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mod 8 E- I Flashcards

(48 cards)

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1
Q

What can throw off the fit of a prothesis

A

fluctuation in weight and fluid volume

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2
Q

What is the disease process seen with those that have a prothesis

A

either slows wound healing or makes the skin susceptible to damage

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3
Q

How many times should you look at the skin and cleanse for prothesis?

A

2 times
- when taking it off and putting it back on
Cleansed: mild soap and water daily

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4
Q

What should you not do when caring for prothesis?

A

The area should not be shaved and no lotions or creams unless prescribed by doctor

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5
Q

Rashes

A

first/ easiest type of skin breakdown to prevent and heal are rashes
Areas suspectable: beneath breast, under arms, and between folds
Overgrowth of yeast

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6
Q

What is another concern for rashes beside skin on skin contact?

A

skin on plastic contact
Devices like IV or oxygen tubing
May be due to latex, ex: allergy
protective cloth can eliminate the contact

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7
Q

when does Friction and Shearing occur

A

Often occurs while pt is in bed
occurs when pt body slides down and skin stuck to linens
creates heat and leads to development of blisters
to eliminate: amount of time spent with head of bed should be eliminated
greater than 30 degrees will slide down the bed

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8
Q

Pressure Injuries, decubits uclers, pressure sores, pressure ulcers, bed sore

A

dangerous medical condition
occurs over the bony prominences areas
Some may heal or may never
Can cause infection
If infection is not taken care of the resident can become septic and die

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9
Q

When did medical stop covering pressure injuries

A

Oct 2008, due to them being preventable

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10
Q

stage 1 pressure injury

A

tell the nurse immediately
skin is intact; reddened or discolored and Non blanching (area pressured while turn white)
may be warm and edema

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11
Q

stage 2 pressure injury

A

skin in open epidermis and sometimes dermis involved
appears as a shallow crater
blister opens to reveal PI

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12
Q

stage 3 pressure injury

A

epidermis, dermis, and subcutaneous tissue involved
eschar may be present
deep carter

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13
Q

what can stage 2 and 3 have?

A

if necrotic tissues or an eschars tissues the wound must be debride
Eschar: necrotic tissues sometimes found in wound bed of a pressure injury
Debriment: chemical or manual removal of eschar

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14
Q

stage 4 pressure injury

A

epidermis, dermis, and subcutaneous tissue and supporting structures including muscles, tendons, joints, and bones involved
may take months to heal
if does not heal: sustain scaring and deformity and loss of function

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15
Q

Affecting factors for developing pressure injuries?

A

immobility
inability to perceive pain
an altered level of consciousness
incontinence
poor nutrition
high microclimate

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16
Q

What can incontience create?

A

it can create a moist environment
skin moisture can macerate the skin
Maceration: appears as a skin that is softened from constant moisture exposure

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17
Q

What from urine and feces creates quick skin break down

A

alkalinity of the skin
action of enzymes
skin can break down quickly

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18
Q

Nutrition’s importance of developing pressure injuries

A

Need adequate nutrition and protein
Protein are building blocks creating new tissue
Without proper protein the skin becomes edematous
DeHydration: can make the tissues dry and skin more brittle

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19
Q

Microclimate

A

close enviornment in which the level of heat and humidity are localized
ex: between the skin and bed
Skin needs a dry and constant temp.

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20
Q

Inspect and cleanliness

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A

need to pull up the folds and look during morning/evening baths
You may apply cornstarch of powder under breasts, arms, and skin folds

21
Q

Shearing and friction prevetnion of 30 degrees angle

Study These Flashcards
A

elbow and heel protectors
if not available use socks or long-sleeved shirts
try to elevate the heels
place pillows under elbows

22
Q

Pressure relieving devices

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A

Mattress toppers: must be repositioned every 2 hr due to increase microclimate
alternating pressure pads for wheelchair
residents who have:
- sore on butt
- high risk of skin breakdown
-spend a lot of time in wheelchair
should have a pad
special boots
- prevent back touching bed or wc
- removed: 2x daily

23
Q

Positining devices

Study These Flashcards
A

Pillows: easiest and most accessible
wedges pillows: position resident on her side
if pillows or wedge pillows unavailable use:
- bed/bath blankets can be rolled up

