nursing
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inflammatory response | a sequential reaction to cell injury
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removes necrotic materials, and establishes an environment suitable for healing and repair | inflammatory response
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Inflammation is an immediate | protective response by the body to any kind of injury to its cells and tissue.
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The vascular response results in | vasodilation causing hyperemia (increased blood flow in the area) and increased capillary permeability.
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vascular response results in increased fluid moving into tissues causing | redness, heat, and swelling at the site.
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the cellular response | neutrophils and monocytes move to the inner surface of the capillaries (margination) and then through the capillary wall (diapedesis) to the site of injury.
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Chemotaxis is the | migration of WBCs to the site of injury
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chemotaxis results in an | accumulation of neutrophils and monocytes at the focus of injury
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Pus is a | creamy substance resulting from dead neutrophils, digested bacteria and other debris
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the first leukocytes to arrive at the site of injury (usually 6-12 hours) and have a short life span (24-48 hours) | neutrophil
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neutrophils phagocytize | bacteria, other foreign material and damaged cells
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the second type of phagocytic cells that migrate from circulating blood are | monocytes
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monocytes transform into | macrophages
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macrophage role is to | clean area before healing can occur
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lymphocytes are related to | humoral and cell-mediated immunity
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Complement system (C1-C9) is the | major mediator of the inflammatory response
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Exudate consists of | fluids and leukocytes that move to the site of injury
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local response of inflammation includes | redness, heat, pain, swelling and loss of function
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systemic manifestations of inflammation includes | an increase of WBC count with a shift to the left, malaise, nausea an anorexia, increased pulse and respiration rate and fever
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inflammation is always present with | infection
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infection is not always present with | inflammation
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infection means an | invasion of tissues or cells by microorganisms such as bacteria, fungi and viruses
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neutropenic means that your | WBC is depleted, and you may not be able to manifest an inflammatory response.
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a low neutrophil count is called | neutropenic
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inflammation is based on the | severity of the injury and the capacity for the person to respond
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vascular response results from | capillaries constricting and this releases hit amine which causes vasodilation.
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hyperemia is the | increased blood flow to an area
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fibrinogen leaves the blood and is | activated to fibrin
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fibrin strengthens a | blood clot formed by platelets
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in a blood clots platelets release | growth factors that start the healing process
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bone marrow releases immature neutrophils are called | bands
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Phagocytosis | engulf foreign matter and debris
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purulent Pus is a | creamy substance resulting from dead neutrophils, digested bacteria and other debris
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an increase in WBC can be due to an | acute bacterial infection
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leukocytosis is the | increase in WBC
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monocytes arrive at the site of infection in about | 3-7 days
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Serous fluid results from | low cell and protein count, seen in early stages of inflammation (skin blisters)
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Catarrhal | – mucous – runny nose with URI
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histamine is stored in | granules of basophils, mast cells, and platelets.
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histamine causes | vasodilation and increased capillary permeability
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serotonin is stored in | platelets, mast cells enterochromaffin cells of the GI tract
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serotonin stimulates | smoother muscle contraction
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Purulent fluid is | a Combo of WBCs, dead cells, microorganisms – abscess, cellulitis, furuncle
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granuloma is when a | monocytes clump together to eat a larger particles
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prostaglandins are generally considered | proinflammatory and prolong the inflammatory response and are potent vasodilators contributing to increased blood flow and edema
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prostaglandins have a role as pyrogens in | causing febrile (fever)
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leukotrienes are more likely to cause | anaphylaxis
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anaphylaxis cause a | vasoconstriction of smooth muscles of the bronchi, which causes a narrowing of the airway
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aldosterone is a | pro-inflammatory which controls sodium ( hangs with water) and causes BP and HR to go up
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Fever above 105.8 F damages | regulation by the hypothalamic temperature control center becomes impair, and damage can occur to many cells, including brain cells
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cortisol is an | anti-inflammatory that inhibits the inflammatory response
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sero-sanguineous fluid is | found during the midpoint in healing after surgery or tissue injury. composed of RBC and serous fluid
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the onset of fever is triggered by | the release of cytokines
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the shivering response is the body's method of | raising the body's temperature until the new set point is attained
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exudate fluid are | leukocytes that move to the site of injury.
