Wound Healing Phases Quiz

Medication Administration

• The 10 rights of medication administration: right medication, right dose, right patient, right route, right time and frequency, right documentation, right reason, right to refuse, right patient education, and right evaluation.
• Always make 3 checks before administering dosage.
• Oral medications for clients with trouble swallowing: crush medication, crush into liquid, contact a language speech doctor, contact a dietitian, and perform a swallowing examination.

Routes of Medication Administration

• Topical route: skin applications, use of gloves or applicators, preparation of skin, and thickness of application.
• Transdermal patch: use on skin for slow release of medication.
• Nasal route: nasal instillation, nasal spray, drop, or tampon, assessment of nares, patient instruction, and self-administration.
• Eye route: eye instillation, drops, ointments, intraocular disc, assessment of eyes, asepsis, and positioning.
• Ear route: ear instillation, assessment of ear canal, warming of solution, and straightening of canal for children and adults.
• Suppositories: vaginal instillation, suppositories, foams, jellies, creams, use of gloves and applicator, self-administration, patient positioning, comfort, and hygiene.
• Rectal instillation: suppositories, use of gloves, patient positioning, comfort, and hygiene.
• Inhalation: metered-dose inhalers (MDIs), dry powder inhalers (DPIs), and slow-stream inhaler devices, patient assessment and instruction, use of spacer, and determination of doses in canister.
• Irrigation: medications used to wash out a body cavity, delivered with a stream of solution (sterile water, saline, or antiseptic), asepsis or clean technique, depending on location.

IM and SC Injections

• IM injections: 90-degree angle, faster medication absorption than SC route.
• SC injections: 45-degree angle, best site for a child: Vastus lateralis.
• Math for medication: Desired / Have x quantity.
• Gauge sizes: smaller number = bigger gauge, bigger number = smaller gauge.

Wound Management

• Approximation: connection, edges being brought together.
• Contusion: bruise from direct blow or impact.
• Debridement: removal of dead or infected skin tissue to help a wound heal.
• Dehiscence: splitting open of a wound or an organ to discharge its contents.
• Ecchymotic: bruise, blood leaks out of blood vessels into the top layer of skin.
• Eschar: dead tissue that sheds or falls off from the skin.
• Evisceration: extrusion of viscera outside the body, especially through a surgical incision.
• Exudate: fluid that oozes out from blood vessels, odour can be strong (infection).
• Hemostasis: process to prevent and stop bleeding.
• Laceration: tearing or rupturing of soft tissue.
• Paresthesia: sensation of tingling, burning, pricking, or prickling of skin.
• Suppuration: formation of, conversion into, or process of discharging pus.
• Hematoma: area of blood that collects outside of the larger blood vessels.
• Serous: pertaining to serum, thin and watery.
• Serosanguineous: containing or consisting of both blood and serous fluid.
• Sanguineous: related to or containing blood.
• Purulent: containing, discharging, or causing the production of pus.
• Primary intention: wound healing, wound edges are approximated, healing is faster.
• Secondary intention: wound healing, sides of the wound are not opposed, healing occurs from the bottom of the wound upwards.
• Blanching: pale or whitening of the skin, capillaries are broken if stays white.
• Reedap: abbreviation for checking wounds (redness, edema, ecchymosis, depth, approximation, pain).

Pressure Ulcers

• Classification: Stage 1 - non-blanchable erythema of intact skin, Stage 2 - presents as an abrasion, blister, or shallow crater, Stage 3 - deep crater with or without undermining or adjacent tissues, Stage 4 - full thickness, skin loss with extensive tissue destruction.
• Wound classifications: Acute (surgical) - follows normal healing processes, clean and intact edges, easy to clean; Chronic (ulcer) - does not heal easily, skin does not return to its normal appearance and function.

Phases of Wound Healing

• Inflammatory phase: lasts up to 3 days, platelets begin the process of controlling bleeding and clot formation, WBCs reach the area to remove bacteria and other debris.
• Proliferative phase: lasts 3-24 days, granulation, tissue development, various reparative cells secrete collagen and build new capillaries, soft pink/red in color, wound contraction occurs.
• Remodeling phase: occurs for more than a year, wound tissue gains greater strength as new collagen continues to form, scar tissue is only 80% as strong as original tissue.

Complications of Wound Healing

• Hemorrhage: internal/external, drains, hematoma formation.
• Infection: develops 4th-5th day post-op, drainage - purulent.
• Dehiscence: most likely 3-11 days after injury, "something gave way".
• Evisceration: serious, requires surgery, visceral organs protruding.
• Fistula formation: abnormal passage between 2 organs or between an organ and the outside body, related to poor healing or disease complication.

Wound Care

• Exudate: quality, quantity, wound dressing products, different ulcer types.
• Exudate - Quantity: small, moderate, large (copious).
• Wound dressing products: Iodosorp dressing, Anticoat dressing, Mesalt dressing, Providine-iodine (Betadine), Gels (Intrasite gel, Duoderm gel).

Ulcer Types

• Arterial ulcers: result from complete or partial blockage of the arteries, known as arterial insufficiency.
• Diabetic ulcer: diabetes affects circulation as well as the nerve endings in the feet.
• Venous leg ulcers: shallow, irregular shaped ulcers that often appear beefy and red, typically located below the knee.
• Braden wound scale: describes severity of ulcers, 1 being low, 4 being high, 6 categories: sensory perception, moisture, activity, mobility, nutrition, friction and shear.