Factors Affecting Skin Integrity and Pressure Ulcers

Which factor does NOT affect skin integrity according to the text?

Types of wounds

What is the largest organ in the body according to the text?

Skin

Which factor can impair skin integrity?

Corticosteroids medication

What is one of the functions of intact skin according to the text?

Maintaining health Signup and view all the answers

Which condition makes skin on the legs damage more easily?

Impaired peripheral arterial circulation Signup and view all the answers

What type of wound is caused by accidental trauma?

Unintentional wound Signup and view all the answers

Skin color and allergies are examples of factors related to which aspect of skin integrity?

Genetics & heredity Signup and view all the answers

What is the impact of poor nutrition on skin integrity?

Impairs skin integrity Signup and view all the answers

In what way do chronic illnesses affect skin integrity?

Impair peripheral arterial circulation Signup and view all the answers

What is the main purpose of understanding factors affecting skin integrity for nurses?

To prevent injury Signup and view all the answers

What are some measures mentioned in the text to promote optimal skin condition?

Understanding factors affecting skin integrity Signup and view all the answers

Which medication is specifically highlighted in the text as affecting skin integrity?

Corticosteroids Signup and view all the answers

What is the maximum score on the Braden Scale?

23 points Signup and view all the answers

What does a Braden Scale score of ≤ 18 points indicate?

High risk Signup and view all the answers

Which of the following is NOT one of the subscales in the Braden Scale?

Moisture Signup and view all the answers

What is the main purpose of a Risk Assessment Tool in pressure ulcer prevention?

To identify individuals at risk for pressure ulcers Signup and view all the answers

What does a Norton Scale score between 14-10 indicate?

High risk Signup and view all the answers

In nursing management, what is assessed during the diagnosing phase related to skin integrity?

Color of the wound bed Signup and view all the answers

What is recommended for preventing pressure ulcers regarding skin hygiene?

Avoid hot water Signup and view all the answers

What is a common nursing intervention for preventing pressure ulcers related to repositioning?

Providing supportive devices like mattresses and pillows Signup and view all the answers

What should be done at each dressing change when treating a pressure ulcer?

Clean the ulcer and surrounding skin with surgical asepsis Signup and view all the answers

What should be considered for medication in the treatment of pressure ulcers?

Consider systemic antibiotics for evidence of infection Signup and view all the answers

What does a Norton Scale score > 18 indicate?

Low risk Signup and view all the answers

What is essential in assessing pressure ulcers regarding nursing management?

Color of the wound bed and location of necrosis Signup and view all the answers

Which type of wound involves accidental wounds and surgical wounds with a major break in sterile technique?

Contaminated wounds Signup and view all the answers

What does an 'Incision' type of wound involve?

Open wound with deep or shallow tissue penetration by a sharp instrument Signup and view all the answers

Which position is considered common for pressure ulcers?

Supine position Signup and view all the answers

What is the defining characteristic of Stage I pressure ulcers?

Non blanchable erythema Signup and view all the answers

Which type of wound involves tissue torn apart and often occurs from accidents?

Laceration Signup and view all the answers

What does 'Full-thickness Tissue Loss' involve in the context of pressure ulcers?

Visible slough that obscures the depth of tissue loss Signup and view all the answers

What causes Pressure Ulcers?

Localized ischemia due to blood supply deficiency Signup and view all the answers

'Dirty or infected wounds' are characterized by:

Evidence of infection like purulent drainage Signup and view all the answers

Why is it important for nurses to understand the factors affecting skin integrity?

To promote optimal skin condition and prevent injury Signup and view all the answers

Which factor does NOT affect skin integrity according to the text?

Medication administration Signup and view all the answers

How do chronic illnesses affect skin integrity?

They impair peripheral arterial circulation leading to easy skin damage Signup and view all the answers

What aspect of skin integrity do skin color and allergies fall under?

Genetics & heredity Signup and view all the answers

What should be done at each dressing change when treating a pressure ulcer?

Document the wound's progress Signup and view all the answers

What is the impact of poor nutrition on skin integrity?

It delays wound healing and impairs skin regeneration Signup and view all the answers

What type of wound is characterized by open, fresh, accidental wounds and surgical wounds involving a major break in sterile technique?

Contaminated wounds Signup and view all the answers

In the context of wound classification, which wound type typically involves tissues that are torn apart and often occurs from accidents?

Laceration Signup and view all the answers

What does a 'Partial-thickness' wound involve?

Loss of epidermis and dermis Signup and view all the answers

Which position is NOT considered common as a pressure site leading to pressure ulcers?

