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Vascular Wounds Quiz

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Questions and Answers

Which of the following factors is NOT a risk factor for arterial insufficiency ulcers?

Obesity

High physical activity levels (correct)

Diabetes

Smoking

What ankle-brachial index (ABI) value indicates better prognosis for arterial insufficiency ulcers?

<0.3

0.5 - 0.8

>0.8

>0.5 (correct)

Which of the following statements regarding the prognosis of arterial insufficiency ulcers is true?

Not observing a wound healing within 2 weeks necessitates a change in plan of care. (correct)

A wound that does not decrease in size after 2 weeks should be aggressively treated with standard care.

Transcutaneous oxygen levels greater than 30 mmHg indicate a poor prognosis.

A toe pressure of 30 mmHg predicts a positive prognosis.

What is a common requirement for all open wounds, particularly those that might indicate arterial insufficiency?

Pulse examination Signup and view all the answers

Which of the following complications is associated with vascular wounds specifically?

Arterial insufficiency ulcer Signup and view all the answers

What is the maximum time allowed for capillary refill to be considered normal?

3 seconds Signup and view all the answers

What indicates arterial insufficiency based on the rubor of dependency test?

Color turns bright red after 30 seconds Signup and view all the answers

Which treatment is recommended for deep tissue infections?

Systemic antibiotic therapy Signup and view all the answers

What is the normal venous filling time range?

15-20 seconds Signup and view all the answers

What type of dressing is suitable for arterial ulcers with minimal exudate?

Moist, non-adherent dressing Signup and view all the answers

Which of the following should be avoided in patients with an ABI greater than 0.80?

High compression (30-40 mmHg) Signup and view all the answers

What is the least harmful wound cleanser for mildly infected wounds?

0.9% saline Signup and view all the answers

What condition should prompt referral to a vascular surgeon?

ABI of less than 0.50 Signup and view all the answers

Study Notes

Vascular Wounds

Arterial Insufficiency Ulcers are caused by insufficient blood flow to the extremities, leading to wounds that are slow to heal (if at all).
Risk Factors for Arterial Insufficiency Ulcers:
- Atherosclerosis
- Overweight and Obesity
- Diabetes
- Smoking
- Hypertension
- Age
- Cardiovascular Disease
Prognosis for Arterial Insufficiency Ulcers:
- Good Prognosis: Ankle Brachial Index (ABI) > 0.5, Toe Pressure > 50 mmHg, Transcutaneous Oxygen Levels > 30 mmHg.
- Poor Prognosis: If wound doesn't decrease in size or heal within 2 weeks, referral to a vascular surgeon is needed.
Pulse Examination: Is essential for all open wounds.

Assessing Vascular Status

Capillary Refill Test:
- Normal: Blood returns in 3 seconds or less.
- Impaired: Blood returns after more than 3 seconds.
Venous Filling Time:
- Normal: 15-20 seconds.
- Arterial Insufficiency: >15-30 seconds.
Rubor of Dependency Test:
- Normal: Color returns to the foot within 15 seconds.
- Arterial Insufficiency: Color returns after 30 seconds and turns bright red.

Wound Management:

Infection Control:
- Ischemic wounds are susceptible to bacterial infections.
- Consider bacterial swab if classical signs of infection aren't present.
- Topical treatments: Silver dressings, cadexomer iodide.
- Deep tissue infections: Systemic antibiotics.
Wound Cleansing:
- Use 0.9% saline for wound cleansing - other solutions can be toxic.
Dressing:
- Arterial ulcers have minimal exudate and fragile surrounding skin.
- Use moist, non-adherent dressings with antimicrobial properties.

Precautions for Patients with Arterial Insufficiency

Compression therapy:
- Avoid high compression (30-40 mmHg) if ABI is above 0.80.
- Avoid compression dressings for patients with ABI greater than 0.50 - Refer to a vascular surgeon.
Debridement:
- Never use sharps to remove debris from wounds with low ABI.

Pressure Ulcers and Risk Factors

Impaired Sensation:
- Lack of pain as an early warning sign of tissue ischemia.
- Individuals with impaired sensation are less likely to reposition themselves, making pressure ulcers more likely.
- Common causes: Spinal cord injuries, Spina Bifida, Stroke, Full thickness burns, and Peripheral Neuropathy.
Impaired Mobility:
- Hospitalization, diagnosis, and surgery can contribute to mobility issues.
- Typically occurs within 3 weeks of surgery and within 1 week of admission to a nursing home.
Previous Pressure Ulcer:
- Scar tissue is 80% as strong as the original tissue.
- Scar tissue + pressure injury = reduced tolerance to external load.
Other Risks: Individuals with high Diastolic Blood Pressure (DBP) are at increased risk.

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Description

Test your knowledge on arterial insufficiency ulcers and their assessment methods. This quiz covers risk factors, prognosis, and key examinations like capillary refill and venous filling time. Ideal for students and professionals in healthcare.