Module 6 & 5 & 4: Wound Healing, Respiratory Care, and CVAD/Blood Transfusions

Comprehensive practice flashcards covering wound terminology, healing phases, pressure injury staging, respiratory emergencies, chest tube management, CVAD types, and transfusion reactions.

Granulation Tissue

Red, moist, beefy, healthy healing tissue.

Slough

Yellow, soft, moist, dead tissue.

Eschar

Black, dry, hard, dead tissue.

Stable heel eschar

A black, dry, hard covering on the heel of an ischemic limb that should NOT be removed.

Biofilm

Bacteria in a protective slime layer that is resistant to antibiotics and delays healing; usually requires mechanical debridement.

Wound VAC (NPWT)

A device using negative pressure to remove drainage, promote granulation tissue, increase blood flow, and collapse dead space.

Surgical Site Infection (SSI)

An infection occurring within $30$ days or within $90$ days if an implant was placed after surgery.

Neutrophils

First responders arriving in the inflammatory phase (~$24$ hours) to eat bacteria and debris.

Macrophages

Cells that arrive after neutrophils to eat debris and release growth factors.

Fibroblast

The key cell of the Proliferative Phase that makes collagen, proteoglycans, and glycoproteins.

Angiogenesis

The formation of new blood vessels during the proliferative phase of wound healing.

Primary Intention

Wound healing where edges are closed (sutured or stapled), resulting in fast healing and minimal scarring.

Secondary Intention

Wound healing for open wounds with significant tissue loss (e.g., pressure ulcers) that heal through granulation tissue.

Tertiary Intention

Wound healing where the wound is initially left open due to infection and closed later; has the longest healing time and most scarring.

Albumin

A nutritional marker where a level $< 3.5$ indicates protein deficiency and delayed wound healing.

Corticosteroids

Medications (e.g., Prednisone, Dexamethasone) that suppress inflammation and mask infection, thereby delaying wound healing.

Dehiscence

A complication where wound edges separate but organs stay inside.

Evisceration

A surgical emergency where the wound opens and organs protrude; requires sterile saline-soaked dressings and Low Fowler's position with knees bent.

Serosanguineous

Pink or light red watery drainage that is common after surgery.

Purulent

Thick yellow, green, or brown drainage indicative of infection.

Stage 1 Pressure Injury

Intact skin with non-blanchable redness.

Stage 2 Pressure Injury

Partial-thickness skin loss characterized by a blister or a shallow ulcer.

Stage 3 Pressure Injury

Full-thickness skin loss where fat is visible but no bone, muscle, or tendon is exposed.

Stage 4 Pressure Injury

Full-thickness skin loss with visible bone, muscle, or tendon.

Unstageable Pressure Injury

A wound covered by slough or eschar such that the base cannot be seen.

DTPI (Deep Tissue Pressure Injury)

Purple or maroon intact skin or a blood-filled blister.

Braden Scale

A tool where a lower score indicates a higher risk for pressure injuries ($\le 9$ is very high risk).

Hydrocolloid Dressing

A dressing that maintains moisture and is used for Stage 2 pressure injuries and moderate drainage; can stay on for $3-5$ days.

Alginate Dressing

Highly absorbent dressing derived from seaweed used for heavy drainage, tunnels, and Stage 3 or 4 injuries.

Jackson-Pratt (JP) Drain

A closed drainage system with a round bulb that provides low suction; should be emptied when $\frac{1}{2}$ full.

Hemovac Drain

A closed, high-suction drainage system with a flat circular disc often used after orthopedic surgery.

Penrose Drain

An open, passive drainage system consisting of a soft rubber tube that allows drainage to pass onto gauze.

Tidaling

The normal upward (inspiration) and downward (expiration) fluctuation of water in the water-seal chamber of a chest tube.

Continuous Bubbling in Water Seal

A finding that indicates an air leak in the chest tube system.

Gentle Bubbling in Suction Chamber

A normal finding in wet suction-control systems.

3-Sided Dressing

The emergency application of sterile petroleum gauze taped on three sides only if a chest tube comes out of the patient.

Bronchoscopy

A procedure to visualize airways where the patient must remain NPO until the gag reflex returns.

Tension Pneumothorax

An emergency where air builds up in the pleural space, characterized by JVD, hypotension, and tracheal deviation AWAY from the affected side.

Stridor

A harsh, high-pitched sound during inspiration indicating an upper airway emergency.

Hypercapnia

High levels of $\text{CO}_2$ in the blood, which serves as the primary drive for breathing.

PICC Line

Peripherally Inserted Central Catheter; used for therapy up to $6$ months, but no blood pressure or venipunctures should be done on that arm.

Implanted Port

A long-term CVAD located entirely under the skin, accessed only with a Huber needle.

Acute Hemolytic Reaction

A life-threatening transfusion reaction from the wrong blood type, presenting with low back/flank pain and hemoglobinuria.

TACO

Transfusion Associated Circulatory Overload; characterized by hypertension, JVD, crackles, and pulmonary edema.

Refeeding Syndrome

A TPN complication characterized by low phosphorus, potassium, and magnesium.

D10W

Dextrose $10\%$ in water; must be hung if TPN runs out abruptly to prevent hypoglycemia.

Rhonchi

Coarse crackles that sound like snoring or gurgling caused by mucus in large airways.

Rales

Fine crackles that sound like popping or 'Rice Krispies' caused by fluid in the alveoli.