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Pressure ulcers and wound careMedical-Surgical Nursing-7th edition

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Question Answer
You notice a sudden decrease in drainage through the tubing may indicate...
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a blocked drain (*Call HCP)
A client who had surgery 2 days ago has edematous skin around their staples. This is...
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normal; 2-3 days if continues closures may be too tight and may lead to wound dehiscence.
What are the steps for culturing a wound?
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Clean the wound. Use sterile swap. Moisten with saline. Rotate swab in wound and apply pressure to elicit fluid. Put in sterile container.
What is the process for needle aspiration procedures?
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10 mL disposable syringe with 22 gauge needle, pull 0.5 mL of air into syringe. Insert needle into intact skin next to the wound, aspirate 10 mL. Move needle back and forth at different angles for 2-4 explorations. Remove needle and expel air, cap.
In general, how do nursing interventions decrease the risk of pressure ulcer development?
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Nurses assess for risk factors (poor nutrition, immobility syndromes, weakness, etc.) and then intervene to decrease or eliminate the risks.
What are the 3 major areas of nursing interventions for prevention of pressure ulcers?
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Skin care; Mechanical loading/support devices (positioning and transfer); and Education.
Elevating the HOB to _______ will decrease the chance of pressure ulcer development from shearing forces.
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30 degrees or less
Which position is recommended to avoid pressure points?
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30 degrees lateral
Type of support surface used to protect newly flapped/grafted surgical sites and for clients with excessive moisture?
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Air-Fluidized Bed
Acute wounds should be assessed every _______.
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8 hours
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Dakin's solution, acetic acid, povidone-iodine, and hydrogen peroxide are used to clean...
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Pressure ulcers (non-cytotoxic)
_______ is a common method of delivering the wound-cleansing solution to a wound.
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Irrigation
What methods are used to ensure adequate irrigation is in the correct range?
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19 gauge needle and 35 mL syringe at 8 psi.
_______ is the removal of nonviable, necrotic tissue.
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Debridement
What type of wound with necrosis should not be debrided?
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Stable, dry, black eschar on heels if they are non-tender, non-fluctuant, nonerythematous and nonsuppurative.
_______ debridement is the use of wet-to-dry saline gauze dressings. It is nonselective and therefore not routinely used.
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Mechanical
_______ debridement uses synthetic dressings over a wound to allow eschar to be self-digested.
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Autolytic
Transparent film and hydrocolloid dressings are a form of autolytic debridement that are used when excessive _______ is present.
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exudate (absorbs moisture while keeping wound bed moist)
Enzymes for pressure ulcer treatment should be applied in a _______ layer and over _______.
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thin, even layer to necrotic area only
_______ debridement occurs with topical enzyme preparation, Dakin's solution or sterile maggots.
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Chemical
_______ is indicated when a client has signs of cellulitis or sepsis. It is the quickest method of debridement.
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Surgical debridement
  
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