Supine position Signup and view all the answers

What is the characteristic of a Stage II pressure ulcer?

Partial-thickness loss of epidermis and dermis Signup and view all the answers

What does 'Iatrogenesis' refer to in the context of describing wounds?

How the wounds were acquired Signup and view all the answers

What is the maximum score on the Norton Scale for assessing pressure ulcers?

20 points Signup and view all the answers

Which subscale is NOT part of the Braden Scale for pressure ulcer risk assessment?

Pain Perception Signup and view all the answers

In the context of pressure ulcers, what does 'Unstageable' mean?

Depth of ulcer obscured by slough or eschar Signup and view all the answers

What is the primary factor considered in determining a client's risk level according to the Norton Scale?

Mobility Signup and view all the answers

What is the significance of a Braden Scale score of 18 points?

Low risk for developing pressure ulcers Signup and view all the answers

What should be the first step in any pressure ulcer prevention model according to the text?

Using risk assessment tools Signup and view all the answers

How does the Norton Scale categorize individuals with scores between 14-10 points?

High risk for pressure ulcers Signup and view all the answers

Which factor is NOT mentioned as affecting skin integrity in the text?

Blood type Signup and view all the answers

What is the defining characteristic of a Stage II pressure ulcer according to the text?

Partial-thickness wound with a loss of dermis Signup and view all the answers

In what way do chronic illnesses impact skin integrity according to the text?

By making the skin on the legs prone to damage Signup and view all the answers

What type of wound is characterized by open, fresh, accidental wounds and surgical wounds involving a major break in sterile technique?

Contaminated wound Signup and view all the answers

Which wound description involves an open wound penetrating the skin and often the underlying tissues by a sharp instrument?

Puncture Signup and view all the answers

What does 'Full-thickness Tissue Loss' involve in the context of pressure ulcers?

Skin loss with necrosis or damage to tendon, muscle, or bone Signup and view all the answers

What is the maximum score on the Norton Scale for assessing pressure ulcers?

20 points Signup and view all the answers

What is the main purpose of using risk assessment tools in pressure ulcer prevention?

Identifying clients at risk Signup and view all the answers

What does 'Suspected deep tissue injury' in pressure ulcers refer to?

Purple or maroon area with intact skin Signup and view all the answers

What is an essential aspect of nursing intervention in treating pressure ulcers?

Repositioning the client regularly Signup and view all the answers

What is the maximum score on the Norton Scale for assessing pressure ulcers?

20 points Signup and view all the answers

In the Braden Scale, what is the significance of a score of 18 points?

At risk for pressure ulcers Signup and view all the answers

What is the primary factor considered in determining a client's risk level according to the Norton Scale?

General physical condition Signup and view all the answers

What is a common nursing intervention for preventing pressure ulcers related to repositioning?

Providing smooth and wrinkle-free foundation Signup and view all the answers

What does 'Full-thickness Tissue Loss' involve in the context of pressure ulcers?

Loss of skin or tissue depth unknown Signup and view all the answers

What factors can affect skin integrity, as discussed in the text?

Chronic illnesses and medications like corticosteroids Signup and view all the answers

Why is it important for nurses to understand the factors affecting skin integrity?

To promote optimal skin condition and prevent injuries Signup and view all the answers

Which aspect of skin is impacted by poor nutrition according to the text?

Skin color and allergies Signup and view all the answers

How are 'clean-contaminated wounds' described in the text?

Uninfected wounds with minimal inflammation Signup and view all the answers

What is the characteristic of a 'Contusion' injury as described in the text?

It is a closed wound resulting in ecchymosis (bruising) Signup and view all the answers

Which factor contributes to Pressure Ulcers according to the text?

Decreased mobility Signup and view all the answers

What is the significance of a Braden Scale score of 23 points?

Low risk of developing pressure ulcers Signup and view all the answers

In the context of nursing management, what does 'Risk for Infection' imply?

The client is immunocompromised and prone to infection Signup and view all the answers

What is the main purpose of 'Preventing PUs' as mentioned in the text?

To implement strategies to avoid pressure ulcer development Signup and view all the answers

Which component is NOT part of the Braden Scale for assessing pressure ulcer risk?

Presence of slough or eschar Signup and view all the answers

Factors Affecting Skin Integrity and Pressure Ulcers

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Questions and Answers

Which factor does NOT affect skin integrity according to the text?

What is the largest organ in the body according to the text?

Which factor can impair skin integrity?

What is one of the functions of intact skin according to the text?

Which condition makes skin on the legs damage more easily?

What type of wound is caused by accidental trauma?

