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NPTE Wound Care

Wounds & Associated Pathology

QuestionAnswer
Three means of transmission of pathogens Airborne, Droplet, & Contact
Examples of Airborne Pathogens and Precautions to take - Tuberculosis, Measles - In facilities, workers need to wear special masks & isolate pt in negative pressure environment
Precautions to take with Pathogens transmitted through Droplets A regular mask with no special ventilation
Examples of Contact Pathogens and Precautions to take - HIV, Hep B - Gloves & hand washing are usually sufficient.
Contraindications for use of Occlusive Dressings Contraindicated over infected wounds, deep ischemic ulcers, full thickness burns, in some cases very heavy exudate or over Stage IV ulcers
What are the recommended parameters and time frame to administer Ultrasound in acute wound? Use once or twice a day in early treatment, with a lower intensity, pulsed US
What are the recommended Ultrasound parameters & time frame in a chronic wound? Use three times per week with medium intensity, continuous US
Signs of Arterial Insufficiency Ulcer - deep & painful with skin pale & cold - common on lateral malleolus & toes
Treatment of Arterial Insufficiency Ulcers Bed rest with head of bed elevated moderately, smoking cessation, wound care, LE PROM, protective environment
Signs of Venous Insufficiency Ulcer - painless & superficial with good peripheral pulses - occur secondary to venous thrombosis, varicose veins & other venous problems - edema present, skin often pigmented secondary to stasis of blood - usually located on medial side of ankle
Treatment of Venous Insufficiency Ulcers elevation & compression to control edema, active exercise may be helpful along with support garments & elevation of the body part (Whirlpool not good because of dependent position)
Define Cellulitis an inflammation of the connective tissue frequently accompanied by infection
Define Dermatitis Superficial inflammation of skin, characterized by vesicles (when acute), redness, edema, crusting, oozing, scaling and usually itching
Define Intermittent Claudication A symptom of arterial insufficiency which results in ischemia to exercising muscle. Relief of pain achieved by resting extremity
Signs of Intermittent Claudication - Pallor with limb elevation, Rubor in the dependent position. - BP decrease in affected extremity - Peripheral pulses are weak or absent in affected extremity
Define Scleroderma A chronic, diffuse disease of connective tissue causing fibrosis of skin, joints, blood vessels & internal organs. Usually accompanied by Raynaud's Phenomenon
Reasons for increased ESR (Erythrocyte Sedimentation Rate) - infection - Inflammation (i.e. Rheumatoid Arthritis)
When would you expect to see decreased Albumin levels? After a burn injury
Which protein is elevated in pts with MS (Multiple Sclerosis)? Gamma Globulin
Normal Hemotocrit Value 35-55% (Slight differences between males & females)
Normal pH range 7.35-7.45
Normal lab value hemoglobin for adult males 14-18 g/dL
Normal lab value Hemoglobin for adult females 12-16 g/dL
Normal SaO2 range > 95%
Normal PaO2 range 75-100 mmHg
Normal PaCO2 range 35-45 mmHg
Healthy cholesterol level < 200 mg/dL
Healthy HDL level > 60 mg/dL
Normal Platelet range 150,000-450,000 cells/mm^3
To classify as obese, BMI would be... > or equal to 30
To classify as morbidly obese, BMI would be... > 40
Normal range RBCs 4.2-6.1 10^6/mm^3
Healthy Triglyceride level < 165
Criteria for diagnosis of metabolic syndrome. 3 or more of the following; waist circumference >40", Triglyceride > or equal to 150mg/dL, HDL <40, BP > 130/85, Fasting plasma glucose > 110mEq/mL
Normal Bicarbonate value 22-28 mEq/mL
Normal WBC 5,000-11,000
What would a patient be allowed to do if their WBC is <5,000 noting
What would a patient be allowed to do if their WBC is 6,000 light exercise
What would a patient be allowed to do if their WBC is <1,000 Nothing, need to be wearing a mask
Hyperventilation causes respiratory alkylosis or respiratory acidosis? alkylosis
COPD and Myasthenia Gravis are associated with respiratory alkylosis or respiratory acidosis? respiratory acidosis
4 causes of metabolic acisosis DM, alcohol, poor kidney function, starvation
3 causes of metabolic alkylosis Vomit, diuretics, decreased potassium
symptoms of decreased potassium muscle weakness, cardiac arrythmias, n/v
Does renal failure cause increased or decreased potassium levels? increased
Hypercalcemia is associated with what endocrine disorder? hyperthyroidism Fatigue, confused, n/v
Hypocalcemia Sx mm cramping, hypotension, ECG changes
What type of exercise can a patient with <20,000 platelet count do? AROM and ADLs
What type of exercise can a patient with 20,000-30,000 platelet count do? light exercise only
What type of exercise can a patient with 30,000-50,000 platelet count do? moderate exercise
Created by: zimrizzle