Other Systems Flashcards
What symptoms will a patient with end stage kidney disease most likely demonstrate
Decreased urine output and anemia
Primary vs secondary vs tertiary healing by intention
Primary: wound edges clean, approximated by sutures, or if superficial partial thickness such as abrasion or blisters.
Secondary: Can’t be approximated. Require ongoing wound care, heal by migrating granulation tissue. Usually associated with pathology such as diabetes.
Tertiary: Delayed primary intention healing-wounds at risk for sepsis or dehiscence.
Wound contamination vs colonization vs infection
Contam: The presence of non-replicationg bacteria on a wound surface that causes no additional tissue injury and does not stimulate an inflammatory response.
Colonization: Replication of bacteria on wound surface that does not invade or further injury, but can delay healing, or may actually help by preventing worse organisms from invading
Infection: Inflammatory, invading, significant delay of healing.
The different general recommendations for arterial/venous ulcers.
Arterial: Avoid elevating limbs
Venous: Elevate limbs when sleeping
Neuropathic vs pressure ulcers
Neuro: usually a result of ischemia and peripheral neuropathy
Pressure: ischemia and pressure
1) Arterial vs 2) Venous vs 3) Neuropathic Ulcers: Location
1) Lower 1/3 of leg-even to distal toes
2) Proximal to medial malleolus
3) Areas of foot susceptible to pressure or shear
1) Arterial vs 2) Venous vs 3) Neuropathic Ulcers: Appearance
1) smooth, well defined, deep, no granulation
2) irregular, shallow
3) Well-defined oval/circle, callused rim, no necrosis, goo granulation
1) Arterial vs 2) Venous vs 3) Neuropathic Ulcers: Exudate
1) minimal
2) moderate/heavy
3) low/moderate
1) Arterial vs 2) Venous vs 3) Neuropathic Ulcers: Pain
1) severe
2) mild to mod
3) low to mod
1) Arterial vs 2) Venous vs 3) Neuropathic Ulcers: Pedal pulses
1) diminished/absent
2) normal
3) diminished/absent
1) Arterial vs 2) Venous vs 3) Neuropathic Ulcers: edema
1) normal
2) increased
3) decreased
1) Arterial vs 2) Venous vs 3) Neuropathic Ulcers: skin appearance
1) thin, shiny, hair loss, yellow nails
2) flaky, dry, brownish
3) dry, inelastic, shiny, decreased sweat/oil
Wound classification by depth
1) superficial
2) partial thickness
3) full
4) subcutaneous
1) epidermis intact
2) through epidermis, may be partially into dermis
3) through dermis into subcutaneous fat
4) through to fat, tendon, muscle, bone
Wagner ulcer grade classification scale: 0-5
0) skin intact, pre-ulcerative lesions, healed ulcers, bony deformity
1) Superficial ulcer, not involving subcutaneous
2) Penetrates through subcutaneous, potentially exposing bone, lig, or joint capsule
3) Osteitis, abscess or osteomyelitis
4) Gangrene of digit
5) Gengrene of foot requiring disarticulation
Pressure Ulcer stages I-V
I: intact, redness
II: Loss of dermis
III: full thickness tissue loss, tendon/muscle not exposed
IV: full thickness with exposed bone/tendon/muscle
V: Suspected deep tissue injury
Which type of selective debridement shouldn’t be used with an infected wound?
Autolytic.
Sharp and enzymatic can be used with an infection
Selective vs non-selective debridement
selective: only nonviable tissue
The 3 types of non-selective debridement
Wet-to-dry, wound irrigation, hydrotherapy
What type of U/S used for wound healing?
low intensity, pulsed duty cycle
Which 2 types of dressings can’t be used on infected wounds, which one usually used for infected wounds?
Hydrocolloids, transparent film
Alginates
Desquamation
Peeling or shedding of the outer layers of the epdidermis.
Friable
tissue that readily tears, fragments or bleeds
Maceration
skin softening from prolonged exposure to moisture
Normotrophic scar
collagen fibers aligned in parallel fashion
