORB excess exudate - maintain moist environment. barrier against bacteria

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2
Q

Foam Dressings

A
  • Hydrophilic polyurethane base contacts wound surface, hydrophobic outer layer absorbs exudate

Full thickness or Partial wound - MIN-MOD draining

Can be used as secondary
Permeable to O2

Encourages autolytic debridement

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3
Q

Gauze Dressing

A

From yarn or thread

Impregnated with petrolatum, zinc, antimicrobials

Can have a chance for increased infection rates

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4
Q

Hydrocolloids

A

Gel forming polymers (gelatin, pectin, cellulose) + strong film

  • Partial or FULL thickness wounds + granular + necrotic wounds. Protection for microbial contamination.

DO NOT USE on infected

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5
Q

Hydrogels

A

Water and gel forming (glycerin)

SUPERFICIAL or PARTIAL thickness (blisters, abrasions, pressure ulcers)

coupling for US

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6
Q

Transparent FIlm

A

Polyurethane w/ water resistant

Permeable to O2 and vapors, impermeable to bacteria and water

SUPERFICIAL or PARTIAL thickness
MIN drainage (scalds, abrasions, lacerations)
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7
Q

Most to least Occlusive dressings

A

Hydrocolloids, hydrogels, semipermeable foam, semipermeable film, impregnated gauze, alginates, traditional gauze

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8
Q

Most to least moisture retentive

A

Alginates, semipermeable foam, hydrocolloids, hydrogels, semipermeable films

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9
Q

Wagner Ulcer Grade 0

A

No open lesion, may possess pre ulcerative lesions; healed ulcers, presence of bony deformity

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10
Q

Wagner Ulcer Grade 1

A

Superficla ulcer not involving subcutaneous tissue

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11
Q

Wagner Ulcer Grade 2

A

Deep ulcer with penetration through the subcutaneous tissue, potentially exposing bone, tendon, ligament or joint capsule

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12
Q

Wagner Ulcer Grade 3

A

Deep ulcer with osteitis, abscess or osteomyelitis

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13
Q

Wagner Ulcer Grade 4

A

Gangrene of digit

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14
Q

Wagner Ulcer Grade 5

A

Gangrene of foot requiring disarticulation

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15
Q

Stage 1 pressure ulcer

A

Non blanch-able erythema of intact skin

may indicate deep pressure injury, color changes dont include maroon or purple

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16
Q

Stage 2 pressure ulcer

A

Particial thickness skin loss with exposed dermis

Wound bed is pink or red, moist, present as an intact or ruptured serum-filled blister

Adipose not visbile

Granulationtissue, slough and eschar are not present

SHEER

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17
Q

Stage 3 pressure ulcer

A

Full thickness skin loss

Adipos is visiable, epibole (Rolled edges) present

Slough and escar may be visable, muscle/tendon/ligament not exposed

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18
Q

Stage 4 pressure ulcer

A

Full thickness skin and tissue loss

Directly exposed or palpable fascia, muscle, tendon, ligament, bone. Slough or eschar may be visible.

Epibole often occur

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19
Q

Unstageable pressure ulcer

A

Obscured full thickness skin and tissue loss

when removed can be a stage 3 or 4

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20
Q

Deep tissue pressure Injury

A

Persistent non blanch-able deep red, maroon, purple discoloration

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21
Q

Phases of healing of wound healing: Inflammatory

Study These Flashcards
A

1 - 10 days
-Platelet activation and clotting cascade

  • Debris and necrotic tissue removed and bacteria killed by mast cells, neutrophils, and leukocytes
  • establish clean wound bed and signal repair
  • Reepithelization occurs 24 hrs at wound borders, visible 3 days after injury
22
Q

Phases of healing: proliferation

Study These Flashcards
A

3 - 21 days

  • Formation of new tissue signals - Formation of new tissue
  • Capillary buds and granulation tissue begin to fill wound bed creating a support structure for epithelial cells.
  • Keratinocytes, endothelial cells, fibroblasts are active and collagen matrix is formed.
  • Wound closure through epithelialization, and wound contraction
23
Q

Phases of healing: Maturation

Study These Flashcards
A

7 days to 2 years

  • Remodeling phase
  • Granulation and epithelial DIFFERENTIATION begin to appear in the wound bed
  • Hypertrophic scarring in burns affect healing
24
Q

Primary intention

Study These Flashcards
A

In acute wounds with min tissue loss

SMooth clean edges reapproximated and closed with sutures, staples, adhesives to facilitate reepithelialization

Superficial partial thickness = primary intention

72 hours

Min scarring and heal quickly (surgical, laceration, puncture, superficial/partial thickness)

