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NRS 210 exam 1 > wound care > Flashcards

wound care Flashcards

(78 cards)

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1
Q

any wound that lasts longer than 3 months is considered

A

chronic

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2
Q

what are the phases of wound healing

A

inflammatory
proliferative
remodeling

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3
Q

what is the inflammatory phase

A

is a sequential reaction to cell injury. It neutralizes and dilutes the inflammatory agent, removes necrotic materials, and establishes an environment suitable for healing and repair.

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4
Q

what is the vascular response of the inflammatory phase

A

transient vasoconstriction right after injury
histamine release/ vasodilation
fibrin/platelets
growth factors

goal is to stop the bleeding, “hemostasis”

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5
Q

what is the cellular response of the inflammatory phase

A

this phase is 6-12 hours later
neutrophils come from bone marrow
monocytes and macrophages come from blood
here we have chemotaxis which is the migration of cell to site of injury

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6
Q

which phase of wound healing creates vasodilation and increase capillary permeability resulting in hemostasis

  1. redness, swelling, heat at injury
  2. vascular response
  3. cellular response
  4. formation of exudate
A

2

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7
Q

what is exudate

A

fluid to site of injury

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8
Q

what is serous

A

clear

ex. blister

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9
Q

what is serosanguinous

A

pink

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10
Q

what is fibrinous

A

sticky
ex. Adhesions, gelatinous ribbons seen in surgical drain tubing
Frequently covers fluid-exuding wounds such as venous ulcers

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11
Q

what is hemorrhagic/sanguinous

A

red
blood
ex.Hematoma, bleeding after surgery or tissue trauma

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12
Q

what is purulent

A

pus, dead WBC

ex. Furuncle (boil), abscess, cellulitis (diffuse inflammation in connective tissue

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13
Q

what is catarrhal

A

mucus

ex. Runny nose associated with upper respiratory tract infection

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14
Q

what are the two phases of the healing process

A

regeneration

repair

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15
Q

what is the local manifestation of inflammation

A

redness, heat, pain, swelling, and loss of function

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16
Q

what is the systemic mainfestation of inflammation

A

increased WBC count with a shift to the left, malaise, nausea and anorexia, increased pulse and respiratory rate, and fever.

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17
Q

what is acute inflammation

A

the healing occurs in 2 to 3 weeks and usually leaves no residual damage. Neutrophils are the predominant cell type at the site of inflammation.

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18
Q

what is subacute inflammation

A

has the features of the acute process but lasts longer. For example, infective endocarditis is a smoldering infection with acute inflammation, but it persists for weeks or months

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19
Q

what is chronic inflammation

A

lasts for weeks, months, or even years. The injurious agent persists or repeatedly injures tissue.

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20
Q

what are the key concept in treating soft tissue injuries and related inflammation.

A

Rest, ice, compression, and elevation (RICE

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21
Q

what is regeneration of the healing process of inflammatory

A

Regeneration is the replacement of lost cells and tissues with cells of the same type.

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22
Q

what is repair of the healing process of inflammatory

A

is healing as a result of lost cells being replaced by connective tissue. Repair is the more common type of healing and usually results in scar formation.

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23
Q

repair has what 3 stages

A

primary
secondary
tertiary

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24
Q

what is primary intention

A

healing takes place when wound margins are neatly approximated, as in a surgical incision or a paper cut.
clean dry clean with normal saline

