WOCN WOUND LATEST
EXAM
What are abnormal lab values associated with necrotizing fasciitis? -
ANSWERS-WBC>14k-15k
Na<135
What is normal WBC? - ANSWERS-4500-11000
What is the treatment for necrotizing fasciitis? - ANSWERS-early
aggressive surgical debridement
antibiotics
HBOT
IV immunoglobulin
NPWT
flaps and grafts
What are bullous lesions? - ANSWERS-Damage to structures that
anchor cells to each other or to ECM
Creates epidermal or intradermal separation and blisters
Partial thickness and usually heal without scarring, post-inflammation
hyperpigmentation may occur
END OF
PAGE
1
, WOCN WOUND LATEST
EXAM
What causes bullous lesions? - ANSWERS-congenital weakness or
absence of anchoring fibrils, autoimmune diagnosis, allergic reactions
targeting anchor fibrils
How do bullous lesions present? - ANSWERS-Less severe: blisters in
response to minor trauma
more severe: severe chronic blistering, secondary infection, scarring and
contracture, muscous membrane and GI tract involvement
How do you manage bullous lesions? - ANSWERS-Treat underlying
process
Topical and systemic corticosteroids
antiinflammatories
immunosuppressives
plasmapheresis
human skin equivalents for congenital conditions
support surface with low shear low friction
nonadherent dressings with or without antimicrobials
END OF
PAGE
2
, WOCN WOUND LATEST
EXAM
What is a fungating tumor? - ANSWERS-Manifestation of solid tumors
that invade surface tissues
must monitor for infection
How do you manage the necrosis/odor associated with fungating tumor?
- ANSWERS-Dakin's soaked gauze
Topical metronidazole
Odorproof pouch
How do you manage the exudate associated with fungating tumor? -
ANSWERS-Dakin's soaked gauze, calcium alginate dressings,
absorptive dressing
How do you manage the bleeding associated with fungating tumor? -
ANSWERS-AgNO3 to control surface bleeds
nonadherent dressings
calcium alginate (hemostatic)
severe - consult surgical
END OF
PAGE
3
, WOCN WOUND LATEST
EXAM
How do you manage extravasation? - ANSWERS-immediate d/c of
infusion, intradermal admin of antidotes
hyaluronidase for most
phentolamine for pressors like dopamine
Wound care
Full thickness on dorsal hand call plastic surgery to maintain function
How is CA-MRSA spread? - ANSWERS-By shared sports equipment,
day care, inmates, armed services, IVDU
What is CA-MRSA like? - ANSWERS-Can cause very severe infections
or septic arthritis
Can begin with minor skin abrasion
How does CA-MRSA present? - ANSWERS-Acutely tender, indurated,
intensely erythematous lesion with common purulent center
How do you prevent CA-MRSA? - ANSWERS-avoid indiscriminate use
of antibiotics
hot showers and antimicrobial soaps if at risk
END OF
PAGE
4
EXAM
What are abnormal lab values associated with necrotizing fasciitis? -
ANSWERS-WBC>14k-15k
Na<135
What is normal WBC? - ANSWERS-4500-11000
What is the treatment for necrotizing fasciitis? - ANSWERS-early
aggressive surgical debridement
antibiotics
HBOT
IV immunoglobulin
NPWT
flaps and grafts
What are bullous lesions? - ANSWERS-Damage to structures that
anchor cells to each other or to ECM
Creates epidermal or intradermal separation and blisters
Partial thickness and usually heal without scarring, post-inflammation
hyperpigmentation may occur
END OF
PAGE
1
, WOCN WOUND LATEST
EXAM
What causes bullous lesions? - ANSWERS-congenital weakness or
absence of anchoring fibrils, autoimmune diagnosis, allergic reactions
targeting anchor fibrils
How do bullous lesions present? - ANSWERS-Less severe: blisters in
response to minor trauma
more severe: severe chronic blistering, secondary infection, scarring and
contracture, muscous membrane and GI tract involvement
How do you manage bullous lesions? - ANSWERS-Treat underlying
process
Topical and systemic corticosteroids
antiinflammatories
immunosuppressives
plasmapheresis
human skin equivalents for congenital conditions
support surface with low shear low friction
nonadherent dressings with or without antimicrobials
END OF
PAGE
2
, WOCN WOUND LATEST
EXAM
What is a fungating tumor? - ANSWERS-Manifestation of solid tumors
that invade surface tissues
must monitor for infection
How do you manage the necrosis/odor associated with fungating tumor?
- ANSWERS-Dakin's soaked gauze
Topical metronidazole
Odorproof pouch
How do you manage the exudate associated with fungating tumor? -
ANSWERS-Dakin's soaked gauze, calcium alginate dressings,
absorptive dressing
How do you manage the bleeding associated with fungating tumor? -
ANSWERS-AgNO3 to control surface bleeds
nonadherent dressings
calcium alginate (hemostatic)
severe - consult surgical
END OF
PAGE
3
, WOCN WOUND LATEST
EXAM
How do you manage extravasation? - ANSWERS-immediate d/c of
infusion, intradermal admin of antidotes
hyaluronidase for most
phentolamine for pressors like dopamine
Wound care
Full thickness on dorsal hand call plastic surgery to maintain function
How is CA-MRSA spread? - ANSWERS-By shared sports equipment,
day care, inmates, armed services, IVDU
What is CA-MRSA like? - ANSWERS-Can cause very severe infections
or septic arthritis
Can begin with minor skin abrasion
How does CA-MRSA present? - ANSWERS-Acutely tender, indurated,
intensely erythematous lesion with common purulent center
How do you prevent CA-MRSA? - ANSWERS-avoid indiscriminate use
of antibiotics
hot showers and antimicrobial soaps if at risk
END OF
PAGE
4
