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neuropathic ulcers

WOCN program

QuestionAnswer
what are the 3 primary causative factors for Lower extremity neuropathic disease Systemic disease (diabetes) trauma, infectious or autoimmune diseases, Vit. Deficiency, alcoholism
xerosis is a sign of what
what is the test for sensory neuropathy Semester-Weinstein 10g monofilament 9 sites in random order for 1-2 seconds
common diabetic foot deformity is called Charcot
name 2 classification systems for diabetic foot ulcers Wagner (0=at risk, thru 5=gangrene) and University of Texas (grade 0-3, stage A-D)
identify the characteristics of a diabetic foot ulcer edges well defined, round, periwound callus, dry or min exudate, pale, pink or necrotic base
what is a method to identify areas of increased pressure and unequal weight distribution of patients feet Pressure mapping
debridement of callus is best accomplished by ___ Paring or sharp debridement
describe the rational for off loading redistribute pressure exposure, tpressure and shear prevent healing and contribute to deterioration, maintain soft tissue viability and support bony architecture
what does "Probe to the bone" indicate Osteomyelitis
What is the most common location for LEND Plantar surface of foot
What are common locations for LEND (other than most common) Metatarsal heads, dorsal and distal aspects of toes, inter-digital areas, pressure points, bony prominence
Describe common wound findings Pale, pink or necrotic base, sm to mod exudate
Describe surrounding skin characteristics Callus, may have maceration,
Complications seen with LEND
Describe pain associated with LEND Tingling, electric, pins and needles, dysthesia, parathesia
Noninvasive tests for LEND monofilament, vibratory and positional
Assessment of LOPS Semester-Weinstein monofilament, vibratory test, deep tendon and patellar reflexes.
Measures to prevent trauma in LEND Proper fitting footwear, offloading wounds, pressure redistribution, keep feet protected from chemical,thermal, mechanical injuries no bare feet, no toe pads, socks w/shoes, no hot soaks, heating pad
Goals of topical therapy in LEND treat/monitor for infection, maintain physiologic wound bed,
Topical therapy considerations/options with LEND Topical abx based on culture results all night with systemic abx
Adjunctive therapy options with LEND HBOT, NPWT,
Types of neuropathy Sensory, motor, autonomic
management of charcot non wgt bearing during acute phase, lifelong protection and monitoring (for ulceration-pt at higher risk)
neuropathic pain management dysthesia=capsaicin, gabapentin,pregabalin, ssri's paresthesia=tricyclics, opoids both=analgesics=topical, systemic
Created by: Beth Perry