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Nursing In a Flash 
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You notice purulent drainage when changing a dressing. No culture is ordered for this change, so you...
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obtain a wound culture anyway
When changing a NPWT unit dressing, the system should be in de vac mode for _______ minutes.
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30-45 minutes
_______ dressings are for infected wounds. They shouldn't be used in dry wounds.
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Calcium alginate
_______ dressings provide a moist environment and are soothing and decrease pain in a wound.
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Hydrogel
_______ is most useful on shallow, or moderately deep dermal ulcers.
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Hydrocolloid
_______ dressings can be used on clean, granulating wounds.
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Hydrocolloid
This type of dressing is self adhesives and traps the wounds moisture over the wound. Ideal for small, superficial wounds or to protect increased risk skin...
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Film dressing
4 x 4's are used in wounds that...
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have exudate or need wound drainage
A Tefla is used on wounds...
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that are clean and with little or no drainage
When removing tape from a wound, it should be pulled _______ the wound.
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toward
What types of clients are at increased risk of developing pressure ulcers?
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Neurologically impaired, chronically ill in LTC, decreased mental status, ICU, oncology, hospice, and/or orthopedic.
A surgical wound heals by _______.
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primary intention
A wound involving loss of tissue like a burn, pressure ulcer or severe laceration heals by _______.
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secondary intention
What are the 3 components of partial-thickness wound healing?
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Inflammatory response, epithelial proliferation and migration, and re-establishment of the epidermal layers.
What are the 3 phases involved in the healing process of a full-thickness wound?
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Inflammation, proliferative, and remodeling.
_______ occurring after hemostasis indicates a slipped surgical suture, a dislodged clot, infection or erosion of a blood vessel by a foreign object.
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Hemorrhage
How can internal hemorrhage be detected?
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Look for distention or swelling; change in type/amount of drainage; and signs and symptoms of hypovolemic shock.
When is the risk of hemorrhage after surgery the greatest?
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24-48 hours after
What 3 factors increase the risk of wound infection, related to the wound itself?
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Wound contains dead/necrotic tissue; foreign bodies in or near the wound; blood supply/local defenses are low.
What are the signs and symptoms of an infected wound?
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Fever, tenderness, pain, increased WBC, and/or inflamed wound edges.
Infection can appear as early as _______ days. Surgical infections usually appear _______ days postoperatively.
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2-3 days; 4-5 days
Dehiscence most commonly occurs _______ days after injury.
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11-Mar
Who is at high risk for dehiscence?
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Obese, poor nutrition, and/or present infection.
What is a strategy for preventing dehiscence?
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Place a folded thin blanket or pillow over the abdominal wound when client is coughing.
What should you do if evisceration occurs?
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Place sterile towels soaked in sterile saline over the extruding tissues to decrease bacterial invasion and drying of tissue; NPO; Watch for shock; and Prepare for surgery.
What conditions can cause fistula formation?
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Trauma, infection, radiation, cancer, and Chron's.
_______ increases the risk of infection and fluid/electrolyte imbalance.
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Fistula
What scales are used to assess risk of pressure ulcers?
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Norton and Braden.
How is the Norton scale of pressure ulcer risk different from the Braden scale?
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Norton: Five factors: physical, mental, activity, mobility and incontinence. 5 - 20. Braden: Six factors: sensory, moisture activity, mobility, nutrition, friction and shear. 6 - 23. 18 is cutoff, most commonly used.
What factors impact pressure ulcer formation and healing?
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Nutrition: proteins, A, C, zinc and copper; Tissue Perfusion; Infection; Age; and Psychosocial.


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