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WOCN Wound Care RN Exam Prep question with verified solution 2024 Steps to heal by Secondary Intention - ✔✔Formation of granulation tissue, contraction of the wound bed edges, and epithelialization Partial thickness repair - ✔✔Inflammatory response, epithelial proliferation and migration, epidermal reestablish
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Steps to heal by Secondary Intention - ✔✔Formation of granulation tissue, contraction of the wound bed edges, and epithelialization Partial thickness repair - ✔✔Inflammatory response, epithelial proliferation and migration, epidermal reestablishment and differentiation What characterizes a chronic wound healing environment - ✔✔Low levels of growth factors and receptor sites. They are needed to move cells out of the inflammatory phase and into the proliferative/Rebuilding Phase What Vitamin assists in collagen/fibroplasia formation? - ✔✔Vitamin C Normal protein intake - ✔✔.8 g/kg/ Protein intake for injury - ✔✔increased 1.25 - 1.5 /kg/24 hours BMI >25 increases - ✔✔dehiscence, infection, delayed wound healing, adipose tissue poorly perfused and heals at a slower rate Keloid Scars are formed how? - ✔✔Overgrowth of collagen within scar tissue, seen with pigmented skin. Trauma. May ulcerate. Genetic. Hypertrophic Scar are formed how? - ✔✔scar with thickened epidermal layer contained within the original incision area. Formed from prolonged inflammatory phase.
Fast/rapid weight loss produces what type of malnutrition? - ✔✔Protein & mixed protein malnutrition: marasmus-kwashiorkor Marjoin ulcer - ✔✔chronic wounds in malignant wound Candidiasis - ✔✔Pustules and satellite lesions with red base Incontinence associated dermatitis - ✔✔blisters with red base Radiation Dermatitis - ✔✔Grade 1: Dry desquamation (Peeling) Grade 2: erythema, moist desquamation (partial thickness), mod edema Grade 3: Bleeding skin Wheal skin lesion - ✔✔Itching, burning, red, elevated, irregular Pyoderma Gangrenosum - ✔✔Ulcer with irregular shape and violaceous (purple) raised edges. Sharp debridement is contraindicated. Calciphylaxix - ✔✔Calcific uremic arteriolopathy elevated calcium/phosphate. Dialysis. may present similar to Pyoderma. Aggressive sharp debridement for necrotic tissue. Partial thickness wound - ✔✔shallow ,.2 cm, moist, pink/red wound base, exposure of basement membrane and of nerve endings. Epidermal/Dermal Loss
Elma (topical prilocaine/lidocaine) - ✔✔best 30-60 min under nonadherent transparent wrap for analgesia PreAlbumin - ✔✔Maybe normal under states of malnutrition Metronidazole (Flagyl) - ✔✔Crushed and used to control odor in fungating wounds (breast CA) Cover partial thickness skin tears with - ✔✔Contact layer (nonadherent dressing) Candidiasis Intervention - ✔✔prevent moisture buildup miconazole nitrate powder 2% Calcium Alginate Dressing - ✔✔Shallow to tunnels with moderate to heavy drainage Surgical Sharp Debridement - ✔✔Non selective. Indicated for advancing cellulitis and wound related sepsis Always culture - ✔✔Clean viable tissue not exudate or eschar A wound that fails to progress as anticipated Levine technique uses a normal saline moistened swab Dankin's (sodium hypochlorite <0.5%) - ✔✔Removes slough and controls odor Kenalog cream - ✔✔reduces hyperplasia Regranex - ✔✔Platelet growth factor for foot ulcers
Unstageable Pressure Ulcer - ✔✔Full thickness with base covered in slough Braden Scale - ✔✔>18-23 not at risk
15-18 mild 13-14 mod 10-12 high <9 very high PUSH Tool - ✔✔Pressure ulcer healing evaluated by size, exudate, and tissue type