NUR 204 — Care of the Client IV Exam 2 Comprehensive Study Guide

Vocabulary flashcards covering key concepts from the NUR 204 Care of the Client IV Exam 2 study guide, focusing on pressure injuries, burns, skin infections, and skin cancers.

Pressure Injury Assessment

A complete evaluation of a wound that describes its characteristics, surrounding skin, patient risk factors, and interventions.

Clock-face Method

A technique used to document the location, undermining, and tunneling of pressure injuries, with orientation based on the patient's perspective.

Braden Scale

A risk assessment tool for pressure injuries; a score of 18 or less indicates risk.

Unstageable Pressure Injury

A full-thickness tissue loss where the base of the ulcer is covered by slough or eschar, making the true depth unknown until debridement.

Stage 2 Pressure Injury

Partial-thickness skin loss with exposed dermis; may present as a shallow open ulcer or serum-filled blister.

Deep Tissue Pressure Injury (DTPI)

Intact or non-intact skin with persistent deep red/maroon/purple discoloration due to pressure and shear.

Undermining

Erosion of tissue beneath intact wound edges, forming a shelf or lip, indicating shear and possible biofilm presence.

Tunneling

A narrow channel extending from the wound into deeper tissue or another cavity, requiring specific depth measurement.

Nutrition for Wound Healing

Recommendations include 1.25–1.5 g protein/kg/day and 30–35 kcal/kg/day along with micronutrient supplementation.

MRSA

Methicillin-resistant Staphylococcus aureus, a bacterial infection that can cause skin abscesses, cellulitis, and wounds.

ABCDE for Melanoma

Warning signs for melanoma: Asymmetry, Border irregularity, Color variegation, Diameter >6 mm, Evolving lesion.

Basal Cell Carcinoma

The most common type of skin cancer, characterized by pearly or translucent papules; rarely metastasizes.

Squamous Cell Carcinoma

A skin cancer arising from keratinocytes that can metastasize; presents as scaly, erythematous plaques or nodules.

Carbon Monoxide Poisoning Interventions

Remove patient from source, apply 100% humidified oxygen, monitor co-oximetry, and provide appropriate supportive care.

Types of Isolation

Precautions taken to prevent the spread of infections, including Contact, Droplet, Reverse, Enteric, and Respiratory isolation.

Fecal Microbiota Transplant (FMT)

A procedure to restore a healthy microbiome for patients with recurrent C. difficile infections.