Wounds & Associated Pathology
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| Three means of transmission of pathogens | Airborne, Droplet, & Contact
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| Examples of Airborne Pathogens and Precautions to take | - Tuberculosis, Measles
- In facilities, workers need to wear special masks & isolate pt in negative pressure environment
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| Precautions to take with Pathogens transmitted through Droplets | A regular mask with no special ventilation
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| Examples of Contact Pathogens and Precautions to take | - HIV, Hep B
- Gloves & hand washing are usually sufficient.
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| 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
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| 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
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| What are the recommended Ultrasound parameters & time frame in a chronic wound? | Use three times per week with medium intensity, continuous US
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| Signs of Arterial Insufficiency Ulcer | - deep & painful with skin pale & cold
- common on lateral malleolus & toes
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| Treatment of Arterial Insufficiency Ulcers | Bed rest with head of bed elevated moderately, smoking cessation, wound care, LE PROM, protective environment
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| 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
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| 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)
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| Define Cellulitis | an inflammation of the connective tissue frequently accompanied by infection
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| Define Dermatitis | Superficial inflammation of skin, characterized by vesicles (when acute), redness, edema, crusting, oozing, scaling and usually itching
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| Define Intermittent Claudication | A symptom of arterial insufficiency which results in ischemia to exercising muscle. Relief of pain achieved by resting extremity
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| 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
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| Define Scleroderma | A chronic, diffuse disease of connective tissue causing fibrosis of skin, joints, blood vessels & internal organs. Usually accompanied by Raynaud's Phenomenon
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| Reasons for increased ESR (Erythrocyte Sedimentation Rate) | - infection
- Inflammation (i.e. Rheumatoid Arthritis)
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| When would you expect to see decreased Albumin levels? | After a burn injury
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| Which protein is elevated in pts with MS (Multiple Sclerosis)? | Gamma Globulin
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| Normal Hemotocrit Value | 35-55% (Slight differences between males & females)
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| Normal pH range | 7.35-7.45
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| Normal lab value hemoglobin for adult males | 14-18 g/dL
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| Normal lab value Hemoglobin for adult females | 12-16 g/dL
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| Normal SaO2 range | > 95%
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| Normal PaO2 range | 75-100 mmHg
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| Normal PaCO2 range | 35-45 mmHg
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| Healthy cholesterol level | < 200 mg/dL
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| Healthy HDL level | > 60 mg/dL
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| Normal Platelet range | 150,000-450,000 cells/mm^3
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| To classify as obese, BMI would be... | > or equal to 30
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| To classify as morbidly obese, BMI would be... | > 40
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| Normal range RBCs | 4.2-6.1 10^6/mm^3
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| Healthy Triglyceride level | < 165
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| 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
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| Normal Bicarbonate value | 22-28 mEq/mL
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| Normal WBC | 5,000-11,000
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| What would a patient be allowed to do if their WBC is <5,000 | noting
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| What would a patient be allowed to do if their WBC is 6,000 | light exercise
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| What would a patient be allowed to do if their WBC is <1,000 | Nothing, need to be wearing a mask
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| Hyperventilation causes respiratory alkylosis or respiratory acidosis? | alkylosis
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| COPD and Myasthenia Gravis are associated with respiratory alkylosis or respiratory acidosis? | respiratory acidosis
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| 4 causes of metabolic acisosis | DM, alcohol, poor kidney function, starvation
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| 3 causes of metabolic alkylosis | Vomit, diuretics, decreased potassium
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| symptoms of decreased potassium | muscle weakness, cardiac arrythmias, n/v
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| Does renal failure cause increased or decreased potassium levels? | increased
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| Hypercalcemia is associated with what endocrine disorder? | hyperthyroidism
Fatigue, confused, n/v
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| Hypocalcemia Sx | mm cramping, hypotension, ECG changes
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| What type of exercise can a patient with <20,000 platelet count do? | AROM and ADLs
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| What type of exercise can a patient with 20,000-30,000 platelet count do? | light exercise only
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| What type of exercise can a patient with 30,000-50,000 platelet count do? | moderate exercise
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