Quiz Questions
Where do 80% of skin tears occur?
arms and hands; In the elderly they are often sustained on the extremities such as the upper and lower limb and on the dorsal aspect of the hands.
An injury that separates various layers of soft tissue, resulting in complete detachment or a flap of skin, is called a(n):
avulsion.
A burn that is characterized by redness and pain is classified as a:
first-degree burn.
Assessment of wounds include:
health status and related issues, risk factors, periwound skin attributes, wound attributes, wound severity
Following debridement, which type of dressing would be most appropriate for a non draining necrotic wound?
hydrocolloid
In addition to external bleeding, the MOST significant risk that an open soft-tissue injury exposes a patient to is:
infection.
A laceration:
is a jagged cut caused by a sharp object or blunt force trauma.
Foam uses, indications, contraindications?
A high density, non-adhesive polyurethane foam, Minimal to heavy exudate , friable peri wound, Contraindications are Infected wounds
What is a normal level of creatine?
0.8 to 1.5 mg / dl
What clean solution should be used for cleansing an arterial ulcer that has the potential to heal?
0.9% saline
According to the rule of palm method for estimating the extent of a patient's burns, the palm of the patient's hand is equal to _____ of his or her total BSA.
1%
In biological debridement, approximately how many larvae are required to debride a wound surface of 1 cm 2?
10 larvae
What is the threshold for severe weight loss?
10% in 6 months
What percentage of the body using the rule of Nines would the torso be?
18%
What is the STAR Classification System, for skin tears?
1a Edges can be realigned. 1b Edges can be realigned to the normal, flap color pale, dusky or darkened. 2a Edges cannot be realigned, flap color is normal. 2b Edges cannot be realigned, flap color is pale, dusky or darkened. 3 Skin flap is completely absent.
What % of bite wounds are represented by human? 2 to 3%; greater than 5%; less than 1%; 5%
2 to 3%
A POC for an arterial ulcer should be reassessed if the wound has not significantly progressed within?
2 to 6 weeks
What compression level is appropriate for venous insufficiency with mild arterial insufficiency?
20 to 30 mmHg
When was the concept of wound bed preparation first formally established?
2003
After mechanical disruption how quickly can a mature bio-film reform?
24 hours
How many layers does the dermis generally have?
2; papillary dermis, reticular dermis
What is the minimum recommended fluid intake per day?
30 mg per kg
The optimum temperature for wound healing is?
37 to 38 degrees celcius. A reduced temperature may stop the activity of cells involved with the healing, therefore modern dressings are designed to maintain this optimum temperature.
What is the range of the skins ph?
4 to 6.5
What is the normal pressure within the arteries?
90 to 100 mmHg
A wound is considered to be infected if it presents with what number of organisms per gram of tissue?
> 100,000 per gram of tissue
Malnutrition can adversely affect collagen production by?
A deficiency of protein can impair capillary formation, fibroblast proliferation, proteoglycan synthesis, collagen synthesis, and wound remodeling. Collagen synthesis requires hydroxylation of lysine and proline, and co-factors such as ferrous iron and vitamin C.
What does the appearance of a Stevens Johnson eruption look like?
A severe drug eruption causing: purpuric macules and targetoid lesions; full-thickness epidermal necrosis, although with lesser detachment of the cutaneous surface; and mucous membrane involvement.
Area of redness over the perianal area extends to the upper inner thighs, Tissue loss over the right buttock is limited to the epidermis, Wound edge is irregular. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Incontinence-Associated Dermatitis
What is the Normal Wound-healing Process?
Inflammation, Proliferation, Remodeling
The pressure injury on the left ear of this male patient is from a medical device. Cartilage can be seen in the wound base. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Stage 4
A malignancy of the endothelial cells that line the small blood vessels is know as:
Kaposi's sarcoma; Is a cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, and throat, in lymph nodes, or in other organs. These patches, are usually red or purple.
Which of the following procedures is appropriate at first response for a spider bite: Early surgical excision, Aggressive debridement, Routine antibiotic therapy, Superficial heat
Aggressive debridement
How does alcohol abuse impair wound healing?