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there is a decrease in mobility due to | pain and swelling
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acute inflammation the healing occurs in | 2-3 weeks and usually leaves no residual damage and neutrophils are the predominant cell type at the site of inflammation
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subacute inflammation has | the same features of acute inflammation but last longer
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chronic inflammation lasts for | weeks, months or even years, with predominate cell types being lymphocytes and macrophages
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the best management of inflammation is the | prevention of infection, trauma, surgery, and contact with potentially harmful agents
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older people have a blunted | febrile response to infection
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antipyretic drugs are used to | reduce fever
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to prevent acute swings in temperature | antipyretic drugs are given around the clock
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key concept in treating soft tissue injuries and related inflammation | RICE
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R in rice stands for | rest and it helps the body use its nutrients and oxygen for the healing process. lets fibrin and collagen to form across the wound edges with little disruption
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I in rice stands for | ICE, and cold application is usually appropriate at the time of initial trauma to cause vasoconstriction and decrease swelling and pain
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when can heat be added to inflammation? | 24-48 hours after and promotes healing by increasing the circulation to the inflamed site
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E in rice stands for | Elevation, reduces edema at the site of inflammation by promoting venus and lymphatic return
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C in rice stands for | Compression, serves to counter the vasodilation effects and development
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regeneration is the | replacement of lost cells and tissues with cells of the same type
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repair is the | healing as a result of lost cells being replaced by connective tissue
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most common type of healing that result in a scar forming | repair
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epithelial cells | readily divide and regenerate
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skin and lining of the blood vessels are | epithelial cells
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connective tissue are | bone, cartilage, tendons and ligaments and blood
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smooth muscle | regeneration usually possible, particularly in the GI tract
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cardiac muscle | damage is replaced by connective tissue
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skeletal muscle | connective tissue replaces severely damaged muscle
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primary intention healing takes place when | a wound margins are neatly approximated, as in a surgical incision or a paper cut
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the initial inflammatory phase lasts for | 3-5 days, approximation of incision edges, fibrin clot forms meshwork for starting capillary growth
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the granulation (fibroblastic, reconstructive) phase is the | second step and last from 5 days to 3 weeks.
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during the granulation phase the wound is | pink and vascular ( good blood flow)
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fibroblasts are | immature connective tissue cells that migrate into the healing site and secrete collagen
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collagen is organized and restructured to | strengthen the healing site, at this stage it is termed scar tissue or fibrous
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during the maturation phase it begins | 7 days after the injury and continue for several months or years
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secondary intention are wounds that | occur from trauma, ulceration, and infection have large amounts of exudate and wide, irregular wound margins with extensive tissue loss
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secondary intention wound edges | cannot be approximated or brought together
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healing and granulation take place from the | edges inward and from the bottom of the wound upward until the defect is filled
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tertiary intention healing occurs with the | delayed suturing of a wound in which two layers of granulation tissue are sutured together
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a contaminated wound is left open and sutured closed after the infection is controlled | tertiary intention
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wounds are classified by their | cause (surgical or non surgical; acute or chronic) or depth of tissue affected (superficial, partial thickness, or full thickness
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superficial wound involves | only the dermis
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partial thickness wounds | extend into the dermis
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full thickness wounds have the | deepest later of tissue destruction because they involve the subcutaneous tissue and sometimes extend into the fascia and underlying structures such as the muscle, tendon or bone
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another system used to classify open wounds is based on | the color of the wound (red, yellow, black)
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adhesions are | bands of scar tissue that form between or around organs, may occur in the abdominal cavity or between the lungs and pleura and may cause intestinal obstruction
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evisceration occurs when | wound edges separate to the extent that intestines protrude through wound
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dehiscence is the | separation and disruption of previously joined wound edges
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dehiscence may be caused by | infection caused by inflammation, granulation tissue not strong enough to withstand forces imposed on wound, obese people are at higher risk because adipose tissue has less blood supply
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fistula formation is an | abnormal passage between organs or a hollow organ and skin
