Term
| percentage of SNF patients that get pressure ulcers |
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Definition
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Term
| % of ICU pt's that develop 1 or more pressure ulcers |
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Definition
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Term
| percentage of home heath care admissions that have one or more pressure ulcers |
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Definition
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Term
| primary forces involved in the development of pressure ulcers |
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Definition
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Term
| perpendicular force exerted on an area causing tissue ischemia and hypoxia |
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Definition
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Term
| occurs when gravity and friction exert a force parallel to the skin causing a stretching and tearing of tissues |
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Definition
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Term
| 2 contributors to the intensity of the damage |
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Definition
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Term
| minimal amount of pressure required to collape a capillary |
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Definition
| capillary closing pressure |
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Term
| what is the pressure required to close a capillary? |
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Definition
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Term
| high pressure over a short amount of time is just as damaging as |
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Definition
| a low amount of pressure over a long amount of time |
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Term
| expert opinoin states that patient's should be repositioned |
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Definition
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Term
| clinical guidelines say that a pt should be repositioned every |
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Definition
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Term
| pt's in a prone position develop pressure ulcers where (5) |
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Definition
| back of head, shoulder blade, lower back, elbow, heel |
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Term
| pt's in sidelying can develop a PU where (6) |
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Definition
| ear, shoulder, elbow, hip, between knees, between ankles, |
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Term
| pt's in wheel chair can develop PU's where (5) |
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Definition
| underside and back of heel, hip, sacrum, lower back, shoulder blade |
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Term
| pt's reclining in bed can develop PU's where? (5) |
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Definition
| back of head, shoulder blade, lower back, sacrum, heel |
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Term
| intrinsic factors of developing PU (4) |
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Definition
| limited mobility, poor nutrition, comorbidities, aging skin |
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Term
| Intrinsic Factors: Limited Mobility examples (7) |
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Definition
| CVA, SCI, pain, fracture, neurlogical disorder, sedation, coma |
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Term
| Intrinsic Factors: poor nutrition (4) |
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Definition
| anorexia, dehydration, poor dentition, poverty/lack of access to food source |
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Term
| Intrinsic Factors: comorbidities examples (6) |
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Definition
| DM, neuropathy, vasculitis or other collagen disorder, malignancies, ESRD (end stage renal disease), dementia |
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Term
| Intrinsic Factors: aging skin examples (5) |
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Definition
| decresae in dermal vascularity, decrese in collagen density, fragmentation of elastin, flattening of the basement membrane, decrsae in the number of mast cells |
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Term
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Definition
| hard surface, friction, shear, moisture, incontinence, excess perspiration, wound drainage |
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Term
| how more likely are pt's with incontinence to develop a PU |
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Definition
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Term
| PU defined by the national prssure ulcer advisor panel |
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Definition
| a localized injury to the skin and/or underlying tissue usually over a boney prominence, as a result of pressure or prsesure in combination with shear and/or friction |
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Term
| a suspected deep tissue injury can have these 2 descriptors |
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Definition
| painful, firm and warm OR mushy, goggy, and cool |
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Term
| deep tissue injury may be difficult to detect in what individuals |
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Definition
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Term
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Definition
| thin blister over a dark wound bed |
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Term
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Definition
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Term
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Definition
| exposing additional layers of tissue even with optimal treatment |
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Term
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Definition
| intact skin with a non-blanchable redness of a localized area usually over a boney prominence |
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Term
| for pt's with a darker skin tone, what should be done to prevent PU's (2) |
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Definition
| multiple skin checks per day, use a flashlight on bony prominences |
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Term
| for pt's with a darker skin tone, what should be done to prevent PU's (2) |
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Definition
| multiple skin checks per day, use a flashlight on bony prominences |
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Term
| major point of emphasis for a stage 2 PU |
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Definition
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Term
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Definition
| partial thickness loss of dermis presenting as shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister |
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Term
| A stage 2 ulcer can also present as |
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Definition
| shiny or dry shallow ulcer without slough or bruising |
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Term
| a stage 2 ulcer with bruising indicates what |
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Definition
| it is not a PU, it is a SusDTI |
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Term
| stage 2 PU should not be used to describe what 5 other injury types |
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Definition
| skin tears, tape burns, perineal dermatitis, maceration, excoriation |
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Term
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Definition
| full thickness tissue loss. Subcutaneous fat maybe visible, but bone tendond or muscle are note exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling |
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Term
| What is the 1st stage of a PU that may include undermining and tunneling |
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Definition
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Term
| partial thickness PU stages |
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Definition
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Term
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Definition
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Term
| the depth of a stage 3 PU is dependent upon what |
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Definition
| anatomical location (bridge of nose vs sacrum) |
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Term
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Definition
| full thickness tissue loss with exposed bone, tendon, or mm. slough or eschar may be prseent on some part of the wound bed. often include undermining and tunneling |
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Term
| which PU stages will never see slough |
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Definition
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Term
| regardless of presentation, if there is slough present in the PU what stage is it? |
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Definition
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Term
| a pt presents with a PU but the whole wound bed is not visible. how is it staged? |
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Definition
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Term
| what is a blood blister classified as? |
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Definition
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Term
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Definition
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Term
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Definition
| by bony prominence it is over |
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Term
| a pt present with a PU where there is no bone/tendon present, but upon using a probe there is a solid thunk is felt. what stage is this PU? |
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Definition