Alcohol abusers tend to have poor eating habits with higher risk of protein energy malnutrition. The results include decreased inflammatory and immune responses to tissue injury, decreased fibroblast migration and angiogenesis, and decreased
Which of the following is a major contributing factor in diabetic ulcerations? Mechanical Stress, Neuropathy, Inadequate education, Vascular disease
Neuropathy
What 4 types of dressings could you use for absorption ?
Alignate, foam, hydrocolloid, Hydrofiber
What is the only the only curative treatment for arterial ulcers?
Amputation
What diagnostic test is considered the gold standard for diagnosing arterial vascular disease?
Angiography is the gold standard for arterial vascular disease.
The popliteal artery branches into the
Anterior tibial artery
A wound caused by impaired arterial blood flow to the lower leg and foot. Impairment in blood flow results in tissue ischemia, necrosis and loss. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Arterial Ulcer
What is Biobrane?
BIOBRANE is a temporary bio synthetic skin dressing used on superficial and partial-thickness wounds and donor sites.
Correct order of epidermal layers - beginning at the deepest layer.
Basale, spinosum, granulosum, lucidm, corneum
Neuropathic ulcer characteristics
Base vary from reddish to brown to black. Margins are well-define, punched-out looking. Painless wound unless there is also infection or an arterial component to the ulcer. Typically more superficial wounds and located on the mid-foot rather than the forefoot.
What does the Rule of Nines measure?
Based on the presumption that the body can be divided into nine anatomic regions that represent 9% of the entire body surface. The rule of nines calculation is different because of the relatively larger surface area of the head and the smaller area of the lower extremities.
Antimicrobial dressings types,?
Cadexomer iodine, Silver, Honey
What is the Payne Martin Classification?
Category 1: Skin tear without loss of tissue. 1a: Linear type; 1b: Flap type; Category 2: Skin tears with partial tissue loss; 2a: Scant tissue loss; 2b: Moderate to large loss of tissue; Category 3: Skin tears with complete tissue loss.
What is Incontinence-Associated Dermatitis?
Caused by prolonged exposure to urine, stool, or both that irritates the skin leading to erosion.
What is Cetyl stearyl alcohol used for in bandages?
Cetyl Stearyl Alcohol (Cetearyl) is a blend of cetyl and stearyl fatty alcohols, and is used as to add viscosity and and as a stabiliser in creams and lotions. Cetyl Stearyl Alcohol is also used as a co-emulsifier and imparts emollient feel and lubricity to the skin.
What type of wound is most suited for enzymatic debridement?
Chronic wounds
What does too much exudate in a wound lead to?
Chronic wounds, exudate appears to impede healing, damaging the wound bed, degrading the extracellular matrix, and causing peri wound skin problems. Maceration.
Which type of dressing is able to stimulate and recruit specific cells, macrophages and fibroblasts to influence wound healing?
Collegen
What is replication of microorganisms and their formation into colonies called?
Colonization
What should be routinely performed after manually lymph drainage in complete decongestant therapy for lymphedema? Remedial exercise, Diuretic therapy, Compression bandage, Surgery
Compression bandage, Complete decongestive therapy (CDT) has 4 parts: A light skin stretching technique, Layered bandaging, Exercises With compression, Keeping the skin clean and moisturized
Are malignant wounds contraindicated in sharps debridement and why?
Correct, due to bleeding abnormalities, ischemic tissue
Is diastolic hypertension more damaging to blood vessels than systolic hypertension?
Correct, due to the repetitive waves of higher pressures generated during cardiac contraction. Smoking is the most significant modifiable risk.
Area of deeply discolored skin is noted on the right heel of this dark skinned patient. Skin surface is intact. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Deep Tissue Pressure Injury
This patient has a localized area of discolored skin on the lateral right heel. A crescent shape portion of this skin is deep maroon in color. The skin surface is intact. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Deep Tissue Pressure Injury
What layer are the sebaceous glands in?
Dermis
What does too little exudate lead to?
Desiccation, Insufficient exudate may be associated with delayed healing, delayed autolysis, dressing adherence and pain on dressing removal.
What does "DIME" , stand for?
Devitalized Tissue, Infection, Inflammation, Moisture Balance, Edge Preparation
This 72 year old male has a full thickness wound over the metatarsal head of the fifth toe, right foot. Callus tissue surrounds the wound. Skin around the wound is reddened. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Diabetic Foot Ulcer
This 78 year old male has a large plantar wound. Wound margins are regular. Band of callus surrounds the wound. Foot and toe deformities are due to motor neuropathy. Impairment in blood flow results in tissue ischemia, necrosis and loss. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Diabetic Foot Ulcer
When should elastic compression be worn?
