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Flashcards in Practical 2 Deck (36):
1

What is important for safety?

- Name
- Credentials (SPT)
- Affiliation (USM)
- Consent for each treatment
- Proper patient positioning
- Proper positioning of self

2

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

3

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

4

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

5

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

6

What dressings are appropriate for a granular, nondraining wound?

gauze
impregnated gauze
transparent film
hydrogel

7

What dressings are appropriate for a granular, draining wound?

gauze
alginate
semipermeable foam
hydrocolloid

8

What dressings are appropriate for a necrotic, nondraining wound?

gauze
impregnated gauze
transparent film
hydrogel
hydrocolloid

9

What dressings are appropriate for a necrotic, draining wound?

gauze
alginate
semipermeable foam
hydrocolloid

10

What are the characteristics of gauze?

finer weave decreases wound bed trauma, inexpensive for frequent dressing changes, no adhesives to traumatize periwound

11

What are the characteristics of calcium alginates?

absorb 20x its weight, requires second dressing, encourages autolytic debridement

12

What are the characteristics of impregnated gauze?

require a second dressing, decrease wound bed trauma and pain with dressing changes

13

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

14

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

15

What are the characteristics of hydrogels?

moisture retentive, facilitates autolytic debridement, should not be used on exudating wounds

16

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

17

What is the prognosis for an AI ulcer?

2-4 weeks

18

What is the prognosis for a VI ulcer?

Healing in 8 weeks, should see improvement in 2-3

19

What is the prognosis for a neuropathic ulcer?

Healing in 12-14 weeks, should see improvement in 4 weeks

20

What is the prognosis for a category I pressure ulcer?

1-3 weeks

21

What is the prognosis for a category II pressure ulcer?

days to weeks (should see improvement in 2 weeks)

22

What is the prognosis for a category III or IV pressure ulcer?

8-13 weeks (should see improvement in 2 weeks)

23

What are the potential outcomes of NOT receiving the proposed wound care intervention?

Infection
Slower healing times
Increased or inappropriate scarring

24

What are the benefits of sharp debridement?

Promotes healing
Removes non-viable tissue
Reduces risk of infection
Takes added pressure off wound

25

What are the risks of sharp debridement?

Injury
Excessive bleeding

26

What is the proper order of PPE application?

Wash hands
Gown
Mask
Goggles
Gloves

27

What is the proper order of PPE removal?

Gloves
Goggles
Gown
Mask
Wash hands

28

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

29

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

30

What is the proper method to secure dressings with tape?

2 inches outside periwound area, 1/4 on dressing, 3/4 on skin

31

What are signs of wound healing?

Decrease in wound bed depth
Advancing wound edges
Granulation tissue
Epithelialization

32

What are signs of infection?

excessive drainage
foul odor
Change in color (yellow/green)

33

What are contraindications for burn scar massage?

AI
Open wounds
Pain exceeding purpose

34

What is the purpose of burn scar massage?

can releive itching, pain, anxiety
remodels scar tissue quality and appearance
can prevent future complications

35

How do you identify scar progress?

vascularity
pliability
pigmentation
height

36

What are some adjunctive treatments for burn scars?

At-home moisturizer several times a day
Compression wraps worn 24/7 for 12-24 months following wound closure
Silicone gel sheets