Exam 3 Outline Flashcards

A set of 200 question and answer flashcards covering wound treatment principles, debridement, dressings, and modalities based on lecture notes.

What frequently indicates a wound infection according to the lecture?

Changes in the amount/color of drainage, peri-wound redness, or warmth.

Is inflammation in a wound context always a negative sign?

No, inflammation isn’t bad even if it looks bad.

What specific time-related details should be looked for in a patient's chart?

Time of onset and the current phase the patient is in (inflammation, proliferative, or remodeling).

What is the primary objective of controlling/creating the ideal wound environment?

To free the wound from necrotic tissue and exogenous pathogens.

Should excess exudate be present in an ideal wound environment?

No, while drainage can be good, it must be controlled and not in excess.

When is it acceptable to add cytotoxic materials to a wound?

If infection is confirmed, to kill off the excess cells.

What are the three rules for maintaining wound moisture?

Maintain moisture, create moisture if absent, and control moisture if in excess.

What pH level should the wound and surrounding skin be kept at?

ACIDIC.

What specific biological components should be protected during wound care?

Growth factors such as ground substance, new skin, and blood cells.

What infection control measures should be taken during wound care?

Wear gloves, mask, keep wound covered, and use sterile techniques/equipment.

What is meant by 'control epithelialization'?

Granulation from the bed up and prevention of early closing until the bed rises to the level of the wound.

How often should a patient’s wound be checked?

EVERY DAY.

According to the lecture, what parts of a gown are considered sterile?

Only the front of the gown and the arms to the waist.

What parts of a gown are NOT considered sterile?

Anything behind the therapist and anything below the waist.

What is the purpose of the cap in wound care PPE?

To prevent the spread of pathogens from the wound to the therapist's hair or vice versa.

What does a mask protect the patient and therapist from?

Protects the patient from pathogens in the therapist's mouth and the therapist from splashes to the face.

How does the lecture distinguish between non-sterile and sterile gloves?

Non-sterile is clean and sterile is clean; there is no such thing as completely sterile.

When are goggles or safety glasses particularly important?

For any kind of splash, such as when using a Pulsavac.

What is the mantra for cleanliness in wound care mentioned in the lecture?

Just be as clean as you can be.

List three common risks for exposure in wound care related to aerosolized or splashing fluids.

Hydrotherapy, pulsatile levage, and suctioning.

List three common patient-related risks for exposure in wound care.

Coughing, TB, and Hep B.

List three specific wound care procedures that pose an exposure risk.

Dressing Changes, Sharp Debridement, and Active Bleeding/Dried blood.

What is one risk associated with heat during whirlpool cleansing?

Heat loss.

What physiological rates increase as a result of whirlpool use?

Heart and respiratory rates.

What risk does whirlpool use pose to the inflammatory stage of healing?

It can prolong the inflammatory stage.

What is the guideline for the duration of whirlpool use?

$5-10\,minutes$ for small areas.

When is 'neutral warmth' (normothermia) a goal for whirlpool use?

When aiming for minimal to no agitation over short times.

Which specific injury type COULD be indicated for intensive water cleansing in a whirlpool?

Burns.

When is it appropriate to use a whirlpool to raise a patient's core temperature?

Heating large areas to raise the core temperature to normal by heating the whole body.

What is the primary contraindication for whirlpool use regarding tissue type?

IF GRANULATION TISSUE IS PRESENT.

Why is whirlpool contraindicated when granulation tissue is present?

Because granulation tissue needs to be treated gently and a whirlpool is not gentle.

What device is used for both irrigation and suction in wound debridement?

Pulsed Lavage or Pulsavac.

What is the recommended pressure for Pulsed Lavage?

LOW PSI, specifically between $4-15\,PSI$.

What is the function of surfactants in wound cleansing?

They lower tension on the wound to help exudate slide off.

What is the desired cytotoxicity ratio for surfactants?

$1:10$.

When are surfactants specifically recommended?

For shallow wounds that are messy, such as after a race fall.

At what pressure level are surfactants contraindicated?

If PSI IS OVER $8$.

When should surfactants NOT be used regarding the wound's own capabilities?

If the wound is clean and CAN AUTOLYTICALLY cleanse itself.

What is the recommended pressure limit for a saline rinse using a bulb syringe?

LESS THAN $4\,PSI$.

What is the core question a therapist should ask regarding debridement and dressings?

Do you want to get something out of a wound, or trap it in there?

What is the definition of Wet to Dry Dressings?

Gauze applied wetted with saline and removed once dry to pull off eschar and exudate.

For which type of wound is a Wet to Dry dressing specifically contraindicated?

CLEAN GRANULATING WOUND.

When might a Wet to Dry dressing be indicated?

For an infected wound.

What occurs during surgical debridement?

A surgeon uses general anesthesia to create an all new wound.

What are the drawbacks of surgical debridement?

It is expensive and painful.

How is Forceful Irrigation performed?

A device like a Pulsavac is rubbed right over the top of the wound.

