Wound Staging
A reddened area of the skin that is intact and non-blanchable.
What is a Stage I pressure ulcer?
This screening tool assesses the patients risk for skin breakdown
What is the Braden Scale?
Administering tube feed via a naso-gastric tube.
What is High Fowler's
The neurological system.
What is the first body system the nurse will assess?
First Professional African American Nurse. Currently honored by the American Nurses Association with a scholarship in her name
Who is Mary Eliza Mahoney?
Reddened, blanchable area of the skin.
What is not yet a pressure ulcer?
Hint: re-position you patient now to prevent this from turning into a pressure ulcer!!!This screening tool assesses the patients ability to preform activities of daily living (ADL's)
What is the Katz Index?
Administering a fleets enema.
What is Sim's?
5th intercostal space, mid-clavicular.
Where can you find the apical pulse?
This nurse established the National Black Nurses association in 1971
Who is Betty Smith Williams?
The top layer of skin is no longer intact and there may be serous fluid at the site.
What is a Stage II pressure ulcer?
This screening tool assesses the patient for issues with cognition.
What is the Mini-Cog Assessment?
What is the Montreal Assessment?
Every 2 hours if the patient is in a bed, every hour if the patient is in a chair.
How often should the nurse reposition the patient?
When assessing this pulse, the nurse should only assess one side at a time.
What is the carotid pulse?
Known as the lady with the lamp
Who is Florence Nightengale?
A wound that the nurse can see muscle and bone. There may be tunneling and mining as well.
What is a Stage IV pressure ulcer?
Screening tools are part of which health prevention intervention?
What are secondary preventions?
Administering a vaginal suppository.
What is dorsal recumbent?
Inspect, auscultate, palpate.
What order should the nurse assess the abdomen?
This nurse created the American Red Cross
Who is Clara Barton?
A wound where the nurse can see as far down as the subcutaneous issue. It may contain tunneling and or mining.
What is a Stage III pressure ulcer?
This screening tool assesses the patient ability to preform instrumental activities of daily living (IADL's)
What is the Lawton's Index?
A patient who is at risk for aspiration should be in this position when eating.
What is an upright position?
Clavicle, sub-mandibular, tonsilar. We palpate these to check for enlargement.
What are lymph nodes?
This famous nurse became the Dean at Tuskegee School of Nursing
Who is Lillian Holland Harvey?