Skin color and allergies are examples of factors related to which aspect of skin integrity?

What is the impact of poor nutrition on skin integrity?

In what way do chronic illnesses affect skin integrity?

What is the main purpose of understanding factors affecting skin integrity for nurses?

What are some measures mentioned in the text to promote optimal skin condition?

Which medication is specifically highlighted in the text as affecting skin integrity?

What is the maximum score on the Braden Scale?

What does a Braden Scale score of ≤ 18 points indicate?

Which of the following is NOT one of the subscales in the Braden Scale?

What is the main purpose of a Risk Assessment Tool in pressure ulcer prevention?

What does a Norton Scale score between 14-10 indicate?

In nursing management, what is assessed during the diagnosing phase related to skin integrity?

What is recommended for preventing pressure ulcers regarding skin hygiene?

What is a common nursing intervention for preventing pressure ulcers related to repositioning?

What should be done at each dressing change when treating a pressure ulcer?

What should be considered for medication in the treatment of pressure ulcers?

What does a Norton Scale score > 18 indicate?

What is essential in assessing pressure ulcers regarding nursing management?

Which type of wound involves accidental wounds and surgical wounds with a major break in sterile technique?

What does an 'Incision' type of wound involve?

Which position is considered common for pressure ulcers?

What is the defining characteristic of Stage I pressure ulcers?

Which type of wound involves tissue torn apart and often occurs from accidents?

What does 'Full-thickness Tissue Loss' involve in the context of pressure ulcers?

What causes Pressure Ulcers?

'Dirty or infected wounds' are characterized by:

Why is it important for nurses to understand the factors affecting skin integrity?

Which factor does NOT affect skin integrity according to the text?

How do chronic illnesses affect skin integrity?

What aspect of skin integrity do skin color and allergies fall under?

What should be done at each dressing change when treating a pressure ulcer?

What is the impact of poor nutrition on skin integrity?

What type of wound is characterized by open, fresh, accidental wounds and surgical wounds involving a major break in sterile technique?

In the context of wound classification, which wound type typically involves tissues that are torn apart and often occurs from accidents?

What does a 'Partial-thickness' wound involve?

Which position is NOT considered common as a pressure site leading to pressure ulcers?

What is the characteristic of a Stage II pressure ulcer?

What does 'Iatrogenesis' refer to in the context of describing wounds?

What is the maximum score on the Norton Scale for assessing pressure ulcers?

Which subscale is NOT part of the Braden Scale for pressure ulcer risk assessment?

In the context of pressure ulcers, what does 'Unstageable' mean?

What is the primary factor considered in determining a client's risk level according to the Norton Scale?

What is the significance of a Braden Scale score of 18 points?

What should be the first step in any pressure ulcer prevention model according to the text?

How does the Norton Scale categorize individuals with scores between 14-10 points?

Which factor is NOT mentioned as affecting skin integrity in the text?

What is the defining characteristic of a Stage II pressure ulcer according to the text?

In what way do chronic illnesses impact skin integrity according to the text?

What type of wound is characterized by open, fresh, accidental wounds and surgical wounds involving a major break in sterile technique?

Which wound description involves an open wound penetrating the skin and often the underlying tissues by a sharp instrument?

What does 'Full-thickness Tissue Loss' involve in the context of pressure ulcers?

What is the maximum score on the Norton Scale for assessing pressure ulcers?

What is the main purpose of using risk assessment tools in pressure ulcer prevention?

What does 'Suspected deep tissue injury' in pressure ulcers refer to?

What is an essential aspect of nursing intervention in treating pressure ulcers?

What is the maximum score on the Norton Scale for assessing pressure ulcers?

In the Braden Scale, what is the significance of a score of 18 points?

What is the primary factor considered in determining a client's risk level according to the Norton Scale?

What is a common nursing intervention for preventing pressure ulcers related to repositioning?

What does 'Full-thickness Tissue Loss' involve in the context of pressure ulcers?

What factors can affect skin integrity, as discussed in the text?

Why is it important for nurses to understand the factors affecting skin integrity?

Which aspect of skin is impacted by poor nutrition according to the text?

How are 'clean-contaminated wounds' described in the text?

What is the characteristic of a 'Contusion' injury as described in the text?

Which factor contributes to Pressure Ulcers according to the text?

What is the significance of a Braden Scale score of 23 points?

In the context of nursing management, what does 'Risk for Infection' imply?

What is the main purpose of 'Preventing PUs' as mentioned in the text?

Which component is NOT part of the Braden Scale for assessing pressure ulcer risk?

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