Wound Types and Healing Intentions

A superficial, partial-thickness wound scraped or rubbed away.

A collection of pus and necrotic tissue resulting from an infectious process.

A bruise

<p>Severe trauma caused by an extreme force or weight compressing part of the body.</p> Signup and view all the answers

<p>A superficial, partial-thickness wound caused by scratching or abrasion of the skin.</p> Signup and view all the answers

<p>A clean and linear wound created by cutting into the skin and tissues with a scalpel or other sharp instrument.</p> Signup and view all the answers

<p>A torn or jagged wound caused by blunt trauma that rips or splits the skin and underlying tissue.</p> Signup and view all the answers

<p>A wound when an object pierces the skin and enters the body, creating an open wound (perforating wound if it passes completely through).</p> Signup and view all the answers

<p>A small, circular wound caused by a sharp pointed object piercing the skin.</p> Signup and view all the answers

<p>A wound where the tissue is destroyed or separated from the underlying structures.</p> Signup and view all the answers

<p>A clean, surgical incision/wound with minimal scarring that is quickly established.</p> Signup and view all the answers

<p>Healing of a large, open wound from the base up and edges inward.</p> Signup and view all the answers

<p>A wound that is left open and allowed to granulate, then surgically re-approximated.</p> Signup and view all the answers

<p>Venous stasis ulcer (A), Arterial ulcer (B), Pressure injury (C), Diabetic foot ulcer (E)</p> Signup and view all the answers

<p>Inadequate arterial blood supply (PAD).</p> Signup and view all the answers

<p>Venous insufficiency.</p> Signup and view all the answers

<p>Hemostasis, inflammatory, proliferative, and maturation.</p> Signup and view all the answers

<p>Clotting and redness/pain.</p> Signup and view all the answers

<p>Granulation tissue forms, new blood vessels grow.</p> Signup and view all the answers

<p>Collagen is remodeled and scar tissue forms.</p> Signup and view all the answers

<p>The inflammatory phase, epithelial proliferation, and maturation.</p> Signup and view all the answers

<p>Hemostasis, inflammatory, proliferative, and maturation phases.</p> Signup and view all the answers

<p>Surgical glue (A), Adhesive strips (B), Surgical staples (C), Sutures (E)</p> Signup and view all the answers

<p>Straw-colored drainage without blood.</p> Signup and view all the answers

<p>Bloody drainage.</p> Signup and view all the answers

<p>A mix of serous exudate and sanguineous drainage.</p> Signup and view all the answers

<p>Pus, yellow, or green.</p> Signup and view all the answers

<p>Blood and pus.</p> Signup and view all the answers

<p>Hemorrhage is bleeding, including hematoma (internal bleeding). It is a risk factor after surgery, and it's important to check beneath the wound dressings.</p> Signup and view all the answers

<p>Poor nutritional status.</p> Signup and view all the answers

<p>A surgical incision that doesn't heal properly, causing a separation of the wound edges.</p> Signup and view all the answers

<p>Complete separation of the wound, with protrusion of internal organs. It is a medical emergency.</p> Signup and view all the answers

<p>An abnormal connection between two organs, often due to an abscess, frequently at GI/GU sites.</p> Signup and view all the answers

<p>A tool for predicting pressure ulcer risk, using 6 subscales. A score less than 16 indicates a risk of developing pressure ulcers.</p> Signup and view all the answers

<p>A: appearance, W: wound/ulcer location, O: odor, U: ulcer category, N: necrotic tissue, N: nutritional status, D: dimension, D: drainage, P: pain, I: induration, C: color, T: tunneling, U: undermining, R: redness, E: edge of skin, E: edema.</p> Signup and view all the answers

<p>0 = no redness, 1 = mild redness, 2 = moderate redness, 3 = severe redness.</p> Signup and view all the answers

<p>Proper hand hygiene (A), Providing pain medication before wound care (B), Cleaning from the best looking wound to the worst (D), Sterile technique when changing dressings (E), Cleaning with sterile saline (F)</p> Signup and view all the answers

<p>Irrigation of tissue with fluid.</p> Signup and view all the answers

<p>Removal of devitalized tissue or foreign material from a wound.</p> Signup and view all the answers

