WOCN WOUND CARE RN EXAM PREP QUESTIONS WITH CORRECT ANSWERS GRADED TO PASS

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/24 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 - Heal by reepithelialization - No scar or loss of function Epibole - rolled skin edge that indicates slow healing. Prevents epithelialization and closure. Cauterization (silver nitrate) or surgical debridement Shearing force - produces extension of tissue damage under intact skin (undermining) Wound infx signs - erythemia, odor, edema, pain, change in exudate Allergic Reaction Phase - Sensitization - No manifested response Allergic Reaction Phase - Elicitation Phase - Acute inflammatory reaction (within72 hrs of exposure) How does a partial thickness wound heal? i.e., skin tear - Epithelialization Payne-Martin Classification Scale - Category I II III.Allergic Reaction Phase -Partial thickness w/o flap