Wound Care Management Quiz

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Questions and Answers

What is a key purpose of a dressing on a healing wound?

To eliminate the need for any follow-up care.

To support the wound site while allowing complete air exposure.

To prevent all types of infections.

To promote thermal insulation and maintain moisture. (correct)

Which method is recommended for educating patients on dressing changes?

Using a return demonstration to ensure understanding. (correct)

Providing lengthy verbal instructions without practical demonstration.

Recommending they read about the process online.

Discouraging questions about the dressing change process.

What should be monitored to assess a patient's nutritional status during wound care?

The color of the dressing material.

The frequency of dressing changes.

The temperature of the wound dressing.

White blood cell count and protein levels. (correct)

In the context of wound management, when is the use of binders or wraps particularly indicated?

For covering exposed wounds or abrasions. Signup and view all the answers

What is the primary difference between dressing care for wounds healing by primary intention versus secondary intention?

Secondary intention needs a moist wound environment to promote healing. Signup and view all the answers

What action should be taken if a dressing becomes stuck to a wound's suture line?

Soak the dressing to loosen it before removal. Signup and view all the answers

Which type of data is essential to record when monitoring the healing progression of wounds?

Wound drainage characteristics and vital signs. Signup and view all the answers

When is it necessary to consult with a wound ostomy continence nurse (WOCN)?

When there is a complex wound care issue that requires specialized knowledge. Signup and view all the answers

What is the primary purpose of the secondary lumen in a Salem Sump tube?

To prevent suctioning of gastric mucosa into the main lumen Signup and view all the answers

When choosing an NG tube for a patient unable to take food by mouth, which option is preferred for comfort?

A small-bore feeding tube Signup and view all the answers

What should be avoided when managing a Salem Sump tube's air vent?

Connecting it to suction Signup and view all the answers

What type of water should be used for reconstituting powdered formula in immunocompromised patients?

Purified water Signup and view all the answers

Which of the following actions should a nurse take after a patient has undergone gastric surgery regarding the NG tube?

Leave the NG tube in place and do not reposition it Signup and view all the answers

Which enzyme is NOT secreted by the pancreas?

Sucrase Signup and view all the answers

What process is primarily responsible for mixing pancreatic secretions with chyme in the small intestine?

Peristalsis Signup and view all the answers

Which of the following is a consequence of inadequate fiber intake?

Constipation Signup and view all the answers

Which water-soluble vitamin is primarily required for collagen synthesis?

Vitamin C Signup and view all the answers

In the digestion of carbohydrates, which products are formed in the small intestine?

Glucose, fructose, and galactose Signup and view all the answers

Which form of dietary fiber is known for helping to remove waste products from the body?

Insoluble fiber Signup and view all the answers

How long does it generally take for food to pass through the small intestine?

5 hours Signup and view all the answers

What common issue can arise from a diet lacking adequate fiber?

Abdominal bloating Signup and view all the answers

Which of the following is NOT a function of lipase secreted in the small intestine?

Break down proteins Signup and view all the answers

What should be considered when choosing a diet to promote normal elimination?

Characteristics of feces Signup and view all the answers

What is the primary reason patients with ileostomies need to increase their fluid intake?

To replace lost fluid and salt Signup and view all the answers

Which of the following correctly describes saturated fatty acids?

They should not exceed 10% of daily intake. Signup and view all the answers

What is the composition of triglycerides?

One glycerol molecule and three fatty acids Signup and view all the answers

Which type of fatty acid is considered essential for humans?

Linoleic acid Signup and view all the answers

What is the caloric content of fats per gram?

9 kcal/g Signup and view all the answers

Which of the following fatty acids is primarily found in animal fats?

Saturated fatty acids Signup and view all the answers

What is the storage capacity for fat-soluble vitamins in the body?

High, potentially leading to toxicity Signup and view all the answers

What occurs when fat intake falls below 10% of daily nutrition?

Deficiency of essential fatty acids Signup and view all the answers

How are the fat-soluble vitamins primarily acquired?

From dietary intake primarily Signup and view all the answers

What kind of fatty acids do monounsaturated fats contain?

One double bond Signup and view all the answers

What is the recommended daily fluid intake for infants, expressed in mL/kg?

100 to 120 mL/kg Signup and view all the answers

Why should infants under one year not consume cow's milk?

It's too concentrated for their kidneys and lacks essential nutrients. Signup and view all the answers

What is considered the typical first semisolid food introduced to infants?

Iron-fortified cereals Signup and view all the answers

What nutritional change occurs in toddlers compared to infants?

Decreased kilocalories but increased protein needs Signup and view all the answers

Which nutrient is particularly important for bone growth in toddlers?

Calcium Signup and view all the answers

What risk is associated with excessive milk consumption in toddlers?

Risk of milk anemia due to low iron intake Signup and view all the answers

What is the significance of breastfeeding according to the American Academy of Pediatrics (AAP)?

It should be continued exclusively for the first 6 months. Signup and view all the answers

At what age can children start having complementary foods along with breastfeeding?

6 months Signup and view all the answers

What commonly known food should never be given to infants under one year?

Corn syrup Signup and view all the answers

What dietary strategy is beneficial for improving nutritional intake in toddlers?

