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