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nursing

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Question
Answer
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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