WOCN Wound Exam Question With Verified Solution 2024

Goals of wound assessment - 1. Determine etiologic factors 2. Assess systemic factors/comorbidities 3. Assess wound to determine phase of healing 4. Determine goals of topical therapy Why does hyperglycemia affect wound healing? - Impairs leukocyte function and negatively impacts collagen syntehesis, development of tensile strength, epithelial resurfacing What BG parameters should be maintained for wound healing? - BG <180 for leukocyte function; <140 for healing A1C <7 for most, <8 if hx of severe hypoglycemia, advanced comorbidities, limited life expectancy Why is nutrition relevant to wound healing? - Muscle or SubQ wasting increases risk of pressure/shear damage malnourished pt unable to synthesize and cross-link collagen normally protein deficiency increases risk of infection What effect do low zinc levels have on wound healing? - compromise collagen synthesis/crosslinkingWhat amino acids are essential for collagen synthesis? What is the effect of stress on these amino acids? - Glutamine and l-arginine Not adequately produced during times of physiologic stress What weight trend suggests nutritional deficiency? - Unplanned weight loss =>2.5% of usual weight in 30 days or =>10% within 180 days BMI <18.5 What serum albumin level indicates malnutrition? - <3.5 g/dl What serum transferrin level indicates malnutrition? - <100mg/dl What serum prealbumin level indicates malnutrition? - <19.5 What total lymphocyte count level indicates malnutrition? - <1500 What are s/s of nutritional deficits? - skin rashes, cracks in mucous membranes, edema, muscle and subQ tissue wasting, nonhealing wounds, dry/pluckable hair, dry flaky itchy skin What is the suggested caloric intake? - 30-35 cal/kg body weight What is the suggested protein intake? - 1.25-1.5 g/kg body weightWhat is the suggested fluid intake? - 30ml per kg (unless fluid restriction indicated) How do you assess perfusion/oxygenation? - capilla