25
Secondary Intention
Wounds close on their own without superficial closure Wounds with significant tissue loss, necrosis, irregular wound margins that cannot be approximated, infection, debris contamination Associated with diabetes, ischemic conditions, pressure damage, or inflammatory response. Ongoing wound care with significant scarring (neuropathic ulcers, arterial, venuos, pressure ulcers, FULL thickness wounds)
26
Tertiary intention
Delayed primary intention healing Wounds at risk for getting complications: sepsis, dehscience Once cleared of infection or other complications then primary intention occurs
27
Hyperkaratosis
Hyperkeratosis, also referred to as callus, is typically white/gray in color and can vary in texture from firm to soggy depending on the moisture level in surrounding tissue.
28
Serous
Presents with clear, light color and a thin, water consistency. Normal in healthy healing Observed in inflammatory and proliferative phases of healing
29
Sanguineous
Presents with red color and a thin, watery consistency. Presence of blood which may become brown if dehydrated. Indicative of new blood vessel growth or the disruption of blood vessels
30
Serosanguineous
Light red or pink color and a thin, watery consistency NORMAL in healthy healing wound and observed in inflammatory and proliferative phase of healing
31
Seropurlent
Cloudy or opaque, with yellow or tan color and thin and watery consistency Early warning sign of impending infection and is ABNORMAL
32
Purulent
Yellow or green color and a thick, viscous consistency
33
Red - RYB system
Pink granulation tissue Protect wound; maintain moist environment
34
Yellow - RYB system
Moist yellow slough Remove exudate and debris; absorb drainage
35
Black - RYB system
Black thick eschar firmly attached Debride necrotic tissue
36
Dehiscience
Separation, rupture, or splitting of a wound by primary intention. Superficial or involve all layers
37
Dessicated
Drying out or dehydrated wound Poor dressing selection
38
Desquamation
peeling, shedding of outer layers
39
Eccymosis
Discoloration below intact skin from trauma and blood seeping into the tissues
40
Induration
Induration refers to the hardening of a normally soft tissue or organ. The hardening most commonly occurs because of inflammation, infiltration of a neoplasm, or an accumulation of blood.
41
Arterial Insufficiency Ulcers Location, appearance, exudate, pain, pedal pulses, edema, skin temp, tissue changes, misc
Secondary to inadequate circulation of oxygenated blood (ischemia) from athlerosclerosis Location: Lower 1/3 of leg, toes, distal web spaces Appearance:Smooth edges, well defined; lack granulation tissue; tend to be deep Exudate: minimal Pain: Severe Pedal pulses: Diminished/absent Edema: normal Skin temp: decreased Tissue changes: Thin and shiny; hair loss; yellow nials Misc: Leg elevation increases pain
42
AI recommendations
Rest Limb protection Risk reduction education Inspect legs and feet DAILY Avoid unnecessary leg elevation Avoid heating pads or soaking feet in hot water Wear appropriately sized shoes with clean, seamless socks
43
Venous insufficiency ulcers Location, appearance, exudate, pain, pedal pulses, edema, skin temp, tissue changes, misc
Impaired function of venous system; inadequate circulation leading to tissue damage and ulceration Location: proximal to the medial malleolus Appearance: irregular shape; shallow Exudate: moderate/heavy Pain: Mild-Mod Pedal pulses: normal Edema: increased Skin temp: Normal Tissue changes: Flaking, dry skin, brownish discoloration Misc: leg elevation lessens pain
44
VI recommendations
Limb protection Risk reduction education inspect legs and feet daily Compression to control edema Elevate legs above heart when sleeping or resting Attempted active exercise including frequent ROM Wear appropriately sized shoes with lean, seamless socks
45
Neuropathic Ulcers Location, appearance, exudate, pain, pedal pulses, edema, skin temp, tissue changes, misc
Complication with ischemia and neuropathy. Associated with DM Location: Areas of the foot susception to pressure or shear forces during WBing Appearance: Well defined oval/circle; callused rim; cracked periwound tissue; little to no wound bed necrosis with good granulation Exudate: low-mod Pain: none: dysesthesia may be reported Pedal pulses: diminished/abset; unreliable ABI index with DM Edema: normal Skin temp: decreased Tissue changes: Dry; inelastic, shiny skin; decreased absent sweat/oil production Misc: loss of protective sensation
46
Neuropathic Ulcer recommendations
Limb protection Risk reduction education Inspect legs and feet daily Inspect footwear prior to donning Wear appropriately sized off loading footwear with clean, cushioned, seamless socks
47
Pressure ulcers
Decubitus ulcers; from sustained/prolonged pressure on tissue greater than capillary pressure. Present as bruising or purple blisters intact skin before opening Full thickness damage. Braden Scale/Norton Scale
48
Pressure ulcer recommendations
Reposition every 2 hours Management of excess moisture Offload pressure relieving devices Inspect skin daily Limit shear, traction and friction forces over fragile skin
49
Superficial Wound
Trauma to epidermis in tact sunburn non blistering heal normal inflammatory process
50
Partial thickness wound
Through epidermis not through dermis abrasions/blisters/skin tears heal by re-epitheliazation or epidermal resurfacing
51
Full thickness wound
through dermis and to subcutanouse fat. Deeper than 4mm Heal by secondary intention
52
Subcutaneous Wound
Extends through integumentary tissues, deeper structures fat, muscle, tendon,bone, muscle Heal by secondary intention

NPTE (13 decks)

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