<p>Use of a sharp, sterile instrument (scalpel or scissors) to remove devitalized tissue.</p> Signup and view all the answers

<p>Wet-to-dry dressings (A), Hydrotherapy (whirlpool) (B), Lavage (C)</p> Signup and view all the answers

<p>Using proteolytic agents to break down necrotic tissue without affecting viable tissue.</p> Signup and view all the answers

<p>Using an occlusive, moisture-retaining dressing and the body's own enzymes to break down necrotic tissue.</p> Signup and view all the answers

<p>Using medical-grade larvae to dissolve dead and infected tissue.</p> Signup and view all the answers

<p>Allows air and water vapor to pass through but keeps bacteria out.</p> Signup and view all the answers

<p>They can be used with hydrogels, saline, or medication. (A), They may contain antimicrobial agents or medication. (C), They are suitable for large, deep, dirty, or heavily draining wounds (D)</p> Signup and view all the answers

<p>They contain water-absorbing particles that form a gel when in contact with wound fluid.</p> Signup and view all the answers

<p>High water content provides moisture, promotes healing, and softens dead tissue.</p> Signup and view all the answers

<p>To secure dressings, reduce bleeding, and provide support for healing.</p> Signup and view all the answers

<p>Heat and cold therapy can influence the body's response to injury based on factors like the injury type, treatment duration, age, skin condition, and health.</p> Signup and view all the answers

<p>Dehydration (A), Immobility (C), Poor nutrition (D), Impaired sensation (E), Edema (F), Aging (G), Fever, infection (H)</p> Signup and view all the answers

<p>Moisture (A), Friction (C), Shearing (D), Pressure (E)</p> Signup and view all the answers

<p>SHEET BURNS, force of two surfaces moving across one another, should not be, rubs against clothing or bedding, moist</p> Signup and view all the answers

<p>vascular bed, head of the bed is elevated and the patient slides downward, sacral area, sliding movement of skin and subcutaneous tissue, stationary, Mechanical force</p> Signup and view all the answers

<p>After a period of tissue ischemia, if pressure is relieved and blood flow returns, the skin turns red due to vasodilation.</p> Signup and view all the answers

<p>Reactive/blanching hyperemia means that when you press your finger on the area, it blanches (turns lighter in color) and then returns to its original color when your finger is removed. It's a sign that the blood flow is returning, and the tissue is trying to overcome being deprived of oxygen. Non-blanching means the hyperemia is advanced beyond blanching and tissue damaging is occurring.</p> Signup and view all the answers

<p>A narrow passageway extending from a wound, sometimes to other wounds, and measured in cm using a sterile, cotton-tipped applicator moistened with saline.</p> Signup and view all the answers

<p>Wounds that extend in all directions due to erosion under the wound edges, resulting in a large wound with a small opening. Measured the same way as tunneling.</p> Signup and view all the answers

<p>A Stage 1 pressure injury is non-blanchable erythema of intact skin. Dark skin may not have visible blanching, but different color than the surrounding tissue, requiring assessment in natural or halogen light. It may also have differences in temperature or texture.</p> Signup and view all the answers

<p>A Stage II pressure injury is a partial-thickness skin loss with exposed dermis. It may look like a shallow open ulcer with a red/pink wound bed. It may also present as an intact or open/ruptured serum-filled or serosanguineous-filled blister.</p> Signup and view all the answers

<p>A Stage III pressure injury is a full-thickness skin loss that may extend down to but not through fascia. The dermis is no longer visible. The wound may have undermining and tunneling.</p> Signup and view all the answers

<p>A Stage IV pressure injury is a full-thickness skin and tissue loss that extends to fascia, muscle, bone, or support structures such as joints. It will have visible necrosis, including slough and unstable eschar.</p> Signup and view all the answers

<p>This includes damage to the skin and tissue with stable eschar (non-moveable) covering the full-thickness loss.</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Aging (A), Edema (B), Immobility (C), Poor nutrition (D), Impaired sensation (E), Dehydration (H), Fever, infection (J)</p> Signup and view all the answers

<p>Friction (B), Pressure (G), Moisture (H), Shearing (I)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers