WOCN Wound Exam Questions And Answers 100% Correct!

WOCN Wound Exam Questions And Answers 10 Goals of wound assessment - ANSWER1. 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? - ANSWERImpairs leukocyte function and negatively impacts collagen syntehesis, development of tensile strength, epithelial resurfacing What BG parameters should be maintained for wound healing? - ANSWERBG <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? - ANSWERMuscle 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? - ANSWERcompromise collagen synthesis/crosslinking What amino acids are essential for collagen synthesis? What is the effect of stress on these amino acids? - ANSWERGlutamine and l-arginine Not adequately produced during times of physiologic stress What weight trend suggests nutritional deficiency? - ANSWERUnplanned weight loss =>2.5% of usual weight in 30 days or =>10% within 180 days BMI <18.5 What serum albumin level indicates malnutrition? - ANSWER<3.5 g/dl What serum transferrin level indicates malnutrition? - ANSWER<100mg/dl What serum prealbumin level indicates malnutrition? - ANSWER<19.5 What total lymphocyte count level indicates malnutrition? - ANSWER<1500 What are s/s of nutritional deficits? - ANSWERskin 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? - ANSWER30-35 cal/kg body weight What is the suggested protein intake? - ANSWER1.25-1.5 g/kg body weight What is the suggested fluid intake? - ANSWER30ml per kg (unless fluid restriction indicated) How do you assess perfusion/oxygenation? - ANSWERcapillary refill, pulses, presence/absence of edema, TcpO2 levels (at least 40), color of wound bed (bright pink/red), ABI for lower extremity ulcers, systolic bp/episodes of hypotension, vasopressor administration How do you assess for immunosuppression? - ANSWERComorbidities/therapies such as HIV, steroid tehrapy in doses >30mg/day for >30 days, and/or chemo resulting in neutropenia; high dose NSAIDs What comorbidities compromise wound healing? - ANSWERrenal failure, liver failure, multisystem trauma, smoking, advanced age What are the layers of the skin - ANSWEREpidermis Basement Membrane Zone Der 0% Correct!