During the day
What adjunct therapy is the only therapy recommended to assist in pressure ulcer healing?
Electrical stimulation
Which of the following: exogenous enzymes, neutrophils, macrophages or growth factors are not involved in autolytic debridement?
Exogenous enzymes are not administered. Autolytic debridement relies on the bodies own enzyme's to promote digestion of necrotic tissue.
Water, Fatty Acids, Fats, or Glucose, which of these nutrients help solubilize vitamins?
Fats
What is the Fibrin Cuff Theory?
Fibrin gets excessively deposited around capillary beds leading to elevated intravascular pressure. This permeability barrier inhibits diffusion of oxygen and other nutrients, leading to tissue hypoxia causing impaired wound healing.
Which of the the following: increasing edema around the wound edges, enhanced sloughing of burned tissue, hardening of focal subeschar, black or brown focal areas of discoloration, is NOT a local sign of burn wound infection?
Focal subeschar is a slough produced by a thermal burn or a corrosive application, or by gangrene.
What is the WAGNER-MEGGITT CLASSIFICATION OF DIABETIC FOOT?
Grade 0 Foot symptoms like pain,only; Grade 1 Superficial ulcers; Grade 2 Deep ulcers; Grade 3 Ulcer with bone involvement; Grade 4 Forefoot gangrene; Grade 5 Full foot gangrene
The first organism to invade a wound with decreased host resistance are typically?
Gram-positive bacteria
What is the clearest indicator of whether a wound is free of a bio-film?
Healing progression
Which of the following is not typical of the wound bed of a lower extremity artery ulcer? Pale tissue, Heavy Drainage, Either deep or superficial, Even Boarders
Heavy drainage. No drainage is present in an arterial ulcer unless the ulcer is infected.
Which of the following is not a typical sign of malnutrition? Heightened Skin Color, Loss of Subcutaneous Fat, listlessness, Swollen Gums
Heightened Skin Color, can be a sign of niacin deficiency.
What does protein do to help with wound healing?
Helps improve tissue integrity and synthesis of collagen. deficiency can result in increased chance of evisceration
What is the best available biochemical bio-marker for predicting poor wound healing in both acute and chronic wounds?
High protease activity is currently the best available biochemical marker for predicting poor wound healing of both acute and chronic wounds.
What are 4 types of dressings you could use for hydration or moisture maintainence?
Hydrogel, impregnated gauze, hydro colloid, transparent film
What is kwashiorkor disease?
Kwashiorkor is a disease caused by the lack of protein in a child's diet.
Which wound shapes, linear, circular, square, rectangular heal the fastest?
Linear wounds are generally the fastest to heal, followed by square or rectangular wounds, with circular wounds requiring the greatest time.
What is Marasmus disease?
Marasmus is a form of severe malnutrition characterized by energy deficiency. A child with marasmus looks emaciated. Body weight is reduced to less than 60%
What does an ABI in the range of 0.75 to 0.90 indicate?
Moderate arterial disease. Abnormal values for the resting ankle-brachial index are 0.9 or lower and 1.40 or higher. If the ABI is 0.91 to 1.00, it is considered borderline abnormal.
Alginate uses?
Moderate to heavy exudate, contaminated or infected slough.A non-woven pad of seaweed fibers. It can slows bleeding and forms a gel when it's filled with fluid. Can absorb up to 100 times it weight and is used as a packing agent
For best wound healing outcome what type of wound environment do you need?
Moist environment
A pressure injury was noted on the nasal mucous membrane of the right nares after removing a nasogastric (NG) tube. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Mucosal Membrane Pressure Injury
This 50 year old female has multiple injuries to the tongue from a bite block. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Mucosal Membrane Pressure Injury
What does vitamin B do with wound repair?
Necessary for carbohydrate metabolism
what does Zinc have to to do with wound repair
Necessary for collagen synthesis and tissue repair
Which of the following is not usually the cause of decreased circulating levels of prealbumin? Inflammation, Liver Disease, Metabolic Stress, Over-hydration
Over-hydration . Prealbumin, or thyroxine-binding prealbumin, is a transport protein synthesized by the liver. Liver disease, metabolic stress, inflammation, and cytokine-induced inflammatory statues decrease circulating prealbumin levels.
