WEEK 4: DISEASE AND WOUNDS Flashcards Preview

NCOP > WEEK 4: DISEASE AND WOUNDS > Flashcards

Flashcards in WEEK 4: DISEASE AND WOUNDS Deck (20)
Loading flashcards...
1

CHRONIC DISEASE AND THE OLDER PERSON

- Complex and multifactorial
- Gradual onset of occurence and symptom variation
- Persistent and long term and eventual progression to deterioration in old age
- Often leads to physical impairment which impacts on quality of life
- Eventually leads to premature mortality

2

HEART FAILURE

- HF→ Heart unable to maintain a strong enough flow to meet the body’s needs
- Can occur suddenly but usually develops slowly over years and becomes gradually weaker and less effective
- Can result from a variety of diseases and conditions that impair or overload the heart, notably heart attack, high blood pressure, primary heart muscle weakness (known as cardiomyopathy) or a damaged heart valve
- Incidence in the older population
- 10% for people aged 65 and older
- Over 50% in people aged 85 and older

3

PARKINSON’S DISEASE

- Progressive neurological condition
- Caused by the progressive impairment or deterioration of neurons (nerve cells) in an area of the brain (substantia nigra)
- This area produces the transmitter dopamine (smooth and balanced muscle movement) and is linked with both motor (movement) and non-motor symptoms

4

PARKINSON’S DISEASE SYMPTOMS: PRIMARY

- Slow movement
- Tremors
- Rigidity
- Poor balance

5

PARKINSON’S DISEASE SYMPTOMS: SECONDARY

- Constipation
- Difficulty swallowing
- Choking, coughing or drooling
- Excessive salivation
- Excessive sweating
- Loss of bowel and/or bladder control
- Loss of intellectual capacity
- Anxiety, depression, isolation
- Scaling, dry skin on the face or scalp
- Slow response to questions
- Small, cramped handwriting
- Soft, whispery voice

6

PARKINSON’S DISEASE: AETIOLOGY AND PREVALENCE

Aetiology is largely unknown but several factors are thought to contribute;
- Environmental toxins
- Oxidative stress (free radical theory)
- Genetic factors
- Multi-factorial
- 2011→ Over 64,000 Australians were living with PD
- Second most common neurological condition in Australia

7

PARKINSON’S DISEASE: TREATMENT

- Major classes of drugs available for treatment
- Levodopa preparations
- Dopamine agonists (combination theory)
- Antidepressants (depression and anxiety)

- Many aim to increase dopamine in the brain, by increasing its production or altering its metabolism
- Side effects: nausea, gastrointestinal symptoms, hypotension, drowsiness, cognitive symptoms and impulse control disorders

8

CHRONIC OBSTRUCTIVE PULMONARY DISEASE: SYMPTOMS AND PREVALENCE

- Persistent (chronic) cough, sputum production and/or dyspnoea
- At least half of those with moderate to severe COPD are unaware they have the disease (a point at which 50% of their lung capacity is lost)
- Approximately 2.1 million Australians have COPD and this number is expected to double by 2050
- Worldwide it is expected COPD will become the 3rd leading cause of death by 2020 due to increased life spans and smoking

9

CHRONIC OBSTRUCTIVE PULMONARY DISEASE: MANAGEMENT

- Smoking cessation
- Drug therapy (bronchodilators, {B2- agonists, anticholinergics}, inhaled corticosteroids)
- Exercise rehabilitation (anaerobic fitness and wellbeing)
- Managing weight (overweight and cachexia)
- Diet
- Oxygen therapy
- Reducing infection risk
- Support network

10

WOUNDS

- A break in the epithelial integrity of the skin
- The disruption could be deeper, extending into the dermis, subcutaneous fat, fascia, muscle or even the bone

11

PROCESS OF WOUND HEALING

- Haemostasis/ inflammatory
- Proliferative
- Remodelling

12

ACUTE WOUND HEALING

- Single injury/ assault on the skin
- Proceeds to heal in an ordinary manner
- Heals quickly
- Cascade of growth factors and cellular stimulants promote healing

13

CHRONIC WOUND HEALING

- Slow to heal
- Prolonged inflammatory phase
- Cellular senescence
- Deficiency of growth factor receptor sites
- No initial bleeding event to trigger fibrin production and release of growth factors
- High level of proteases

- Commonly underlying pathology (e.g. vascular insufficiency)
- Need to correct underlying pathology

14

FACTORS AFFECTING WOUND HEALING: LOCAL FACTORS

- Necrotic burden
- Wound temperature
- Wound exudate
- Wound moisture

15

FACTORS AFFECTING WOUND HEALING: SYSTEMIC FACTORS

- Underlying disease (e.g. diabetes, renal, vascular)
- Oedema
- Sepsis
- Stress
- Medications
- Smoking
- Obesity

16

SKIN TEAR MANAGEMENT

- Attempt to replace tissue if viable (e.g. roll back skin, use moistened cotton bud and gently soak with saline)
- Dress with non-adherent dressing e.g. Mepitel or Mepilex range of products which can be left intact for 5 days, mark direction for removal

17

SKIN TEAR PREVENTION

- Identifying ‘at risk’ patients
- Handling patients with care
- Practicing good wound care techniques
- Implementing local policies
- Sourcing the right equipment
- Using preventative aids e.g. limb protection devices

18

PRESSURE INJURY

- Localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with sheet and/or friction

19

SKIN ASSESSMENT FOR INDICATIONS OF PRESSURE INJURY

- Erythema
- Blanching response
- Localised heat
- Oedema
- Induration
- Skin breakdown

20

PREVENTING/ MANAGING PRESSURE INJURIES

- Addressing risk factors
- Skin protection strategies
- High protein oral nutritional supplements
- Consider arginine supplements
- Constant low pressure redistribution support surfaces
- Regular repositioning
- Patient education