Skin Wound Healing- Week 2
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Questions and Answers

What is a key parameter to consider when performing a wound assessment?

  • Wound exudate (correct)
  • Patient's blood type
  • ethnicity of patient
  • Patient's age

    • In wound assessment, what does the extent of tissue involvement refer to?

  • Patient's previous medical history
  • Skin type (moisture levels)
  • The depth of the wound (correct)
  • The circumference of the wound

    • When assessing a wound, what should be noted in terms of wound size?

  • Wound progression in healing phases
  • Wound dimensions like width, length, and depth (correct)
  • The patients whole integ system
  • Patient's pain level

    • What should be considered when identifying the type of wound during assessment?

    <p>The etiology of the wound such as surgical or pressure injury</p> Signup and view all the answers

    How does medication impact wound healing?

    <p>Can sometimes delay wound healing</p> Signup and view all the answers

    What is the primary focus during the Planning stage of patient care according to Dr. Ide Costa's lecture?

    <p>Identifying prevention interventions</p> Signup and view all the answers

    In the Implementation stage of patient care, what is emphasized in terms of topical care?

    <p>Health promotion through proper positioning</p> Signup and view all the answers

    What is crucial to assess during the Evaluation stage of patient care related to skin integrity and wound healing?

    <p>Patient's understanding about skin integrity</p> Signup and view all the answers

    During the maturation phase of wound healing, what happens to the tensile strength of the healed tissue?

    <p>It reaches approximately 80% of the original skin</p> Signup and view all the answers

    When documenting wound appearance, what should be noted regarding granulation tissue?

    <p>It should account for 50% of the wound bed tissue</p> Signup and view all the answers

    In primary intention wound healing, what is a characteristic of the wound edges?

    <p>The wound edges remain close together</p> Signup and view all the answers

    What characterizes wound healing through tertiary intention?

    <p>Leaving wounds open to allow healing by scar formation</p> Signup and view all the answers

    In secondary intention wound healing, what fills in the area of tissue loss?

    <p>Granulation tissue</p> Signup and view all the answers

    How long does the healing process typically last in wounds that are closed but will continue to heal?

    <p>2 years</p> Signup and view all the answers

    What is the primary purpose of the hemostasis phase in wound healing?

    <p>Stop bleeding by coagulation</p> Signup and view all the answers

    Which type of cells are essential for cleaning the wound and defending it against bacteria during the inflammatory phase?

    <p>Macrophages</p> Signup and view all the answers

    What is the main function of fibroblasts during the proliferative phase of wound healing?

    <p>Synthesize collagen</p> Signup and view all the answers

    During which phase of wound healing does angiogenesis occur?

    <p>Proliferative phase</p> Signup and view all the answers

    Which cellular events take place to achieve resurfacing, reconstitution, and restoration of tensile strength in injured tissue during wound healing processes?

    <p>Formation of granulation tissue</p> Signup and view all the answers

    Which of the following is NOT one of the key principals included in the acronym TIME for wound bed preparation?

    <p>Cell regeneration</p> Signup and view all the answers

    What is the main focus of selecting a dressing for a wound?

    <p>The characteristics of the wound</p> Signup and view all the answers

    Which phase of wound healing involves vasodilation, edema, exudate formation and macrophage/ leucocyte presences?

    <p>Inflammation</p> Signup and view all the answers

    How does infection impact the wound healing process?

    <p>It slows down healing by causing inflammation</p> Signup and view all the answers

    What is the purpose of wound packing in wound care management?

    <p>To fill dead space and prevent abscess formation</p> Signup and view all the answers

    In wound care, what type of gauze is typically used for filling narrow areas?

    <p>Ribbon gauze</p> Signup and view all the answers

    During an episode of acute bleeding, what is the priority in applying a pressure bandage?

    <p>Stopping blood flow and promoting clotting</p> Signup and view all the answers

    What is the primary use of an abdominal binder in post-operative care?

    <p>To support large abdominal incisions and reduce post-op pain</p> Signup and view all the answers

    Which nursing diagnosis is related to insufficient knowledge regarding pressure injury prevention?

    <p>Insufficient knowledge regarding pressure injury prevention</p> Signup and view all the answers

    What is a key principle of patient-centered wound care highlighted in the lecture?

    <p>Accommodating different cultures and religious practices</p> Signup and view all the answers

    Which of the following is NOT a step emphasized in Principles of wound management lecture?

    <p>Using any type of gloves when changing a dressing</p> Signup and view all the answers

    What type of dressing is known to keep the wound moist for increased wound healing?

    <p>Hydrogel dressing</p> Signup and view all the answers

    What is the significance of assessing a patient's or caregiver's knowledge of wound care?

    <p>To ensure they apply the dressings correctly</p> Signup and view all the answers

    Why is it important to identify the cause and type of wound in wound management?

    <p>To select the appropriate wound cleansing agents</p> Signup and view all the answers

    What action can help prevent accidental dislocation of wound drainage tubes when changing the dressing?

    <p>Being mindful of the tubes' presence during the process</p> Signup and view all the answers

    Which type of dressing is particularly good at managing wounds with high levels of exudate?

    <p>Alginate dressing</p> Signup and view all the answers

    What is a key reason for emphasizing hand hygiene before and after dressing changes?