What is the indication for Forceful Irrigation?

Superficial Wounds with non-attached debris.

When is Forceful Irrigation contraindicated?

For a CLEAN, NON-INFECTED WOUND.

What is the primary indication for Sharp Debridement?

The presence of necrotic tissue.

When is Sharp Debridement contraindicated?

When there is a large presence of VIABLE TISSUE.

How is Chemical or Enzymatic debridement applied?

Enzymes mixed with topical gel or petroleum jelly are applied to the wound (requires prescription).

What is the goal of Enzymatic debridement?

To break down collagenous materials in chronic wounds to remove necrotic tissue.

When is Enzymatic debridement indicated?

Wounds with small amounts of eschar held by collagen, when not in a hurry.

Why is Enzymatic debridement contraindicated for large wounds?

It is expensive, painful, and takes forever to work.

What is the indication for Maggot Debridement Therapy?

Antibiotic resistant pathogens or wounds that aren’t closing.

Why is Maggot Debridement Therapy contraindicated for wet wounds?

Because maggots can’t swim.

What is Autolytic debridement?

The removal of necrotic tissue through self-produced enzymes.

When is Autolytic debridement indicated?

For wounds confirmed to NOT HAVE INFECTION.

What is a contraindication for Autolytic debridement regarding skin condition?

Presence of wound maceration.

What skin requirement is necessary for Autolytic debridement?

DRY PERI WOUND TISSUE.

Why is Povidone-Iodine generally avoided in PT practice?

It is TOO CYTOTOXIC.

When is Povidone-Iodine indicated?

For wounds with Staph Aerus.

What is the indication for Sodium Hypochlorite Solution?

Infected wounds.

What are the ingredients of Dakin's Solution?

Bleach and Boric Acid.

For which bacterial infections is Dakin's Solution indicated?

Staph and Strep infections.

When is Acetic Acid Solution indicated?

For pseudomonas to help control biofilm.

For which type of wounds is Hydrogen Peroxide indicated?

Shallow wounds.

Why is Hydrogen Peroxide contraindicated for tunneling wounds?

It is cytotoxic and not effective for deep tracks.

When are OTC antibiotic creams indicated?

When a wound is CLOSED BUT NOT FULLY HEALED to keep it moist.

When are OTC antibiotic creams contraindicated?

When early epithelial growth is present.

What is a potential side effect of prescription antibiotic creams?

Can cause renal problems.

How does the lecture describe Growth Factors in solution?

An energy drink for cells.

What is the indication for Growth Factors in solution?

Chronic wounds.

Why are Growth Factors contraindicated for infected wounds?

They INCREASE the INFECTION RATE.

Which product is used in an Unna’s Boot?

Topical Zinc impregnated into gauze.

What is the clinical use for an Unna’s Boot?

Venous leg ulcers.

When is Silver Nitrate indicated?

For burn wounds to help stop over granulation.

Does Silver Nitrate penetrate eschar?

No, it will not penetrate eschar.

What is the indication for Silvadene?

Burn wounds to soften eschar.

List two contraindications for Silvadene.

Clean, granulating wounds and patients with Sulfa allergy issues.

What are the indications for Medical Grade Honey?

Wounds that are inflamed, have a foul odor, or to help control biofilm.

List two contraindications for Medical Grade Honey.

Bee pollen allergies and poorly granulating wounds.

What is a common side effect of Medical Grade Honey during application?

Stinging pain in some individuals.

What is a Primary Dressing?

The first dressing put on the wound.

What is a Secondary Dressing?

The second dressing put on the wound.

What is an Occlusive Dressing?

A dressing that fully closes off the wound, preserving moisture.

How frequently must occlusive dressings be changed?

Every $3-5-7\,days$.

Rank the three general dressing types from worst to best for wound healing.

Permeable Dressings, Semi-Permeable, Occlusive.

What is Kerlix?

Non-stretchy permeable gauze.

Which gauze is used for body contours like head injuries?

Conform.

What are the two common uses for $4x4$ gauze pads?

Drying peri-wound skin and wiping off tools during debridement.

What is a major advantage of using gauze dressings?

The wound can be viewed frequently and it is absorptive.

Why is gauze considered expensive despite its low unit price?

Because of how often it must be removed and replaced.

Why is gauze contraindicated for non-infected wounds?

It is permeable to air and bacteria.

What is a disadvantage of gauze regarding the wound bed?

It leaves fibers behind and is painful to remove.

Describe the composition of Telfa.

Non-adherent with a shiny middle and a sticky outline.

What are Adaptic and Vaseline Gauze indicated for?

Providing moisture to dry wounds or wounds that are almost closed.

What is a disadvantage of non-adherent or impregnated gauze?

They are not occlusive and do not block pathogens from entering.

What is a Calcium Alginate dressing made from?

Natural fibers derived from seaweed.

What is a major advantage of Calcium Alginates?

They are very absorptive and easy to remove as they hold their shape.