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Nf3 Final exam Questions and Answers 100% Pass

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Nf3 Final exam Questions and Answers 100% Pass

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Publié le
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Nombre de pages
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Écrit en
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Nf3 Final exam Questions and

Answers 100% Pass


Sterile principles - CORRECT ANSWER-

What are the Principles of Sterile Asepsis? - CORRECT ANSWER-> A sterile

object remains sterile only when touched by another sterile object. > Only sterile

objects may be placed on a sterile field. > A sterile object or field out of the range

of vision or an object below a person's waist is contaminated. • A sterile object or

field becomes contaminated by prolonged exposure to air. > When a sterile surface

comes in contact with a wet, contaminated surface, the sterile object or field

becomes contaminated by capillary action. > Fluid flows in the direction of gravity

> The edge of a sterile field or container is considered to be contaminated.

Sterile Technique - CORRECT ANSWER-Understand the principles of sterile

technique Recognize contamination > Correct contamination

Wound Assessment - CORRECT ANSWER-Drainage • Wound bed- color, type

and percentage of tissue present Wound edges • Measurement length x width x

depth • Peri-wound

,Туре Types of Drainage - CORRECT ANSWER-> Assess using TACO Туре

Amount - describe as percentage of dressing Colour/consistency Odour

Wound Beds - CORRECT ANSWER-> Slough Granulation • Epithelialization

Eschar > Scab

Wound Measurement - CORRECT ANSWER-STEP 1: Measure the wound.

STEP 2: Measure the STEP 3: Select dressing size. peri-wound.

Wound Cleansing - CORRECT ANSWER-From area of least contamination to

area of greatest contamination Gentle friction to peri-wound Wounds can be

cleansed with moistened gauze or irrigation • Avoid abrading the wound bed with

gauze

Wound Irrigation - CORRECT ANSWER-Washing or flushing out the wound

STERILE TECHNIQUE

Irrigation - CORRECT ANSWER-> Solutions used > Normal saline (most

common) > Antibiotic solutions (sometimes) > Do not use skin cleansers

(povidone iodine) or antiseptic agents > Instill a steady stream of solution and

irrigate until solution is clear > Amount required will vary by wound > Use a

pressure of 4 psi to 15 psi with a 30-60 ml syringe > Hold syringe above wound

irrigate in the direction of gravity • After irrigation cleanse peri-wound with at least

3 concentric circles

Purpose Of Packing - CORRECT ANSWER-Packing is instilled into a wound via

sterile technique to allow the wound to heal from the bottom up. Granulation

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,tissue forms in the wound bed and is red in appearance, healing by secondary or

tertiary intention Absorbs drainage so that an abscess doesn't form in a deep

wound while it heals. Wet-to-damp technique

Wound Packing Type of packing strip - CORRECT ANSWER-Type of packing

strip determined by doctor's order for moisture balance, treatment of infection, etc.

Eg: ½ inch wide plain packing strip, 1 inch wide plain packing strip, iodoform. •

Woven- to prevent fibers from being left in the wound bed • Length of packing:

replace what is removed3; monitor the wound for healing and decrease length of

strip as wound bed heals • Gently apply packing One piece of packing strip only -

do not use multiple small pieces > If more than once strip is required, securely tie

strips together and CHART the number of strips used

Preparation - CORRECT ANSWER-Review doctor's/ET nurse orders Review

previous wound/dressing documentation > Assess pain - COLDSPA • Administer

analgesia 30 minutes prior to procedure (depends on route of administration) if

needed • Gather supplies

Purposes of Wound Dressings - CORRECT ANSWER-• Protects wound from

microorganism contamination Aids in hemostasis Promotes healing by absorbing

drainage and supports autolytic debridement Supports or splints the wound site

Protects the patient from seeing the wound Promotes thermal insulation of the

wound surface Provides a moist environment for the wound bed

, Choosing a Wound Dressing - CORRECT ANSWER-> Ask: > What is the type

of wound to be dressed? >Surgical incision Dehisced incision Laceration Abrasion

Ostomy or fistula > What is the goal for the dressing? Exudate management,

protection, debridement, curative or chronic management

Types of Wound Dressings - CORRECT ANSWER-Non-adherent Contact

Protects granulation tissue Allows moisture to evaporate Soft Silicone Removed

without trauma to wound or peri-wound • Decreases pain

Vacuum Assisted Closure - CORRECT ANSWER-• Negative Pressure Wound

Therapy-NPWT For acute & traumatic wounds, pressure ulcers, chronic open

wounds, burns Cannot be used with bleeding disorders, infections, malignancies,

or fistulas • Foam, covered by an occlusive dressing, with a suction tube attached >

Dressings are done every 2-3 days or longer & prn

Wound/Incision Dressings - CORRECT ANSWER-Monitor drainage • Outline

shadowing (date, time, initials) • Change as per doctor's orders/protocol

What Factors can Affect Wound Healing? - CORRECT ANSWER-Intrinsic

factors Extrinsic factors • Health status • Mechanical stress • Diabetes • Circulation

• Debris, microorganisms • Anemia • Immune status • Temperature • Infection •

Age • Nutritional • Chemical stress status/Fluid balance • Medication • Radiation

NERDS (superficial infection) - CORRECT ANSWER-Non-healing state or

deterioration of wound Exudate level increased Red wound bed, bleeds easily

Debris in the wound Smell is increased


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