A cutaneous eruption of acneiform is not commonly associated with which of the following medications? Penicillin, Perdnisone, Anticonvulsants, oral contracentives
Penicillin; Commonly associated with prednisone, anticonvulsants and oral contraceptives.
What is the name of the veins that connect the deep and superficial vein systems throughout the lower leg?
Perforating veins
How do you grade pulses?
Peripheral pulses are graded on a scale of 0-4 by the following system; 0 = absent, without a pulse; +1 = diminished, barely palpable; +2 = average, slightly weak, but palpable; +3 = full and brisk, easily palpable; +4 = bounding pulse, sometimes visible.
What are the 3 phases of wound healing?
Phase 1 - INFLAMMATORY PHASE 0-3 Days the body's normal response to injury. Phase 2 - PROLIFERATION PHASE 3-24 Days the time when the wound is healing. Phase 3 - MATURATION PHASE 24-365 Days the final phase of healing,
What is the Phase 1 - INFLAMMATORY PHASE of wound healing?
Phase 1 - INFLAMMATORY PHASE, 0-3 Days, This phase activates vasodilatation leading to increased blood flow causing HEAT, REDNESS, PAIN, SWELLING, LOSS OF FUNCTION. Wound ooze may be present and this is also a normal body response.
What is the Phase 2 - PROLIFERATION PHASE of wound healing?
Phase 2 - PROLIFERATION PHASE, 3-24 Days the time when the wound is healing. The body makes new blood vessels, which cover the surface of the wound. This phase includes reconstruction and epithelial. The wound will become smaller as it heals.
What is the Phase 3 - MATURATION PHASE of wound healing?
Phase 3 - MATURATION PHASE, 24-365 Days the final phase of healing, when scar tissue is formed. The wound at this stage is still at risk and should be protected where possible.
Skeletal deformations, idiopathic fractures and bone pain are indicative of a deficiency in which nutrient? Zinc, Iron, Phosphorous, Vitamin K
Phosphorous is required for bone formation and bone health and is also needed for normal metabolism.
Which may suggest the presence of infection as opposed to appropriate inflammation?
Poorly defined erythemal border.
A wound over the left lower leg was observed after the patient's cast was removed. The wound is oval in shape. Slough is noted in the wound bed. Little wound drainage. New epithelial tissue is seen along the wound edge. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Pressure Injury
How long does it take fora visible pressure ulcer to develop after the causative pressure has been applied?
Pressure ulcers may not develop until 2 to 7 days after tthe pressure was applied.
How does depletion of protein impair wound healing?
Protein is one of the most important nutrient factors affecting wound healing. A deficiency of protein can impair capillary formation, fibroblast proliferation, proteoglycan synthesis, collagen synthesis, and wound remodeling.
What are the major nutritional deficiencies that can retard healing of wounds and compromise the immune system?
Protein., carbohydrates and fat, vitamin a, vitamin B, vitamin C, zinc
Which organism most commonly associated with the skin infection Mycetoma in the US?
Pseudallescheria boydii; Mycetoma, named because of the tumor-like mass it forms, is a chronic granulomatous disease characterized by actinomycetes or fungi.
Which of the following conditions results from accelerated cell kinetics of keratinocytes? Dermatitis, urticaria, Eczema, Psoriasis
Psoriasis
What are the 7 recognized reasons for debridement?
Reduce inflammatory phase, Decrease bacteria, Increase effectiveness of antimicrobial, Improve activity of leukocytes. Decrease the energy required by the body for wound healing. Eliminate the physical barrier to wound healing. Decrease wound odor.
Of the following effects: increased capillary permeability, reduced metabolic rate, hypotension, or pulmonary edema;which does not usually occur as a result of burn injury?
Reduced metabolic rate
What is the most common site of a pressure ulcer in acute care facilities?
Sacrum
Which type of secondary lesion can be described as dry, greasy laminated masses of keratin?
Scales
What types of exudates are commonly seen with wounds?