    <p>To prevent contamination and infection</p> Signup and view all the answers

    Pressure ulcer prevention strategies often focus on:

    <p><strong>Regularly changing positions</strong></p> Signup and view all the answers

    How can medication impact wound healing?

    <p>By suppressing the immune response, delaying healing.</p> Signup and view all the answers

    Match all below.

    <p>Stage 1 = intact skin with a darkened area Stage 2 = partical thickness skin loss with exposed dermis Stage 3 = full thickness skin loss without adipose tissue exposure Stage 4 = full thickness tissue loss with exposed fascia, muscle and/or bone</p> Signup and view all the answers

    A deep tissue injury is not gradable due variation in skin integrity. Can be intact or not intact skin with blanch-able deep red or maroon discolouration revealing blood filled blisters.

    <p>False</p> Signup and view all the answers

    An unstageable pressure injury is a full thickness skin and/or tissue loss where the loss cannot be determined due to obscure slough and eschar.

    <p>True</p> Signup and view all the answers

    What does the numonic for evidence-based practice or pressure injury prevention stand for? (ADSD)

    <p>A- assess, D- document, S- score, D- detect</p> Signup and view all the answers

    An acute wound progresses through the normal stages of wound healing and show clear signs of healing within four weeks. (ex. abrasion, lacerations, surgical incisions)

    <p>True</p> Signup and view all the answers

    A chronic wound doesn't progress normally through the four stages of healing often getting stalled at one of the phases. They also show no evidence of healing within four weeks. (venous, arterial or diabetic ulcers)

    <p>True</p> Signup and view all the answers

    MATCH the stages of healing

    <p>Hemostasis = purpose is to stop the bleeding and start immediately after injury Inflammatory = there is vasodilatation to the wound increasing the presents of plasma and WBC (Leukocytes &amp; macrophages) Proliferative = production of new granulation tissue occurring which increase 02 and nutrients present Remodling = the formation of a scar where collagen is remodelling and tensile strength is at 80% of normal</p> Signup and view all the answers

    match the types of wounds

    <p>primary = the edges of the wound are clean and remain close together which has fastest healing time secondary = occur due to loss of skin tissue and is an open wound which has granulated tissue generation tertiary = known as delayed primary intention or closure and occurs when surgical incision is left open for 3-5 days N/A = N/A</p> Signup and view all the answers

    What is not a factor affecting healing processes?

    <p>ethnicity, gender, type of wound</p> Signup and view all the answers

    Study Notes

    Wound Assessment

    • A key parameter to consider when performing a wound assessment is the extent of tissue involvement.
    • When assessing a wound, the wound size should be noted in terms of length, width, and depth.
    • The type of wound should be identified, considering factors such as wound edges, granulation tissue, and tissue loss.

    Wound Healing

    • Medication can impact wound healing by affecting the healing process.
    • The primary focus during the Planning stage of patient care is to identify the type of wound and develop a plan for wound management.
    • During the Implementation stage, topical care is emphasized, including dressing selection and wound cleaning.
    • During the Evaluation stage, skin integrity and wound healing should be assessed.
    • During the maturation phase of wound healing, the tensile strength of the healed tissue increases.
    • In primary intention wound healing, the wound edges are well-approximated, and the wound is closed.
    • In secondary intention wound healing, granulation tissue fills in the area of tissue loss.
    • In tertiary intention wound healing, the wound is left open and then closed at a later time.
    • The healing process typically lasts several weeks in wounds that are closed but will continue to heal.

    Wound Healing Phases

    • The primary purpose of the hemostasis phase is to stop bleeding.
    • During the inflammatory phase, neutrophils and macrophages clean the wound and defend it against bacteria.
    • During the proliferative phase, fibroblasts produce collagen to strengthen the wound.
    • Angiogenesis occurs during the proliferative phase, allowing for new blood vessel formation.
    • During the remodeling phase, cellular events take place to achieve resurfacing, reconstitution, and restoration of tensile strength in injured tissue.

    Wound Care Management

    • The primary purpose of wound packing is to remove dead tissue and debris.
    • In wound care, gauze is typically used for filling narrow areas.
    • During an episode of acute bleeding, the priority is to apply a pressure bandage to stop the bleeding.
    • An abdominal binder is used in post-operative care to provide support and stability.
    • Insufficient knowledge regarding pressure injury prevention is a key nursing diagnosis.
    • A key principle of patient-centered wound care is to emphasize education and involvement in wound management.

    Wound Types and Prevention

    • An acute wound progresses through the normal stages of wound healing and shows clear signs of healing within four weeks.
    • A chronic wound doesn't progress normally through the four stages of healing and often gets stalled at one of the phases.
    • Pressure ulcer prevention strategies often focus on reducing pressure and ensuring proper wound care.
    • The mnemonic ADSD stands for evidence-based practice or pressure injury prevention.
    • A deep tissue injury is not gradable due to variation in skin integrity.
    • An unstageable pressure injury is a full-thickness skin and/or tissue loss where the loss cannot be determined due to obscure slough and eschar.

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    Related Documents

    Skin Integrity and Wound Care Lecture Notes PDF

    Description

    Test your knowledge on wound packing and cleansing techniques such as using gauze impregnated with hydrogel for undermining, and ribbon gauze for filling narrow areas. Learn about the purpose of wound packing to promote healing and prevent abscess formation.

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