Flashcards in Practical 2 Deck (36):
What is important for safety?
- Credentials (SPT)
- Affiliation (USM)
- Consent for each treatment
- Proper patient positioning
- Proper positioning of self
What is important for dressing selection for wounds?
- Wound characteristics
- Dressing characteristics
- Reason for choosing dressing
- Dressings that are contraindicated
- Prognosis/purpose/potential outcomes
- Assemble supplies
- Maintain sterility
What is important for sharp debridement?
- Describe procedure to patient with risks and benefits
- Gain consent
- PPE use/application
- Patient positioning
- Clean environment/appropriate draping
- Body mechanics
- Hold scissors parallel to wound
- Use tweezers appropriately
- Stabilize self appropriately
What is important for application of wound dressings?
- Describe procedure to patient
- Gain consent
- Apply in appropriate sequence
- Apply periwound protection
- Secure with appropriate method and verbalize reason
- Instruct patient on frequency of dressing changes
- Instruct patient on activities to avoid
- Verbalize positive signs of healing and signs of infection
- Demonstrate appropriate removal techniques
What is important for burn scar massage?
- Describe procedure
- Gain consent
- Position appropriately
- Safe body mechanics
- Verbalize contraindications
- Demonstrate transverse
- Demonstrate linear
- Adjunctive treatment options
- Adjust per patient response
- Verbalize assessment of scar quality
What dressings are appropriate for a granular, nondraining wound?
What dressings are appropriate for a granular, draining wound?
What dressings are appropriate for a necrotic, nondraining wound?
What dressings are appropriate for a necrotic, draining wound?
What are the characteristics of gauze?
finer weave decreases wound bed trauma, inexpensive for frequent dressing changes, no adhesives to traumatize periwound
What are the characteristics of calcium alginates?
absorb 20x its weight, requires second dressing, encourages autolytic debridement
What are the characteristics of impregnated gauze?
require a second dressing, decrease wound bed trauma and pain with dressing changes
What are the characteristics of semipermeable film?
permeable to water vapor, O2, and CO2 but impermeable to water and bacteria, allow visualization of wound, highly elastic and comfortable, have little absorptive or insulating capabilities, adhesive may traumatize periwound, can be left on 5-7 days
What are the characteristics of semipermeable foam?
permeable to gas but not bacteria, provide thermal insulation and cushioning, promotes autolytic debridement, should not be used for eschar or heel ulcers
What are the characteristics of hydrogels?
moisture retentive, facilitates autolytic debridement, should not be used on exudating wounds
What are the characteristics of hydrocolloids?
absorb moisture slowly swelling into a gel-like mass, impermeable to water, O2, and bacteria, have special pressure ulcer designs
What is the prognosis for an AI ulcer?
What is the prognosis for a VI ulcer?
Healing in 8 weeks, should see improvement in 2-3
What is the prognosis for a neuropathic ulcer?
Healing in 12-14 weeks, should see improvement in 4 weeks
What is the prognosis for a category I pressure ulcer?
What is the prognosis for a category II pressure ulcer?
days to weeks (should see improvement in 2 weeks)
What is the prognosis for a category III or IV pressure ulcer?
8-13 weeks (should see improvement in 2 weeks)
What are the potential outcomes of NOT receiving the proposed wound care intervention?
Slower healing times
Increased or inappropriate scarring
What are the benefits of sharp debridement?
Removes non-viable tissue
Reduces risk of infection
Takes added pressure off wound
What are the risks of sharp debridement?
What is the proper order of PPE application?
What is the proper order of PPE removal?
When is sharp debridement terminated?
clinician fatigues, pain is not adequately controlled, extensive bleeding occurs, a new fascial plane is identified, nothing remains to be debrided
How do you prepare the patient for debridement/dressing change?
assemble supplies, position patient comfortably, ensure sufficient lighting, wash hands, done clean gloves, remove old dressing, discard gloves and don clean gloves, inspect wound/measure, remove soiled gloves, explain procedure to patient and gather materials (open), ensure pain control, don clean gloves, debride, rinse wound with saline, assess for changes and perform measurements, dispose of instruments, dispose of gloves, don clean gloves, pack wound, apply skin sealant, apply dressing, remove and dispose of gloves, initial and date dressing, wash hands, patient education
What is the proper method to secure dressings with tape?
2 inches outside periwound area, 1/4 on dressing, 3/4 on skin
What are signs of wound healing?
Decrease in wound bed depth
Advancing wound edges
What are signs of infection?
Change in color (yellow/green)
What are contraindications for burn scar massage?
Pain exceeding purpose
What is the purpose of burn scar massage?
can releive itching, pain, anxiety
remodels scar tissue quality and appearance
can prevent future complications
How do you identify scar progress?