Serous drainage is clear, thin, watery plasma. Sanguinous exudate bleeding, Serosanguineous exudate, is thin, watery, and pale red to pink, Seropurulent exudate is thin, watery, cloudy, and yellow to tan, Purulent exudate is thick and opaque. It can be tan, yellow, green, or brown
Which of the following statements regarding severe burns is correct?
Severe burns are typically a combination of all degrees of burn.
Types of debridement?
Sharp; At the bedside, using scalpel, Surgical, Autolytic, biological, Enzymatic, Mechanical
A wound is observed over the right forearm of a 90 year old male. The epidermis is separated from the dermis leaving a loose flap of skin. The skin flap can be re-positioned to cover the wound bed. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Skin Tear
Is skin grafting effective in managing pressure ulcers?
Skin grafting is generally ineffective because it neither fills the void of the ulcer nor protects the area from future pressure.
Types of wound edges and the common wounds associated with them.
Sloping: Venous ulcer; Punched out: Arterial or vasculitic ulcer; Rolled-Basal cell carcinoma; Everted: Squamous cell carcinoma; Undermining: Tuberculosis, syphilis; Purpl-Vasculitic such as pyoderma gangrenosum
A reddened area is seen on the right lateral foot from pressure. The skin surface is intact. The area of redness does not pale when compressed. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Stage 1
This 80 year old male has a localized area of reddened skin over his right sacrum. No blistering of the skin or loss of epidermis is noted. The reddened area does not blanch with lightly applied pressure. No area of purple or maroon skin discoloration is noted. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Stage 1
Mr. H. is a 73 year old male who is chairbound. A pressure injury is observed on the right ischial tuberosity. The wound is shallow with a red wound bed. No slough is observed. Tissue loss extends into the dermis. Please make a selection Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury, Mucosal Membrane Pressure Injury
Stage 2
sacral pressure injury extends into dermis. Wound bed is pink red. Periwound skin is reddened. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Stage 2
Area of tissue loss extends into subcutaneous tissue. Wound is 5 cm in length, 3 cm in width and 0.6 cm in depth. Wound bed contains granulation tissue. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Stage 3
How would a pressure ulcer that presents as a deep crater with possible undermining be staged?
Stage 3
The circled pressure injury is approximately 11 cm in length and 3 cm in width. Subcutaneous fat is visible in the wound bed. No tendon, bone or muscle is visualized. Slough is present at the left proximal wound edge. The slough does not obscure the depth of tissue loss. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Stage 3
Pressure injury over the left buttock has exposed muscle tissue. Tunneling or undermining is present. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Stage 4
Which of the following is the most common cause of abscesses, furuncles, and carbuncles? Streptococcus pyrogenes infection, Epidermophyton infection, Varicilla zoster virus infection, Staphylococcus aureus infection
Staphylococcus aureus infection
What does vitamin C have to do with wound repair?
Supports collagen formation, increases capillary formation
An immunocompromised patient with a known egg and soybean allergy has an urgent need for debridement of an infected wound on an area of friable skin. Which is the preferred method of debridement? Enzymatic, Maggot Larvae, Autolytic, Surgical
Surgical
A patient with lymphedemia should not: Wash with soap and water, Use moisturizing lotion, Bathe daily, Take long hot showers
Take long hot showers
What is the Lund-Browder Chart measure?
The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected.
Which of the following processes occurs during the inflammation phase of the healing process?
The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.
What does the mnemonic TIME stand for?
The objectives underpinning TIME are: T Tissue Non-Viable or Deficient; I Infection or Inflammation; M Moisture Imbalance; E Epidermal Margin non advancing or undermined
Between excessive moisture, increased skin temperature, smoking or low diastolic blood pressure; which is the most strongly linked with the formation of pressure ulcers?
The presence of excessive moisture is one of the 4 key factors that increase the risk of pressure ulcers. Moisture, shear, impaired mobility, and malnutrition.
Examples of group 3 support surface devices:
air-fluidized beds. An air-fluidized bed uses the circulation of warm filtered air through small, silicone coated ceramic beads creating the characteristics of fluid.
Can thermal regulation be impaired as a result of protein deficiency?
Thermoregulation is not affected by protein levels, although it can be affected by low levels of fat. Lack of protein impairs all 3 phases of wound healing:collagen synthesis, angiogensis, granulation tissue formation, remodeling, immune system, phagocytosis and antibiotic response time.