24
Q

reducing microclimate

Study These Flashcards
A
  • does not have too many blankets
  • fevers should be reported
  • special low air loss mattress help reduce microclimate
25
friction and shearing devices
friction/shearing prevention devices: can be used when moving a resident upward in bed 2 cna - obese or fragile skin on 3 resident is gently slid upward there is no lifting
26
Urinary retention
- Body does not send the message to the brain/ brain doesn't receive them or blockage Inability to empty the bladder either partially or fully if bladder does not empty it can be damaged or even rupture
27
Steps taken when there is no bowel elimination
no bowel movement in 3 days: latex or milk of magnesia is given if it has been 4 days: a suppository is inserteds 5 days: edema is given
28
Edema
injection of fluid into the rectum resident holds fluid in rectum as long as possible over the counter fleet enema resident must always lay on left side when given edema
29
suppository
a wax cone that is inserted into the rectum to help the resident have a bowel movement
30
What is Incontinent
incontinences: involuntary leakage or passing of urine from the bladder or feces from rectum if resident is physically able to sit on toilet help do so try to run faucet clean, peri-care, apply barrier cream
31
types of incontinence products
liner is pad that is inserted into underwear briefs: worn in place of underwear barrier cream should be applied to anyone that is incontinence if no red areas apply to anal area and buttocks
32
Urostomy
bladder is diseased or removed from trauma no longer functioning urostomy: ureters are detached from blader and hen attached to a segment of the bowel one end then extends outside of the abdominal wall which allows the urine drain outside of the body 1/3 to 1/2 full
33
Stoma (urine)
Is an opening that protrudes form the abdomen connecting an internal organ to the outside to the body usually pink or red in color urine is collected and emptied once bag is 1/2 to 1/3 full and at the end of each shift
34
what are ostomies + 2 types
rectum/colon is disease they may not have a bowl movement via the rectum colostomy: made from large intestine ileostomy: made from the small intestine
35
removal and procedure of ostomies
- empty and clean ostomy bag bag should be emptied when: - approximately half full - when resident requests clean stoma and surrounding area w adult wipes reusable bag: - rinse and empty bag - dry bag and reattach
36
Devices used for elmination- bedpan, commode, urinal, commode hat
bedpan: - bed bound - strict bed rest - cannot sit up on a toilet or commode - used at night so they do not need to get out of bed commode: - cannot walk, can sit on toilet - empty/ clean with adult/disinfecting wipes - replace it under toilet seat of commode - if resident is on intake/output: place commode hat under toilet seat of commode urinal: - in replace of graduate to measure urine - place bed protector underneath - place washcloth around rim - tell pt to place on side rails commode hat: - used for collecting output or a sample of output - measuring urine: place hat in front part of commode - collecting stool: place it in back part of commode - both: place one in front and back - no tp in it
37
Traditional and fracture bedpan
commonly used: fracture more economical/smaller - assisting a resident w/hip surgery you must only use a fracture pan
38
digestive tract bleeding
upper bleeding: stomach/beginning of intestine will result in black starry tool blood in stool is occult (hidden) lower: may be frank blood (red/obvious) hemorrhoids: large distended veins around the anus - due to constipation - bleed frank blood tell the nurse if: - occult/frank blood - do not flush toilet
39
bowel/bladder retaining
- ask pt to wait longer - nrs would begin/educate program - cna: encourage/ remind longer waiting times - help them feel relaxed
40
height and weight
proper height/weight: - calc fluid and nurition needs/ med
41
heights
cannot stand: tape measure can be used resident facing away, looking straight ahead: back, shoulders, and buttocks against the scale stand up scale: feet flat on floor, toes pointing forward, shoes kept on
42
weights
once per week- bath day hospital: taken daily, @ same time loss or gained 3 pounds is out of normal limits and should be reported to nrs.
43
What residents may not perceive pain
comatose, confused, certain disease like disease
44
breast prosethic
can be fitted 6 weeks after maestomcy partial or full partial: only part place inside their brea/specila bra may be a partial mastectmy or lumpectomy
45
Artificial limb
sock or gel insert cushion join during movement absorbs sweat no wrinkles not on: use ACE bandage or special shrink sock to prevent swelling
46
what is the relationship between incontience and maceration
moist environment it skin will cause skin to macerate maceration is softened from constant moisture once macerated can be damaged by friction
47
External cath
removes urine via cath single use 8-12 hrs removed if soiled replaced every 60 days
48
Orthosis
Brace, splint, or orthopedic device (aka orthotic) * Custom made * Can be made for upper/lower extremities, back, neck, head * Used by those with an injury, disability, or birth defect help with ROM exercises

CNA (11 decks)

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