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NSG 521

Bottom Up Injuries/Pressure Ulcers

The etiology of a skin tear is ______________ and is caused by _________ and _________. MARSI, friction and shear
Friction is a factor in what kind of injuries? Top down
Shear is a factor in what kind of injuries? Bottom up
T or F: Bottom up injuries are usually preventable True
T or F: Epidermis and dermis are more resilient to pressure than muscle. True
Most common pressure ulcer site? Sacrum
Second most common pressure ulcer site? heel
Who's at higher risk for PUs? Geriatrics Pediatrics with devices SCI (Spinal cord injurieis) Critical care
African Americans are at higher risk for PUs than caucasion? True
Major risk factors for PU? (5) advanced age fractured hip spinal cord injury significant mobility impairment exposure to excessive moisture
___________ up damage is caused by intense or sustained compression of the tissue and begins at the _______________. Bottom up, muscle-bone interface
Braden scores: 15-18 Mild risk
Braden: mild risk 15-18
Braden Scores: 13-14 Moderate risk
Braden: Moderate Risk: 13-14
Braden Scores: 10-12 High risk
Braden: High risk 10-12
Braden Scores: 9 or below Very high risk
Braden: Very high risk <9
Friction is what kind of injury? Top Down
Shear is what kind of injury? Bottom Up
What is the biggest risk factor for PU development? Immobility!
Patients with fecal incontinence are how many times more likely to develop a PU? 22x
Patients with fecal incontinence: their skin has an increase in _________ and increases ___________. pH, and trans epidermal water loss (TEWL)
5 AREAS OF SKIN ASSESSMENT: temperature of skin color of skin skin texture and turgor integrity of skin moisture status
Skin assessment is NOT a wound assessment. TRUE
PU staging: Stage I: Nonblanchable erythema
PU staging: Stage II: Partial Thickness skin loss
PU staging: Stage III: Full Thickness Skin loss
PU staging: Stage IV: Full thickness tissue loss
T or F: Staging pressure ulcers: You can back stage and healing occurs FALSE
PU: 3 factors that impede healing: Comorbid conditions tissue perfusion/meds limited or unavailable resources for care
Partial thickness wounds show evidence of healing in how many weeks? 1-2
Full thickness wounds show evidence of healing in how many weeks? 2-4
3 classes of support surfaces: Preventative VS Therapeutic Type (wheelchair, bed) Medium or components
PU: visual inspection is fraught with error? TRUE
What type of support surface is a powered mattress or overlay that changes is load distribution properties with or without an applied load? ACTIVE
What type of support surface moves or changes its load distribution properties only response to an applied load? REACTIVE
Nutritional recommendations: How many kcal per kg body weight per day? 30-35
Nutritional recommendations: How much protein per day? 1.25-1.5 g/kg/day
Nutritional recommendations: How much fluid per kg? 30mL per kg EXCEPT IN THOSE WITH RENAL OR CARDIAC DISTRESS
T or F? Skin damage from moisture is not a PU? TRUE
Skin damage from moisture increases PU risk? TRUE
What type of support surface for: LARGE FULL THICKNESS WOUNDS ex: stage III and IV or ulcers that involve multiple turning surfaces: low air loss or air fluidized surfaced may be indicated
PU are unavoidable when: hemodynamic instability poor nutrition and hydration advance directives prohibiting nutritional support
T or F? Pressure redistribution surfaces replace repositioning? FALSE, pressure redistribution surfaces DO NOT replace repositioning!
Created by: smcallahan