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25
what is secondary intention
leave it open, edges cannot be approximated cleansing, keeping wound moist filling dead space transparent dressing provides moisture and oxygen transfer ex. from trauma, ulceration, and infection have large amounts of exudate and wide, irregular wound margins with extensive tissue loss.
26
what is tertiary intention
(delayed primary intention) healing occurs with delayed suturing of a wound in which two layers of granulation tissue are sutured together after infection is controlled
27
what are the wound classification
``` superficial partial thickness full thickness skin tear color system: red yellow black ```
28
what is a superficial wound
involves only the epidermis
29
what is a partial thickness wound
extends to the dermis
30
what is a full thickness wound
wounds have the deepest layer of tissue destruction because they involve the subcutaneous tissue and sometimes even extend into the fascia and underlying structures such as the muscle, tendon, or bone
31
what is a skin tear
is a wound caused by shear, friction, and/or blunt force resulting in separation of skin layers. A skin tear can be partial thickness or full thickness.
32
what are complications of wound healing
``` adhesions contractions dishesnce evisceration fistula excess granulation tissue hypertrohpic scars kelid formation hemorrahge infection ```
33
what is an adhesion
Bands of scar tissue that form between or around organs
34
what is contractions
results in deformity
35
what is dehisence
Separation and disruption of previously joined wound edges | usually occurs when primary site bursts open
36
what is evisceration
Occurs when wound edges separate to the extent that intestines protrude through wound
37
what is excess granulation tissue
Excess granulation tissue may protrude above surface of healing wound
38
what is a fistula formation
An abnormal passage between organs or a hollow organ and skin
39
what is hypertrophic scars
Inappropriately large, raised red and hard scars
40
what is keloid formation
Great protrusion of scar tissue that extends beyond wound edges and may form tumor-like masses of scar tissue
41
what is the proliferative stage of wound healing
new capillary networks granulation tissue epitheliaization contracture- wound edges being pulled to each other
42
what are the principles of care
wound hydration blood supply infection minimization
43
when is the wound very fragile
during the proliferative stage
44
what does moisture promote
epithelization
45
what is the remodeling phase of the wound healing
cells responsible for the collagen synthesis and anigogensis undergo apoptosis wound strength increases wound contraction continues scar formation
46
how long could the remodeling phase take
up to 2 years
47
what is leukocytosis
anything above 10,000
48
what is a red wound
healthy very fragile don't scrub non adherent dressing- moist techaderm
49
what is a yellow wound
drainage, exudate needs to be removed to heal clcium aginate- seaweed it absorbs drainage
50
what is a black wound
necrosis going on, dead cells need to be removed for healing gangerous wound, needs to be debrided
51
what does the color system come from
secondary intention
52
if a dehiscence happens between 1-3 day who's fault
technical problem
53
if a dehiscence happens between 3-10 days who's fault
nutrtional status obesity infection the surgeon would be charged because something is wrong inside
54
what are the factors that delay wound healing
``` nutrtional deficience inadequate blood supply corticosterioid drugs infection mechanical friction advanced age obesity DM anemia poor general health smoking necrotic tissue ```
55
what are the types of debridement
surgical mechanical autolytic enzymatic
56
what is surgical debridement
scapel or scissors can change chronic wound into acute wound- promote bleeding stimulates platelets Used when large amounts of nonviable tissue are present • Prepares wound bed for healing, skin grafting, or flaps
57
what is mechanic debridement
either wet to dry or wound irrigation
58
what is wet to dry debridement
open-mesh gauze is moistened with normal saline, lightly packed into wound surface, and outer layer allowed to dry. Wound debris adheres to dressing and then dressing is removed
59
what is wound irrigation
Make certain bacteria are not accidentally driven into wound with high irrigation pressure
60
what is autolytic debridement
Semiocclusive or occlusive dressings used to soften dry eschar by autolysis
61
what is enzymatic/biological debridement
Drugs applied topically to dissolve necrotic tissue and then covered with moist dressing ex: leaches
62
what are the stages of pressure ulcers
``` stage 1 stage ll stage lll stage lV deep tissue injury nonstageable ```
63
what is a stage 1 pressure ulcer
non-blancable redness intact skin tender, firm, soft warm or cool
64
what is stage ll pressure ulcer
partial thickness skin loss exposure of dermis no loud nor bruising serios or serosanguious blister
65
what is stage lll pressure ulcer
full thickness tissue loss, stubcutaenous, fat, but bone tendon and muscle not exposed slough present undermining and tunneling
66
what is stage lV pressure ulcer
``` full thickness tissue elosee bone, tendon, or muscle exposure slough or eschar present underminng and tunneling ostomyelitis and osteitisi ```
67
what is slough
stringy,attached to wound bed, could be necrotic
68
what is a deep tissue injury pressure ulcer
a purple or maroon localized area of discolored intact skin or a blood filled blister due to damage of underlying soft tissue from pressure eo sheet. painful, firm, mushy, boggy
69
what is unstageable pressure ulcer
full thickenss tussue loss in which base of ulcer is covered in slough and/or eschar in the wound be can't see how deep it is because necrotic tissue on outside
70
untreated ulcer may lead to
cellulitis
71
Stage III or IV (full skin–thickness injury) pressure ulcer acquired after admission to a health care setting is considered
serious reportable event
72
what do we assess with wounds
``` location size color surrounding skin drainage temperature pain wound closure ```
73
what are some diagnostic tests
``` CBC sedirmentaion rate C reactive protein albumin total lymphocyte count ```
74
what is the normal albumin levels
anything over 3.5
75
what is a marker of sepsis
procalcitonin
76
what is a negative pressure wound therapy
vaccum/suction
77
what are additional therapies for wound healing
negative pressure wound hyperbaric oxygen positioning
78
what types of dressings are ther
``` gauze nonadherent transpaent films hydrocolloids hydrogels calcium alignate foam antimircobials ```

NRS 210 exam 1 (8 decks)

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