What is the disadvantage o 3 or 4 layer wraps as compression therapy for venous ulcers?
They interfere with cleaning and bathing.
What is Lichehification?
This is a skin lesion that occurs on your body in an area of chronic irritation. shiny and ooze or it could be scabby and dry, flaky or leathery, Itching, Burning sensation, Red rashes on your skin
What does the Palmer Method measure?
This method used the patient's hand-size to estimate the percent TBSA of small burns. The palmer surface of the hand (palm and fingers) equals roughly 1% TBSA in all age groups.
What is the function of the dermis?
To provide a physical and chemical barrier
Hydro-colloid types, uses, indications?
Types: Carbomethocellose, gellatin, or pectin, Uses: Autolysis and maintains a moist wound bed, Indications: Dry to heavy exudate, Slough, Granulation
Honey types, uses, contraindications ?
Types: Honey gels or impregnated honey dressings Uses: Draws fluid from the wound by osmotic pressure, Antimicrobial, odor reduction, Aides in debridement, burns, Necrotic wounds. Contraindications: Not to be used with enzymatic debridement
Hydro fiber types, indications?
Types: Non-woven fibers of carbooxymethylclullulose that forms gel when filled with fluid. 33%ore absorbent than alginate, Indications: Mod to heavy exudate, Contaminated or infected slough or granulation.
Silver impregnated dressing types, use, indications,
Types: available in foam, alginate, hydro fiber, hydro-colloid a, hydro-gels, creams, powders, transparent films and non-stick pads. Uses: Antimicrobial, Reduces inflammation, burns Contraindications: Enzymatic debridement, not compatible with normal saline solution.
When calculating the ankle-brachial index (ABI), if the ankle systolic pressure is 90 and the brachial systolic pressure is 120, what is the ABI? 1.33, 13.3, 7.5, 0.75
ankle systolic pressure is 90 and the brachial systolic pressure is 120: 90 divided by 120 = 0.75. Normal value is 1 to 1.1 with lower values indicating decreasing perfusion. 0.75 indicates severe disease
Which of the following treatments is not recommended for sickle cell anemia due to lack of clinical evidence: Ultraviolet light therapy; Hyperbaric therapy; Nitric oxide therapy; Negative wound pressure therapy
Ultraviolet light therapy; Standard treatments: wet-to-dry dressings, protection from trauma, loose-fitting clothing around the ankles to avoid friction, and use of pressure dressings like an Una's boot.
The wound bed of this sacral pressure injury is covered with slough/eschar. The base of the wound cannot be visualized. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Unstageable
This pressure injury is located over the coccyx. The wound bed is covered by slough/eschar and cannot be visualized. Please make a selection: Stage 1, Stage 2, Stage 3, Stage 4, Unstageable, Deep Tissue Pressure Injury. Mucosal Membrane Pressure Injury
Unstageable
Collagenase Santyl use, indications, contraindications?
Use: A debriding ointment with enzymes derived from bacteria. Indicated: Necrotic tissue. Contraindicated: silver and patients that are hypersensitive to it
Hydrogel uses, indications?
Uses: A water based gel used to hydrate the wound. It promotes autolysis and keeps structures moist, Indications: minimal exudate, eschar, slough, granulation, deep exposed structures.
Transparent film uses, indications?
Uses: Adhesive film with various shapes , sizes and occlusiveness. Autolysis and reduces surface tension. Indicated: Dry to minimal exudate, partial thickness wound or as secondary dressing.
Cadexomer iodine use, indications, contraindicated ?
Uses: Adsorption and odor reduction. Indicated: Mod to heavy exudate, odor. Contraindicated: Hyperthyroidism and iodine sensitive patients
Impregnated gauze uses, indications?
Uses: Gauze that has been impregnated with petrolatum or hydro-gel. Maintains moisture, no adherent, promotes autolysis. Indicated: Dry to minimal exudate , eschar, slough , granulation, deep exposed structures
Wound is located at and slightly above the right medial malleolus. Thickened, brown discolored skin is noted around the lower calf, ankle, and proximal foot. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Venous Ulcer
Wound is located medially on the left lower leg between the calf and ankle. Skin around the wound is reddened and edematous. Periwound skin is reddened and scaly. Please make a selection: Arterial Ulcer, Venous Ulcer, Diabetic Foot Ulcer, Incontinence-Associated Dermatitis, Skin Tear, Pressure Injury
Venous Ulcer
Site of wound and type of ulcers:
Venous ulcer:Gaiter area of the leg; Pressure ulcer: Sacrum, greater trochanter, heel, Dorsum of the foot Arterial or vasculitic ulcer; Shin: Necrobiosis lipoidica; Lateral malleolus: Venous, arterial, or pressure ulcer or hydroxyurea induced ulceration; Plantar and lateral aspect of foot and toes: Diabetic ulcer; Sun exposed areas:Basal cell carcinoma; squamous cell carcinoma.
