It's just a phase...
Name that drainage!
99 problems, but I don't want one!
If you like it then you shoulda put a dressing on it
Surgical Wound Potpourri
100
During this phase of wound healing, there is an initial increase in the flow of blood elements and water out of the blood vessel and into the vascular space. This engorgement allows the repair cells to move toward the wound. This phase is the _________ phase.
What is the inflammatory phase?
FAHN 9th ed. Ch. 22 p. 626
100
The way you would describe the drainage shown in the picture above.
What is serous drainage?
Watery plasma that is mostly clear but may have some pink of yellow tinge to it.
FAHN 9th ed. Ch. 22 p. 629
100
Name four factors that affect wound healing:
_______, _________, ________, & __________.
(Answers will vary)
age, malnutrition, obesity, impaired oxygenation, smoking, drugs, diabetes, radiation, & wound stress
FAHN 9th ed. Ch. 22 Table 22.1 p. 628
100
This type of dressing is used on superficial wounds, abrasions, and over IV sites.
What is a transparent dressing?
*Also accepted: tegaderm
100
In the above picture, the nurse is careful to irrigate the surgical wound from the area ___________ to the area ____________.
What is from the area that is least contaminated to the area that is most contaminated.
FAHN 9th ed. Ch. 22 p. 635, also Skill 22.4 p. 638
200
As blood platelets adhere to the walls of the injured vessel, a clot begins to form. Fibrin in the clot begins to hold the wound together. This is the _______ phase.
What is the hemostasis phase?
FAHN 9th ed. Ch. 22 p. 626
200
The way you would describe the drainage in the picture above.
What is sanguineous? Bright red; indicates active bleeding
FAHN 9th ed. Ch. 22 p. 629
200
The protrusion of an internal organ through a wound or surgical incision.
What is evisceration?
FAHN 9th ed. Ch. 22 Table 22.3 p. 639
200
For a wound with very little exudate or drainage, and non-draining post-operative wounds, a ______ dressing is typically the dressing of choice.
What is a dry dressing?
FAHN 9th ed. Ch. 22 p. 631
200
Pictured above is this type of drain, often inserted during the surgical procedure. The nurse should document the amount, color and odor of any drainage emptied at least once per shift.
What is a Jackson-Pratt (JP) drain?
FAHN 9th ed. Ch. 22 p. 645
300
Collagen is formed during this phase, and the wound can begin to retract some. This is the _______ phase.
What is the reconstructive phase?
FAHN 9th ed. Ch. 22 p. 626
300
The way you would describe the drainage pictured above.
What is purulent? Thick, yellow, green, tan, or brown
FAHN 9th ed. Ch. 22 p. 629
300
This term is defined as an infection of the skin, characterized by heat, pain, edema, & redness.
What is cellulitis?
FAHN 9th ed. Ch. 22 Table 22.3 p. 639
300
If you anticipate that the patient will endure pain with the dressing change, you should assess the patient's pain and medicate ____________ prior to the dressing change with an oral analgesic.
What is 30 minutes?
FAHN 9th ed. Ch. 22 p. 631
300
Pictured in "Example C" above, healing by this type of intention means the surgeon left the wound open to granulate and wound healing will be delayed, due to an infection in the wound.
What is tertiary intention?
FAHN 9th ed. Ch. 22 p. 626-7
400
As collagen has formed, it now begins to cross-link. The wound continues to gain strength and it is important to let the patient know that it can actually take up to a full year for complete healing. This is the _______ phase.
What is the maturation phase?
FAHN 9th ed. Ch. 22 p. 626
400
The way you would describe the type of drainage pictured above.
What is serosanguineous?
Pale, red, watery; mixture of serous and sanguineous
FAHN 9th ed. Ch. 22 p. 629
400
The recommended time frame for suture/ staple removal postoperatively is _________. Leaving them in longer increases the patient's risk for infection.
What is 7-10 days?
FAHN 9th ed. Ch. 22 p. 640
400
This is what the nurse is doing in the picture, following a dressing change.
What is wrapping the soiled dressing that was removed inside his/her gloves and discarding it?
The nurse discards of the soiled dressing in this way to reduce contaminants in the environment and to reduce the likelihood of touching the soiled dressing.
FAHN 9th ed. Ch. 22 Skill 22.3 p. 636
400
This type of wound management was frequently used in the past, but is now not used as often. It consists of placing wet dressings in the bed of the wound and covering them with dry dressings. When the dressing is changed, debridement occurs from the wet dressings having adhered to the wound bed.
What is a wet-to-dry dressing?
FAHN 9th ed. Ch. 22 p. 631-2
500
In order for the body to regenerate and repair tissue, it needs a dietary source of ________.
*Daily Double Double Question (LOL)
Labs:
The patient's albumin should be _____________ and their total protein should be _____________.
In order for the body to regenerate and repair tissue, it needs a dietary source of protein.
Labs:
Albumin 3.5-5 g/dL
Total protein 6.4-8.3 g/dL
500
_________ drainage can be seen in infected wounds.
*Daily Double Double Question (LOL)
Use four adjectives to describe this type of drainage: _______, ________, _________, & _________.
(Answers will vary)
Purulent drainage can be seen in infected wounds.
Four adjectives could include:
beige, brown, tan, green, yellow, thick, foul-smelling, sticky, copious, scant, etc.
*Anything that YOU note- describe it so that the nurse who comes behind you can easily decipher what you were trying to state. *Better yet, have the wound care team take a photo of the wound & drainage and enter it into the chart.
500
For Wound VAC therapy, the black polyurethane foam is used because it has large pores and is most effective in stimulating both _______ and __________.
What are wound contraction and granulation of new tissue?
FAHN 9th ed. Ch. 22 p. 647 Skill 22.7, step 12 b
500
This type of solution is used to facilitate debridement in a wound with necrotic debris and is an effective deodorizing solution.
What is Dakin's solution?
1/2 strength bleach (sodium hypochorite)
FAHN 9th ed. Ch. 22 p. 633
500
Prior to calling the physician, the nurse must ensure that he/she does this when he/she finds a wound evisceration.
What is cover it with sterile saline soaked abd pads or gauze? (preferably warmed saline if available)
FAHN 9th ed. Ch. 22 Box 22.3 p. 639