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