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keloid formation is a | great protrusion of scar tissue that extends beyond wound edges and may form tumor like masses of scar tissue. occurs more in african americans
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hypertrophic scar occurs when | an overabundance of collagen is produced during healing, raised red and hard scar that is non life threatening
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wound measurements are made | in centimeters
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tunneling of a wound is when | cotton tip is placed in a wound and there is movement
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underminin of a wounds is when | there is a lip under the wound
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tunneling and undermining are charted in respect | to a clock
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sutures and fibrin sealant are used to | facilitate wound closure and create an optimal setting for wound healing
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fibrin sealant can be used with | sutures or can used independently to seal wound sites where sutures cannot control bleeding
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primary intention wounds is common to cover wound with | a dry sterile dressing that is removed as soon as drainage stops, or 2-3 days
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topical antimicobials shouldn't be used in a clean granulating wound because they | may damage the new epithelium and delay the healing process
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red wound the purpose of treatment is to | protection of the wound and gentle cleansing
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for a red wound the dressing material | should keep the wound surface clean and slightly moist is optimal to promote epithelialization
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transparent films are | semipermeable dressing that permits gaseous exchange between wound and environment, use
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used for dry noninfected wounds or wounds with minimal drainage | transparent films (tegaderm, transeal, OpSite, BlisterFilm)
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yellow wound dressing materials should | absorb the exudate and cleanse the wound surface. number of dressing changes is determined by the amount of wound secretions
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black wound treatment calls for | immediate debridement of the nonviable, eschar tissue
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hydrocolloid dressings are used to treat | yellow wounds
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the inner part of hydrocolloid dressings interact with | exudate, forming a hydrated gel over the wound. doesn't allow O2 to diffuse from the atmosphere to the wound
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type of therapy that uses suction to remove drainage and speed wound healing | negative pressure wound therapy (wound vac)
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for negative pressure therapy you should monitor the patients | serum protein levels and fluid and electrolyte balance due to losses from the wound
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gauzes and nonwovens provides absorption of | exudates, supports debridement if applied and kept moist. can be used for cleaning or packing of a wound ( kerlix, kling)
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nonadherent dressings are | woven or non woven dressings, with either saline, petrolatum or antimicrobials in them. used on minor wounds or as a second dressing
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foam dressings are | sheets or other shapes of foamed polymer solution with small, open cells capable of holding fluids. used for partial or full thickness wounds or infected wounds ( allevyn, curafoam)
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absorptive dressings are for | large volumes of exudates that need to be absorbed. for partial or full thickness wounds (ABD pads, Covaderm, Abdominal pads)
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hydrogel dressing is | available as a sheet, gel or gauze designed to donate moisture to a dry wound and maintain a moist healing environment, serves to rehydrate the wound tissue. provides limited absorption of exudate, partial of full thickness wounds (AquaSite, Tegagel,)
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angiogenesis is the | production of new blood vessels
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surgical debridement is the | quick method of debridement to prevent, control, or remove infection
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mechanical debridement is when | a wet to dry dressing in which open mesh gauze is moistened with normal saline, packed on or into wound surface and allowed to dry
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a diet high in | protein, carbs, and vitamins with moderate fat intake is necessary to promote healing.
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a pressure ulcer is a localized | injury to the skin and/or underlying tissue (usually over a bony prominence)
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pressure ulcers fall under the category of | healing by secondary intention
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most common site for pressure ulcers is the | sacrum and then the heels
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shearing force is the | pressure exerted on the skin when it adheres to the bed and the skin layers slide in the direction of body movement
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risk factors the pressure ulcers include | advanced age, anemia, diabetes, immobility, incontinence, low diastolic BP <60 mmHg, obesity, vascular disease
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unstageable pressure ulcer is when | (full thickness)the actual depth of the tissue loss is obscured by slough (yellow, tan, gray, green or brown) and/ or eschar (tan, brown, or black) in the wound bed
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stage 1 pressure ulcer is | a nonblanchable redness of a localized area usually over a bony prominence
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stage 2 pressure ulcer is | partial thickness loss of dermis manifesting as a shallow open ulcer with red pink wound bed, with out slough
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stage 3 pressure ulcer is | full thickness tissue loss with subcutaneous fat may be visible but not bone
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stage 4 pressure ulcer is | full thickness tissue loss with exposed bone, tendon or muscle. slough or eschar may be present on some parts of the wound bed
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risk assessment should be done using the | braden scale to assess for risks of pressure ulcer
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document a pressure ulcer based on | stage, size, location, amount of exudate, type of wound, presence of infection or pain
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