Surgical Incision- EXAM 4

Question 1

Assessing incison

Answer 1

How is it dressed
Review amount of drainage
IS there any bleeding or drainage underneath the patient
Are there drains in place? If so are they set properly
Every 8 hours assess for redness, increases warmth, swelling, tenderness, pain

Question 2

Describe normal wound healing

Answer 2

Some drainage from sanguineous or sergoanguineous to serous is normal for 1st few days
Continuing after day 5 is a sign of possible dishiscence
Crusting of incision is normal as is pink color to the line and slight swelling

Question 3

Healing time

Answer 3

2 weeks to regain tissue integrity without trauma, infection, disease, malnutrition or steroid use
Complete tissue integrity occurs in 6 months -2 years

Question 4

Describe impaired wound healing

Answer 4

Loss of tissue integrity from infection, distention, stress at surgical site ir other health problems
Can be caused from forceful coughing, vomitting, straining to non proper splinting

Question 5

Dehiscence

Answer 5

Partial or complete operation of outer layers
“splitting open”
Occurs often in patients with DM, obesity, immune deficiency or malnutrition
broken sutures, bleeding from would entry point, fever, inflammation, can be symptoms to its occurrence
Caused 5-10 days after surgery

Question 6

Evisceration

Answer 6

The total separation of all wound layers or profusion of internal organs through open wound
Caused 5-10 days after surgery

Question 7

Management of dehiscence

Answer 7

Apply sterile nonadherant or saline dressing to wound
Instruct patient to bend knees and avoid coughting

Question 8

Management if Evisceration

Answer 8

Requires surgical emergency!!!
RRT– Supine position with knees and hips bent– Raise head to 15-20 degrees– Place large abdominal dressings in warm saline and over the exposed area– Place sterile waterproof drape over the dressing to prevent sheets from getting wet– Do not attempt to reinsert protruding organ– Assess for shock and document vitals signs every 5-10 min until surgeon or RRT arrives– Keep dressing continuously moist with warm saline

Question 9

How do you prevent wound infections and delayed healing

Answer 9

Reinforcing dressing changes, assessing the wound for healing and infection, care for drains, empty drainage containers, measure drainage
Remember to always splint with chest or abdomen when coughing!!

Question 10

Signs and symptoms of infection

Answer 10

Abscess, erythmia, increased temperature and exudate, odor and severe pain