Seminar

Question 1

What is the most common bony prominence for pressure injuries in supine?

Answer 1

Sacrum and Coccyx

Question 2

What pressure ulcer risk factor is associated with Cancer?

Answer 2

Increased body temp.

Question 3

What pressure ulcer risk factor is associated with Hypotension?

Answer 3

Nutritional issues

Question 4

What pressure ulcer risk factor is associated with Obesity/ Low body weight?

Answer 4

Impaired mental status

Question 5

What pressure ulcer risk assessment tool has the highest reliability?

Answer 5

Braden Scale

Question 6

What indicates at risk for the Braden scale?

Answer 6

18 and higher

Question 7

What is the stage of the pressure ulcer that refers to” shallow ulcer without sloughing or bruising”?

Answer 7

Stage 2 NPUAP

Question 8

What is the usual complication of NPUAP Stage 4 pressure ulcer?

Answer 8

Osteomyelitis (Bone infection)

Question 9

What is the gold standard for diagnosing osteomyelitis?

Answer 9

Bone biopsy

Question 10

When should an eschar should not be removed?

Answer 10

When there is stable eschar (dry adherent and intact without erythema or fluctuance) which acts as a natural cover and protection.

Question 11

___ ulcer is caused by sensory neuroparthy.

Answer 11

Diabetic ulcer

Question 12

What is the etiology of venous ulcers?

Answer 12

Ambulatory venous hypertension

Question 13

What common joint site is most commonly affected in Charcot’s joint?

Answer 13

Lisfranc joint/ Tarsometatarsal joint

Question 14

What is the gold standard for treating diabetic ulcer?

Answer 14

Total contact casting

Question 15

What is the most important lab value?

Answer 15

Serum albumin

Question 16

What does low albumin mean?

Answer 16

Increased protein intake to a nutritionist for the pt.

Question 17

What is the difference between scab and eschar?

Answer 17

Eschar is firmly adherent and concave whereas the scab is convex and loosely to firmly adherent.

Question 18

What is the difference of the texture between eschar and scab?

Answer 18

Eschar = Soft to hard, smooth and leathery
Scab = Rough

Question 19

For PLWS what are the parameters for pressure and suction?

Answer 19

Pressure = 4-15 mmHg
Suction = 80-100mmHg

Question 20

What is a contraindication to sharp debridement?

Answer 20

Anticoagulant meds like Heparin/ Warfarin

Question 21

What are the agents for enzymatic debridement? Enumerate its specific enzymes.

Answer 21

Proteolytic & Fibrinolytic
enzymes and Collagenase

Proteolytic & Fibrinolytic
enzymes = Elase, travase, Others (Papain, streptokinase, streptodornase, sutilains)

Collagenase = Santyl

Question 22

What selective debridement will you choose if the amount of granulation tissue is less than the amount of necrotic tissue?

Answer 22

Enzymatic

Question 23

What selective debridement will you choose if the amount of granulation tissue is greater than the amount of necrotic tissue?

Answer 23

Autolytic

Question 24

What topical antibacterial agent is good for MRSA but not used for Pseudomonas?

Answer 24

Mupirocin 2%

Question 25

What topical antibacterial agent is good broad-spectrum vs. gram negative bacteria?

Answer 25

Gentamicin sulphate

Question 26

What is the effect of US during the inflammatory phase?

Answer 26

US facilitates the release of histamine from mast cells to shorten inflammatory period

Question 27

What is the effect of US during the proliferative phase?

Answer 27

US increases the activity of fibroblasts to help you form the collagen

Question 28

The application of electrical stimulation is __ days anode and ___ days cathode.

Answer 28

Application: 3 days cathode then 3 days anode

Question 29

What is the side effect of immunosuppressive agents to wound healing?

Answer 29

Affects fibroblast function, collagen synthesis, & phagocytic action in the wound

Question 30

What is the side effect of Antiprostaglandins to wound healing?

Answer 30

Decrease in blood supply (constriction)

Question 31

Prednisone is both a corticosteroid and a ___.

Answer 31

Immunosuppressive agent

Question 32

What are the topical cytotoxic agents that are bacteriostatic?

Answer 32

Hydrogen Peroxide and Acetic Acid

Question 33

What is the indication of Sodium Hypochlorite?

Answer 33

Sodium Hypochlorite for Staph. Aureus

Question 34

What is the formula for Dakin's Solution?

Answer 34

0.4-0.5% Sodium Hypochlorite and 0.4% Boric Acid

Question 35

What is the indication for Dakin's Solution?

Answer 35

Staphylococci, Streptococci and Pyocyaneus microorganisms

Question 36

What topical agent refers to 0.005% solution is bactericidal but not cytotoxic

Answer 36

Sodium Hypochlorite

Question 37

What is the side effect of immunosuppressive agents to wound healing?

Answer 37

Affects fibroblast function, collagen synthesis, & phagocytic action in the wound

Question 38

What is the side effect of Antiprostaglandins to wound healing?

Answer 38

Decrease in blood supply (constriction)

Question 39

Prednisone is both a corticosteroid and a ___.

Answer 39

Immunosuppressive agent

Question 40

__% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)

Answer 40

0.005% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)

Question 41

What is the indication of Sodium Hypochlorite?

Answer 41

Sodium Hypochlorite for Staph. Aureus

Question 42

Which substance functions to stabilize membrane structure & function, acts as a cofactor in enzyme systems, affects immune response, & inhibits bacterial growth?

Answer 42

Zinc

Question 43

What is the difference between cellulitis and dermatitis?

Answer 43

Cellulitis = Infection of soft tissues with fever Dermatitis = Inflammation of tissues without fever

Question 44

What are the ff. enzymes used for? Elase Travase Santyl

Answer 44

``` Elase = Venous ulcers with fibrinous exudates/ glassy edematous wounds Travase = Wounds with eschar Santyl = Stubborn necrotic collagen ```

Question 45

What are the poorly vascularized areas that are usually affected with arterial ulcers?

Answer 45

Toes, dorsum of the foot, lateral malleolus and anterior tibia

Question 46

What is the primary goal of treating arterial ulcers?

Answer 46

The primary goal is to increase the circulation to the area in question.

Question 47

What is the topical agent most effective with adhered biofilms?

Answer 47

Surfactants (Saf Clens)

Question 48

__% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)

Answer 48

0.005% solution is bactericidal but not cytotoxic (Sodium Hypochlorite)

Question 49

Which substance functions to provide the structural components for wound healing; proteins?

Answer 49

Amino Acids

Question 50

Which substance functions to stabilize membrane structure & function, acts as a cofactor in enzyme systems, affects immune response, & inhibits bacterial growth?

Answer 50

Zinc

Question 51

What is the difference between cellulitis and dermatitis?

Answer 51

Cellulitis = Infection of soft tissues with fever Dermatitis = Inflammation of tissues without fever

Question 52

Enumerate 5 signs of infection.

Answer 52

``` Low grade fever Local pain Inc. local temp. New breakdown Abnormal discharge ```

Question 53

What are the poorly vascularized areas that are usually affected with arterial insufficiency?

Answer 53

Toes, dorsum of the foot, lateral malleolus and anterior tibia

Question 54

What is the primary goal of treating arterial ulcers?

Answer 54

The primary goal is to | increase the circulation to the area in question.

Question 55

What is the topical agent most effective with adhered biofilms?

Answer 55

Surfactants

Question 56

Besides histamine what else do mast cells release?

Answer 56

Heparin and serotonin