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.

Test your knowledge on the phases of wound healing, including the inflammatory phase and proliferative phase. Learn about how platelets control bleeding, white blood cells remove bacteria, and tissue development during the healing process.