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Term
| describe an unstageable PU |
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Definition
| full thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed |
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Term
| what colors can slough be (5) |
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Definition
| yellow, tan, gray, green, brown |
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Term
| what colors can eschar be (3) |
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Definition
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Term
| when should eschar not be removed |
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Definition
| when present on PT's heels are is considered stable (dry, adherent, intact without erythema or fluctuane) |
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Term
| a dti will become at least how much denuded skin |
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Definition
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Term
| if the wound is not healing and the bone was exposed, then there is a 70-80% chance that there is what present |
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Definition
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Term
| how is osteomyelitis confirmed? |
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Definition
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Term
| when should there be a change in protocol/call to doctor |
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Definition
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Term
| eschar must be surgically removed, and cannot be done by the PT IF what? |
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Definition
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Term
| 2 risk assessment tools for PU's |
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Definition
| Norton Scale, Braden Scale |
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Term
| Aside from the risk assessment, what are the other components of assessment? (4) |
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Definition
| full medical hx, full skin assessment, nutrtional assessment, labs |
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Term
| When should an assessment be done? |
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Definition
| admission, change in pt condition/function, as per facility policy |
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Term
| Interventions based on risk assessment: schedule |
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Definition
| turn and repositioning schedule |
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Term
| Interventions based on risk assessment: control |
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Definition
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Term
| Interventions based on risk assessment: head of bed |
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Definition
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Term
| Interventions based on risk assessment: daily (2) |
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Definition
| skin inspection, inspection of proper support surface while pt is on it |
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Term
| Interventions based on risk assessment: avoid |
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Definition
| massaging boney prominences |
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Term
| Interventions based on risk assessment: supplements |
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Definition
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Term
| Interventions based on risk assessment: improve |
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Definition
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Term
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Definition
| total number of patients with pressure ulcers on any given day within a given agency or facility |
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Term
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Definition
| number of patients who ACQUIRE pressure ulcers while in the care of a given agency/facility |
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Term
| Important note about support surfaces to reduce pressure distribution |
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Definition
| no device completes relieves pressure |
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Term
| 2 categories of support srufaces for pressure redistribution |
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Definition
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Term
| prevention surfaces can prevent pressure ulcers and treat what types of pressure ulcers? |
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Definition
| treat partial thickness ulcers through stage 2 |
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Term
| prevention support surfaces can also be used for (2) |
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Definition
| comfort and pain reduction |
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Term
| what are prevention devices usually made with (materials) [3] |
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Definition
| static devices: air, gel, foam overlay |
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Term
| support surface which reduce interface pressure to below capillary closing pressure |
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Definition
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Term
| therapeutic support surfaces are used to treat what kinds of ulcers? |
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Definition
| full thickness pressure ulcers through stage 4 |
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Term
| therapeutic support surfaces are also used for these 2 conditions/procedures |
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Definition
| myocutaneous flap, grafts |
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Term
| a therapeutic support surface can also be used for these (4) |
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Definition
| moisture and heat dissapation, comfort, and pain management |
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Term
| what type of materials are therapeutic devices made of (3) |
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Definition
| dynamic devices: low air loss, alternating air, turning/rotating |
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Term
| group 1 cushioins are what category |
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Definition
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Term
| gropu 2 cushions are what category? |
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Definition
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Term
| What is a Kennedy Terminal Ulcer |
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Definition
| pressure ulcer some people develop as they are dying |
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Term
| which cushions are generally considered much more effective? (foam or air) |
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Definition
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Term
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Definition
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|
Term
| what reflects durablity and performance? |
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Definition
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Term
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Definition
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Term
| thereapeutic cushions are typically between what pound per cubic foot |
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Definition
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Term
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Definition
| the higher the density the stronger the foam |
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Term
| which will last longer a 5PBC foam mattress or a 3 PBC foam pad? |
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Definition
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Term
| firmness is expressed as what? |
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Definition
| indentation force deflection (IFD) |
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Term
| a low IFD indicates what? |
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Definition
| softer, more immersion, less pressure |
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Term
| a high IFD indicates what? |
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Definition
| firmer foam, less immersion, more pressure |
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Term
| low air loss pads have a cooling effect which may have a negative effect on what population? |
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Definition
| extremely frail and thin pt |
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Term
| precautions with low air loss: settings |
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Definition
| don't want a high setting as the bladders are hard and allow less immersion |
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Term
| precautions wiht low air loss: power outage |
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Definition
| unless compressor driven, the padding will deflate |
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Term
| the Isch-dish belogns to what group of padding? |
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Definition
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Term
| the Isch-Dish is used for what? |
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Definition
| high risk ischeal and coccyx breakdown |
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Term
| fluid immersino simulation whereby patient "floats" on computer regulated pads which auto adjust and readjust every 11 seconds |
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Definition
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Term
| what is used to evaluate a DTI? |
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Definition
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Term
| frequency of ultrasound for evaluation of a DTI |
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Definition
| 10-MHz (intermediate frequency) |
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