Test 1

Question 1

Three phases of healing

Answer 1

Inflammation

Proliferation

Maturation/Remodeling

Question 2

PMNs (polymorphonuclearneutrophils)

Answer 2

1st to site of injury, kill bacteria, clean wound, degrade debris

Question 3

Macrophages

Answer 3

kill pathogens, direct repair process

Question 4

Mast cells

Answer 4

produce histamine and secrete enzymes to accelerate riddance of damaged cells

Question 5

Angioblast

Answer 5

New blood vessels

Question 6

Fibroblast

Answer 6

lay down extracellular matrix

Question 7

myofibroblast

Answer 7

pull wound margins together

Question 8

maturation of tissue healing

Answer 8

type 3 collegen replaced by type 1, up to 2 years following wound closure, 80% full strength, no sweat, less sensitive.

Question 9

Age slowing healing

Answer 9

slowed immune response, decreased collagen synthesis, skin atrophy, less sweat, decreased pain perception

Question 10

Systemic factors

Answer 10

Immunocomprimised: HIV/AIDS

Oxygen perfusion: PVD, Anemia, COPD, Cardiac Conditions.

Question 11

Medications delay healing

Answer 11

Steroids, chemotherapy, NSAIDS.

Question 12

Clinician induced factors affecting healing

Answer 12

Prolonged use of antiseptic
Wrong dressing selection
Failure to detect infection
Poor wound exploration
Poor temp management

Question 13

Three wound closures

Answer 13

Primary Intention: Wound edges are closed directly with sutures, staples, or glue for quick healing.

Secondary Intention: Wound is left open to heal naturally from the inside out.

Tertiary Intention: Wound is initially left open and later closed after ensuring it is clean.

Question 14

DIME

Answer 14

Debridement: safe to debride?

Inflammation: What stage?

Moisture balance: Tissue type, masceration?

Edge effect: Stalled/rolled(Epibole), Callus, Attached.

Question 15

Key questions within history specific to wound care

Answer 15

General Demographics

Lifestyle and Functional Status

Past and Current Medical History

Question 16

Test and measures for wound assessment

Answer 16

location, dimensions, tissue type, wound edges, drainage, odor, periwound skin, edema.

Question 17

Undermining, tracts, and tunnels

Answer 17

Undermining: tissue under wound edge is eroded.

Tracts: narrow passageway, extension of wound

Tunnels: entrance and exit

Question 18

Wound bed tissue types

Answer 18

Question 19

Undermining documentaion

Answer 19

Document the length of undermining using the clock method to note location.

Ex. Underming noted measuring 4.2 cm from 12 oclock to 3 oclock.

Question 20

Wound edges examples

Answer 20

Question 21

Four types of drainage

Answer 21

Serous: Clear-pale yellow watery, protein rich

Sanguineous: Blood or drying blood, red dark brown.

Serosanginous

Purulent: Indicator of infection, white-pale yellow, viscous or creamy

Documentation: Type, color, consistency, amount.

Question 22

Acute vs Chronic Wound

Answer 22

Acute progress sequentially through the natural phases of healing in timely manner.

Chronic do not progress sequentially through healing; frequently stuck in inflammatory phase.

Question 23

Wound bed preparation model

Answer 23

Question 24

How to tell if a wound is healable?

Answer 24

Adequate blood supply

Question 25

universal vs standard precautions

Answer 25

universal: all body fluids are considered contaminated. standard: hand washing and PPE

Question 26

Clean vs sterile technique

Answer 26

Clean: standard for wound care, wash hands and use PPE. Sterile: use everything sterile, much higher detail than clean.

Question 27

What are the common types of irrigaiton?

Answer 27

Normal saline: water/salt Sterile water: must use with silver dressing Tap water: caution with immunocompromised Wound Cleansers Antiseptics: can kill everything on skin.

Question 28

When is immersion or soaking contraindicated?

Answer 28

Recent skin graft, surgical incision, diabetic feet, bleeding wounds, dry gangrene.

Question 29

safe psi for wounds

Answer 29

4-15

Question 30

Whirlpool contraindicated

Answer 30

clean granulating wounds, uclers, active bleeding, venous insufficiency, multi wounds same area, seizures, bowl and bladder issues.

Question 31

Pulsed lavage with suction/ ultrasonic mist therapy.

Answer 31

PLWS: irrigation with suction. Expensive Ultrasonic Mist: irrigation with ultrasonic waves. Expensive

Question 32

PLWS contraindications

Answer 32

Aerosolization risk, confined space, cover horizontal surfaces.

Question 33

re-black system

Answer 33

Question 34

six types of debridement

Answer 34

Sharp Mechanical Enzymatic Autolytic Biologic Surgical

Question 35

Contraindications for debridement

Answer 35

Arterial supply, ABI, Types of tissue

Question 36

Mechanical debridement

Answer 36

solft abrasion, wet to dry, hydrotherapy

Question 37

enzymatic debridement

Answer 37

do not use with dressing containing silver, iodine, HP, acetic acid. use of creams, collagenase santyl, prescription

Question 38

Autolytic Debridement

Answer 38

Contraindications: infection, dry gangreene, deep cavity wounds.

Question 39

Biosurgical Debridement

Answer 39

maggots. blood vessels to organs, near eyes respiratory tract and Gi are contraindications.