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Integumentary set 1

examination of a patient with a wound

QuestionAnswer
what are the three issues that are impacted by a patient examination? diagnosis, prognosis, and intervention (treatments, education, recommendations/referrals)
What is important to ask during subjective history taking? (8) how long have you had the wound? Did you know you had a wound? what caused the wound? how have you cared for the wound? is the wound dry? Wet? is there pain around the wound? Do you have a hx of wounds? What is your nutritional status?
What is important to know in the medical history? previous wounds, comorbidities, sensation deficits, strength deficits, surgeries, have you had cancer/treatment, O2 saturation, age, smoking, nutrition
What are the important lab values relevant to wounds? hemoglobin, protein levels, fasting glucose, red blood cells, thrombocytes, white blood cells
What does the amount of hemoglobin in the blood indicate? the ability to carry oxygen and important for healing (low means poor healing)
How does fasting glucose affect a wound? high blood glucose may make it more likely for the individual to get an infection
What two proteins are important lab valuse? albumin and c-reactive proteins
Why is the level of albumin important in wounds? tests the nutritional status of the individual
why is it important to know the lab value of c-reactive proteins in the blood? indicates inflammation/infection if it is high
what are thrombocytes important for? clotting
What are the categories assessed with the Braden Scale? sensory perception, moisture, activity, mobility, nutrition, friction and shear
What does a score of <16 mean with the Braden Scale? 100% risk of an ulcer, 18 is also high risk of ulcer
What does a high score on the Braden Scale indicate? less risk of developing an ulcer
What are the three factors that impede healing? infection, medication and comorbidities
Which disease (arterial or venous) tends to present with a high BP? venous
What two pulses are used to indicate blood is getting to the extremities? dorsalis pedis, tibialis posterior
Explain the Rubor of Dependency test and what it is testing for. tests for arterial disease (arterial patency); observe the foot for color, raise the foot 45-60 degrees for about 1 min; the foot should turn pale Lower down to dependent position and look for the return of blood and color (15-30 s)
Which test do you use to test arterial health? venous filling time
What is the ABI? ankle brachial index compares the SBP of the ankle to the SBP of the brachium (should equal 1.0, low is bad)
What is claudication? a symptom of arterial disease; causes pain when walking and goes away with rest
What are the four types of wounds? arterial, venous, pressure, neuropathic
Which tool is used to score the attributes and progress of wounds over time? Bates-Jenson Wound Assessment Tool
What are the three wound measurement techniques? clock method, longest width by longest length, area calculation
What is tunneling? when the wound starts to go deeper in one area compared tot he depth of the wound bed
What is epithelialization? epidermal cells advance from the wound edge to form over the wound bed
What wound edge is thick, hyperkeratotic tissue around the wound edge? callus
What does it mean to be hyperkeratotic? excessive callus cells over the edge of the wound; raised edges with no epithelial cells
What are the 4 types of exudate? serous, sanguinous, purulent, pseudomonas infection
What are the 4 stages of pressure ulcers? stage 1: skin is red/darker in color, no blanching, may feel warm stage 2: ulcer extends into the dermis but superficial stage 3: through the dermis stage 4: deep enough to see muscle, bone, tendons, etc.
what are the two pressure ulcer classification systems? University of texas and Wagner Ulcer classification (more widely used)
Created by: mcush1
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