Skin Ulcers: Ven, Art, DM, Pressure

Question 1

Venous Ulcers:
Etiology: 
Associated with chronic \_\_\_\_\_ insufficiency
Valvular incompetence
\_\_\_\_\_\_
\_\_\_\_\_hypertension
Calf \_\_\_\_ \_\_\_ failure

Answer 1

Venous
DVT
Venous
Muscle pump

Question 2

Venous Ulcers:
Etiology: Recurrence is _____
_____ insufficiency may co-exist

Answer 2

High

Arterial

Question 3

Venous Ulcers:
Clinical Features:
Can occur anywhere in lower leg: common over area of ____ ____, sometimes _____

Answer 3

Med mal, lateral

Question 4

Venous Ulcers:
Clinical Features:
Pulses: ______

Answer 4

Normal

Question 5

Venous Ulcers:
Clinical Features:
Pain?

Answer 5

None to aching pain in dependent position

Question 6

Venous Ulcers:
Clinical Features:
Color?

Answer 6

Normal or cyanosis in dependent position
Hemosiderosis may appear
Liposclerosis

Question 7

Venous Ulcers:
Clinical Features:
Temp?

Answer 7

Normal

Question 8

Venous Ulcers:
Clinical Features:
Edema?

Answer 8

Present, often marked

Question 9

Venous Ulcers:
Clinical Features:
Skin changes?
Pigmentation, Stasis _______ may be present, thickening of skin as scarring develops

Answer 9

Dermatitis

Question 10

Venous Ulcers:
Clinical Features:
Ulceration: may develop, especially _____ ankle; wet, with _____ _____ of exudate

Answer 10

Medial

Large amount

Question 11

Venous Ulcers:
Clinical Features:
Gangrene?

Answer 11

Absent

Question 12

Venous Ulcers:
Examination:
Venous ulcers are typically ______ and _____ and located over _____ prominences

Answer 12

Shallow
Irregular
Bony

Question 13

Venous Ulcers:
Examination:
Associated findings? Edema, _____ dermatitis, _____-pigmentation, varicosities, and chronic _______

Answer 13

Venous
Hyper
Cellulitis

Question 14

Venous Ulcers:
Examination:
Subjective reports of venous insufficiency include what?

Answer 14

Burning, throbbing, cramping, aching, and leg fatigue

Question 15

Venous Ulcers:

Interventions: Compression wrap worn during ___ and ____

Answer 15

Day and night

Question 16

Venous Ulcers:

Examination: Compression is CONTRA or what two scenarios?

Answer 16

Active DVT

Or ABI < 0.7

Question 17

Arterial Ulcer:
Etiology:
Associated with chronic _____ insufficiency, ________, _______

Answer 17

Arterial
Arteriosclerosis obliterates
Atheroembolism

Question 18

Arterial Ulcer:
Clinical Features:
Can occur anywhere in lower leg, common on ____, _____, and bony areas of trauma (____)

Answer 18

Toes, feet

Shin

Question 19

Arterial Ulcer:
Clinical Features:
Preceded by signs and symptoms of arterial insufficiency
Pulses are \_\_\_\_\_ or \_\_\_\_\_\_
\_\_\_\_\_ \_\_\_\_\_\_

Answer 19

Poor or absent

IC

Question 20

Arterial Ulcer:
Clinical Features:
Pain?
What position is it the worst?

Answer 20

OFTEN SEVERE, intermittent, progression to pain at rest

Pain inc with limb elevation

Question 21

Arterial Ulcer:
Clinical Features:
Color?

Answer 21

Pale on elevation, rubor on dependency

Question 22

Arterial Ulcer:
Clinical Features:
Temp?

Answer 22

COOL

Question 23

Arterial Ulcer:
Clinical Features:
Skin changes?

Answer 23

Tropic changes (thin, shiny, atrophic skin)
Loss of hair on foot and toes
Nails thickened

Question 24

Arterial Ulcer:
Clinical Features:
Ulceration?

Answer 24

Of toes or feet, can be deep

Question 25

Arterial Ulcer: Clinical Features: Gangrene?