What is the White Cell Trapping Theory?
White blood cells adhere to the endothelial, which was considered to be the explanation for the loss of white blood cells. Lead to a reduction in capillary diameter or to occlusion of micro-vessels, which might further diminish capillary flow.
How quickly will a wound dehydrate if it is let to air dry?
Within 2 to 3 hours. The best environment for the natural wound healing process is a warm, moist and non-toxic one. Drying out the wound will cause the healing process to stop.
Vitamin D, Iron, Calcium or Zinc which is an essential mineral for protein and collagen synthesis?
Zinc is an essential mineral for protein and collagen synthesis, taste acuity, and cell replication,
Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?
abrasion
What is the name of the outer protective layer of the artery?
adventitia
In contrast to animal bites, the bite of a human:
carries with it a wide variety of virulent bacteria and viruses.
What occurs in Remodeling during the Normal Wound-healing Process?
collagen remodeling, vascular maturation and regression
The germinal layer of the epidermis contains pigment granules that are responsible for skin:
color
A closed soft-tissue injury characterized by swelling and ecchymosis is called a:
contusion.
What type of treatments should be avoided in patients Pyoderma gangrenosum?
debridement and surgery; Surgery should be avoided, if possible, because of the pathergic phenomenon that may occur with surgical manipulation or grafting, resulting in wound enlargement.
Burns are classified according to:
depth and extent.
A partial-thickness burn involves the outer layer of skin and a portion of the:
dermal layer.
What are characteristics of a typical diabetic ulcer?
dry and cracked peri wound, normal temperature, lesion that is round and punched out in appearance, normal pulses, callus rim with little or no drainage
Which of the following areas of the body has the thinnest skin?
ears
How often does the epidermis regenerate itself?
every 4 to 6 weeks
Which of the following is of least importance when initially assessing the severity of a burn?
known drug allergies
When a tourniquet is applied during the Trendelenburg test, vein incompetence is suggested by a time to venous distension of:
less than 20 seconds
What degree of of drainage and exudate is normally evident in venous ulcer?
moderate to heavy
An abdominal evisceration:
occurs when organs protrude through an open wound.
The hallmark sign of compartment syndrome is:
pain out of proportion to the injury.
Burns to pediatric patients are generally considered more serious than burns to adults because:
pediatric patients have more surface area relative to total body mass
Examples of group 2 support surface devices:
powered pressure reducing mattresses, semi-electric hospital beds with powered pressure reducing mattresses, powered pressure reducing mattress overlays, advanced non-powered pressure reducing mattresses and advanced non-powered pressure reducing mattress overlays.
Examples of group 1 support surface devices:
pressure pads for mattresses, non-powered pressure reducing mattresses and powered pressure reducing mattress overlay systems.
What occurs in Proliferation during the Normal Wound-healing Process?
re-epithelialization, angiogenesis, collagen synthesis, ECM formation
Functions of the skin include all of the following, EXCEPT:
the production of key antibodies.
When treating a partial-thickness burn, you should avoid"
the use of creams, lotions, or antiseptics.
What occurs in Homeostasis during the Normal Wound-healing Process?
vascular constriction, platelet aggregation, degradation, and fibrin formation, Inflammation, neutrophil infiltration, monocyte infiltration and differentiation to macrophages, lymphocyte infiltration
The sebaceous glands produce sebum, a material that:
waterproofs the skin and keeps it supple.
Which of the following is a contraindication to negative pressure wound therapy?. Chronic Stage IV pressure ulcer, Wound malignancy, Unresponsive arterial ulcer, Dehiscent surgical wound
wound malignancy, untreated osteomyelitis, exposed blood vessels or organs, and nonenteric, unexplored fistulas.