Three frequent meals with interspersed high-nutrient snacks Signup and view all the answers

Study Notes

Wound Care

Provide high protein, zinc, copper, vitamins A and C
Administer pain medication
Monitor prealbumin and albumin levels
Monitor white blood cell count
Administer antibiotics
Consult with dietitian, nutritionist, social worker, and WOCN
Use binders or wraps to cover exposed wounds with sterile dressings
Monitor vital signs, especially temperature
Use NPWT
Debride if ordered

Patient Education

Educate patients and families on:
- treatment purpose
- changing dressings
- recognizing infection
- disposing of old dressings
- wound healing
- when to contact health care provider
- next follow-up visit
Have patient and/or family member perform a return demonstration before discharge
Provide written instructions
Provide video and image support
Determine patient’s acceptance and coping abilities with wound/injury
Use active listening and therapeutic communication
Consult with social worker and WOCN

Dressings

Protect wound from microorganisms
Aid in hemostasis
Promote healing by maintaining wound moisture
Absorb drainage and debride the wound
Support or splint the wound
Promote thermal insulation
Gauze dressings:
- sponges for packing wounds with depth and drainage
- topper dressing for shallow wounds
- wicking dressing for wound drainage

Ileostomy Management

Encourage drinking 8 ounces of fluid after emptying the pouch to stay hydrated

Fat Function

Most calorie-dense nutrient, providing 9kcal/g
Composed of triglycerides and fatty acids
Triglycerides circulate in the blood and contain three fatty acids attached to a glycerol
Fatty acids are chains of carbon and hydrogen atoms; they are saturated or unsaturated
Dietary fat should not exceed 10-35% of daily intake
Saturated fats are animal based and solid at room temperature
Unsaturated fats are plant based and liquid at room temperature
Monounsaturated fatty acids have one double bond
Polyunsaturated fatty acids have two or more double carbon bonds
Essential fatty acids:
- Linoleic acid (unsaturated)
- Linolenic acid (unsaturated)
- Arachidonic acid (unsaturated)
The body manufactures linolenic and arachidonic when linoleic acid is available
Fat-soluble vitamins (A, D, E, and K) are stored in the fatty compartments of the body and are acquired through diet
Pancreatic secretions:
- Amylase - digests starch
- Lipase - breaks down emulsified fats
- Trypsin, elastase, chymotrypsin, and carboxypeptidase - break down proteins

Small Intestine Digestion

Peristalsis mixes secretions with chyme
The mixture becomes increasingly alkaline, inhibiting gastric enzymes and promoting duodenal secretions
Epithelial cells in small intestinal villi secrete enzymes for digestion
Major digestion occurs in the small intestine:
- Carbohydrates break down into glucose, fructose, and galactose
- Proteins break down into amino acids and dipeptides
- Lipids break down into fatty acids, glycerides, and glycerol
Peristalsis takes approximately 5 hours to move food through the small intestine

Water Soluble Vitamins

Vitamins C and B complex
Body does not store water-soluble vitamins, they are needed in daily food intake
Easily absorbed from the GI tract
Toxicity can still occur

Fiber Intake

Encourage patients to eat fiber to prevent constipation
Signs of inadequate fiber:
- Constipation
- Abdominal bloating
- Infrequent bowel movements
- Hard stools
- Straining during bowel movements
Fiber helps with waste removal from the body
Bulk forming foods such as whole grains, fresh fruits, and vegetables
Certain foods such as cabbage, broccoli, or beans produce gas which increases colonic motility

Nutrition for Different Age Groups

Premature infants need higher amounts of energy for growth
Commercial formulas and breast milk provide approximately 20 kcal/oz
Full term newborns can digest simple carbohydrates, proteins, and emulsified fat
Infants need 100-120 mL/kg/day of fluid
The American Academy of Pediatrics (AAP) recommends breastfeeding from birth to 6 months, and continues with breastfeeding and complementary foods from 6 to 12 months.
Infant formulas contain the nutrient composition of human milk. Protein in the formula is typically whey, soy, cow's milk, casein hydrolysate, or elemental amino acids
Infants should not have regular cow's milk during their first year of life
Infants under 1 year old should not ingest honey or corn syrup due to botulism toxin risk
Breast milk or formula provides sufficient nutrition for the first 4- 6 months of life
Iron-fortified cereals are typically the first solid food introduced
Cereals are the most important nonmilk source of protein for 4-11 month olds
Growth rate slows during toddler years (1-3 years)
Toddlers need fewer kilocalories, but an increased amount of protein
Toddlers exhibit strong food preferences
Toddlers need to drink whole milk until the age of 2
Children who consume more than 24 ounces of milk in place of other foods may develop milk anemia

Nasogastric (NG) Tube Positioning

Tubes are placed by nurses at the bedside without visualization of the GI tract
Levin and Salem Sump tubes are common for stomach decompression
Levin tube has one lumen with holes at the tip and is connected to a drainage bag or suction device
Salem Sump tube has two lumens: one for removal of gastric contents and the other for air vent to prevent suction of gastric mucosa
NG tube is inserted with clean technique and the smallest lumen that is effective should be used
NGT can be used to initiate enteral feedings when a patient is unable to safely take food by mouth
Supportive care includes changing soiled tape, ensuring tube is not dislodged, and ensuring adequate function
Lubricate and clean the nares
Provide frequent mouth care
Do not reposition the NG tube if the patient has undergone gastric surgery

Water for Flushes and Medication

Select water based on the patient's immunocompromised state
Tap water may be contaminated and pose a risk
Contaminated water has been linked to outbreaks of infections
Use purified or sterile water for flushing and medication preparation
Use sterile water for reconstituting powdered formula and all procedures involving immunocompromised patients.

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Description

Test your knowledge on effective wound care management techniques, patient education, and dressing procedures. This quiz covers essential aspects like nutrition, infection recognition, and consultation processes to ensure optimal healing. Ideal for nursing students and healthcare professionals.