Answer 25

Black, gangrenous skin adjacent to ulcer can develop

Question 26

Arterial Ulcer: Exam: Examine peripheral pulses, temp, segmental BP (Greater than ___ mmHG drop between segments is significant)

Answer 26

20

Question 27

``` Arterial Ulcer: Exam: ABI Arterial Doppler studies Outcome measure: _____ ```

Answer 27

Walking impairment questionnaire

Question 28

Arterial Ulcer: Interventions: Manage these 4 things

Answer 28

BP Cholesterol Triglyceride Glucose levels

Question 29

Diabetic Ulcer: Etiology: Diabetic ulcer is associated with ______ _____ ___ ___ and peripheral ____

Answer 29

Atherosclerotic PAD and peripheral neuropathy

Question 30

Diabetic Ulcer: Etiology: | Caused by loss of ____ sensation, loss of muscle ______, and mechanical trauma

Answer 30

Protective | Coordination

Question 31

Diabetic Ulcer: Clinical features: Occurs where arterial ulcers usually approach; or where peripheral neuropathy appears (_____ ____ ___ ____)

Answer 31

Plantar aspect of foot

Question 32

Diabetic Ulcer: Clinical features: Pain?

Answer 32

Typically NOT painful | Sensory loss usually present

Question 33

Diabetic Ulcer: | Clinical features: Pulses?

Answer 33

May be present or diminished

Question 34

Diabetic Ulcer: Clinical features: Absent ______ ____ with neuropathy

Answer 34

Ankle jerks

Question 35

Diabetic Ulcer: Clinical features: _____ common ____ may develop

Answer 35

Sepsis | Gangrene

Question 36

``` Diabetic Ulcer: Exam: 1. Exam general condition of extremity 2. Exam for _____ insufficiency 3. Exam for _____ _____: with _____ ____ of sensory integrity ```

Answer 36

Vascular Peripheral neuropathy Monofilament testing

Question 37

Diabetic Ulcer: | Intervention: Off loading the wound by using protective therapeutic ________

Answer 37

Footwear

Question 38

``` Pressure Ulcer (decubitus ulcer): Etiology: lesions caused by _______ pressure resulting in _____ hypoxia and damage to underlying tissue ```

Answer 38

Unrelieved | Ischemic

Question 39

``` Pressure Ulcer (decubitus ulcer): Risk Factors: 1. Prolonged pressure, shear forces, friction, repetitive stress 2. _______ deficiency 3. Maceration 4. Common in ____, _____, or _____ pts Decreased blood flow from hypotension or microvascular disease (____, ____) Neuro impaired skin: decreased ______ Cog impairment ```

Answer 39

Nutrition Elder, debilitated, immobilized DM, atherosclerosis Sensation

Question 40

Pressure Ulcer (decubitus ulcer): Clinical Features: Location?

Answer 40

Over bony prominences (sacrum, heels, trochanter, M/L mal, ischial areas

Question 41

Pressure Ulcer (decubitus ulcer): Clinical Features: Color?

Answer 41

Red Brown/black Yellow

Question 42

Pressure Ulcer (decubitus ulcer): Clinical Features: Localized _______

Answer 42

Infection

Question 43

Pressure Ulcer (decubitus ulcer): Clinical Features: Pain?

Answer 43

Can be painful if sensation intact

Question 44

Pressure Ulcer (decubitus ulcer): Clinical Features: Inflammatory response with ______ tissue: hyperemia, fever, increased WBC

Answer 44

Necrotic

Question 45

Pressure Ulcer (decubitus ulcer): Clinical Features: If left untreated, will progress to superficial simple erosion to involvement of _____ layers of skin and underlying ____ and ____

Answer 45

Deep | Muscle and bone

Question 46

Pressure Ulcer (decubitus ulcer): Clinical Features: Exam: Use a standardized pressure ulcer assessment such as?

Answer 46

Bates Jensen wound assessment tool | Pressure ulcer scale

Question 47

Pressure Ulcer (decubitus ulcer): Clinical Features: Exam: Examine circulation, sensory integ, and pain level Utilized a risk assessment instrument for individuals at risk for development of pressure ulcers like what?

Answer 47

Gosnell, Braden, or Norton scales Braden Q for kids