Dehisced
Patient had surgery 3 weeks ago but the scar reopened after pt bent over to pet dog. Name 3 questions to ask this patient.
Do you have any history of arterial/venous issues?
Have you been examined for diabetes?
Are you feeling any pain?
(Multiple answers obv)
Pt. presents with partial thickness wound that is not infected. What stage ulcer and what intervention?
NPIAP: Stage 2
Intervention: autolytic debridement w/ occlusive dressing
Pt. has. ischemic rest pain. What stage is this wound?
Rutherford: Stage IV
What signs would lead you to suspect a venous wound?
Edema, high exudate, hemosiderin staining, lipodermasclerosis, spider veins, varicose veins, low venous refill time, palpable pulses, shallow/jagged edges, gator area, localized pain, increased temp
What could indicate a diabetic ulcer?
Callus rim, round, punched out, no/diminished pain, increased or normal temp, little/no drainage, plantar surface of foot, normal pulses, skin appears dry/cracked
Patient has a wound on their abdomen from a scar that has been splitting open. Theres no necrotic tissue, the tissue is all pink/red with serous exudate. What intervention would you do?
Autolytic with an occlusive dressing. It is not infected so occlusive is fine. No pulse lavage on abdomen.
Pt has history or HPN, DM, obesity. He accidentally sat on his catheter for 14 hours. What would be your differential diagnosis
Pressure or diabetic
Pt. presents with weak pulses, 42 sec pallor w/ elevation time, edema, and varicose veins. Name 3 contraindications and your differential diagnosis
PAD: Sharp debridement, compression, adhesive dressings
DD: Vascular, arterial, or mixed
Pt. presents with a current ulcer, edema, spider veins, and lipodermasclerosis. What grade would this person have on CEAP?
C6, C3, C1, C4B
Treatment for diabetic?
Patient Ed on foot checks, offload, NWB, modify risk factors, refer to nutritionist if obese, exercise program, ankle ROM
Patient has reopened wound on thoraic spine. He has a history of DM, PAD, and obesity. He is in long term care with nurses who move him every 4 hours. The wound presents with a lot of necrotic tissue, little slough. What assessment would you choose?
Full wound assessment
Pt. has ulcer on their sacrum where there is exposed tendon. What 3 interventions would you do?
Pt. Ed on removing pressure/weight shifting, self checks, upper extremity strenghthening program
Name each test time that would indicate Arterial Insufficiency
Cap Refill: More than 3 seconds
Rubor: Any color change, greater than 30 seconds
Pallor: Any color change, Mild (45-60 sec), Moderate (30-45 sec), Severe (within 25 sec)
ABI: Below .9
Venous Refill: Greater than 20 seconds
Pt. presents with a 3 second venous refill time, edema, and an inconclusive ABI. Wound assessment showed max exudate, odd odor, and purelent exudate. The wound has 80% slough, 15% necrotic, and 5% granulation. What intervention would you conduct and what dressing?
Monofilament wound debridement pad.
Dressing: alginate (primary) with gauze (secondary). Wrapped gauze tape to hold
Tests for diabetic?
Monofilament, vibration, sharp/dull
Pt presents with an infected dehisced wound. He has DM, HPN, and smokes. His pulses are faint. What would be your differential diagnosis?
Dehisced wound or diabetic (past history) or arterial (low pulses)
Pt. has pressure ulcer. on heel. It is infected with a lot of slough. What intervention would you do?
Monofilament wound debridement pad
Pt. presents with arterial insufficiency ulcer. Name 3 interventions
Patient Education, improve circulation w/ Buerger Allen or calf pump, foot checks, take care of skin
What assessments could you conduct for venous?
venous refill, wound assessment, edema assessment
Interventions for diabetic?
Pulse lavage for clensing, monofilament, autolytic, enzymatic
Pt has dehisced wound over L knee. He has DM and is a smoker. The wound bed has moderate exudate, no infection. What 3 interventions could you do? What dressing would you put?
Patient Ed on signs/symptoms of infection, skin checks, risk factors
Dressing: hydrogel with foam, non-woven gauze/tape to hold
Pt. has pressure ulcer on greater trochanter. You want to use pulse lavage to clean at 4-6 psi. List the contraindications for pulse lavage you should be aware of.
Facial wounds, active bleeding, latex allergies, vascular bypass grafts/flaps, over abdomen, near exposed tendon/bone/arteries/nerves
Pt. has DM, smokes, and presents with dry/cracked skin. He has a deep wound with exposed tendon. What stage ulcer? What intervention?
Wagner stage 3. Pulse lavage for cleaning (4-6 psi)
Treatments for venous?
Ankle ROM, patient ed on skin checks/footwear, strength program for lower leg
WHAT WILL YOU GET ON THIS PRACTICAL
100000000