Wounds
What are the stages of wound healing
Inflammatory - 1-5 days
Proliferative - 5-21 day
Maturation and remodeling - 3-6 month
What are the risk factors for pressure injuries
advanced age, anemic, diabetic, more frickem going on, anemic, obese/ more frail (skinny), immobile, incontinent, vascular disease
What is the cause of PAD?
Involves thickening of the artery walls and progressive narrowing of arteries of upper and lower extremities.
What are risk factors for chronic venous insufficiency?
family history, women tend to have higher rates, smokers, aging, obesity, people who have had multiple pregnancy, history of certain leg injuries, prolonged sitting or standing.
Describe the different precautions
standard
contact
droplet
airborne
How are the 3 different depths of wounds defined
Superficial
Partial thickness -
Full thickness
this is the best treatment for pressure injuries
Prevention
This ischemic muscle pain is seen when a patient moves; and goes away when the patient rest
Intermittent claudication.
What are the 5 main manifestations of CVI?
1. Edema: in the lower extremities; entire leg because fluid cannot get back up to the heart.
2. Red, purplish, brown color to lower leg: might look leathery
3. Dermatitis: inflammation of the skin; eczema or scaling of the skin.
4. Varicose veins: back of the calves.
5. Pain: in lower extremities
Worsens when dependent (legs below heart): gets worse at the end of the day.
Improves with elevation
what are some of the differences between OA and RA?
OA: Wear and tear '' arthritis. When cartilage that cushions the ends of bone in your joints gradually deteriorates. Slowly progrssive NON-INFLAMMATORY disorder. RF: menopause/ genetics
RA: AUTOIMMUNE and inflammatory disease. Immune system attacks healthy cells in your body by mistake. Causes joint pain and stiffness, decreased movement.
What are the 3 different types of healing
Primary: well approximated edges; surgical insicions
Secondary: Not well approximated; heals from the inside then to the surface; Heals slowly; (pressure injury)
Tertiary: Delayed primary; we leave it open to heal then when the edges are approximated; we close it up.
According to the Braden's scale; a patient who received a score of 11 is more; or less at risk for developing a pressure injury than someone who is at 23.
They are more; the lower the number; the more at risk you are.
Most common site of Arterial Ulcers?
Tips of toes and pressure points.
Where are Venous Ulcers typically found
Medial Malleolus: this is the classic location, (inner ankles)
Dry Cough, pain in chest, coughing up blood (late), wt loss, no appetite, chills, sweating at night. Prevent with screenings - these are s/sx of what disease?
TB
Separation of one or more layers of the wound bed; typically happens 5-8 days post op
Dehiscence; this is similar to evisceration except with evisceration we have total separation of the wound and evisceration also may affect internal organs
What is the difference between unstageable and deep tissue injury?
Whereas;
Deep tissue injury is a purple/maroon blood filled blister
Describe what these wounds look like?
Pale, well-defined edges, minimal exudate; may have eschar/more necrotic tissue.
How would you describe a venous ulcer?
Irregular shape, shallow, high exudate,
Wound bed -->Yellow slough, Ruddy granulation tissue, Maceration on wound bed edges
Match these: LDL, HDL, Fasting TRI, Cholesterol
> 200
<40
>150
>130
Bad levels: Cholesterol > 200, HDL < 40, LDL >130, fasting tri >150
Name as many factors that affect wound healing as possible
(hint: there is 11 of them!)
Nutrition, inadequate blood supply, corticosteroids, infection, anemia, smoking, mechanical friction, advanced age, obesity, smoking, poor general health.
Describe the four stages of pressure injuries
Stage 1: intact skin, redness, nonblanchable
Stage 2: partial thickness dermis loss
Stage 3: full thickness loss, subQ may be visible
Stage 4: full thickness loss, reaching muscle tendons and organs.
What are going to be interventions for PAD?
(hint: how does CVD, DM, Exercise, and positioning affect PAD)
What is the #1 treatment for CVI?
Compression.
What are HgB ranges for men and women ?
Men 14-18
Women 12-16