Pressure Ulcers

Front 1

Fracture at T4. What neurologic injuries would you expect?

Back 1

paralysis of lower body.
loss of sensation from T5 down.
will vary depending on severity.

Front 2

Frature at T4. How would movement be affected?

Back 2

full use of upper body (head and neck movement, arms)
complete paralysis of lower body

Front 3

a) Why is heart rate not a good target for determining intensity of physical exercise in px in wheelchair?

b) How would you determine intensity in px in wheelchair?

Back 3

a) SNS dysfunction

b) sweating or SOB

Front 4

What are the 3 components of an exercise perscription?

Back 4

1. Time (how often and for how long?)
2. Intensity (how hard?)
3. Type (how to?)

Front 5

Why are px with SCI at higher risk of developping pressure ulcer?

Back 5

immobility + decreased sensation

Front 6

How does immobility lead to increased risk of developping pressure ulcer?

Back 6

pressure on skin leads to reduced blood flow to that area
reduced blood flow to that area leads to skin death
skin death leads to ulcer formation

Front 7

How does urinary incontinence and/or bowel incontinence increase risk of developing pressure ulcer?

Back 7

skin is constantly moist leading to maceration (softening and whitening) of skin (think pruning from being in the bath too long).
maceration of skin leads to skin is breaking down.

Front 8

When inspecting px for development of pressure ulcers, you notice a reddened area of skin that, when pressed, does not turn white.
T/F: this is an indication for increased risk of developing pressure ulcer. It would be classified as pre-stage I.

Back 8

F. reddened skin that does not blanche is a sign that a pressure ulcer is starting to develop.
classified as: Stage 1

Front 9

Pressure ulcer is deep with damage to muscle, bones and joint. Stage this ulcer.

Back 9

Stage IV

Front 10

What is the difference between a stage II pressure ulcer and a pressure stage III ulcer?

Back 10

both have open sores. stage III has damage to tissue below the skin.

Stage II: skin blisters or forms open sore. area around sore is red and irritated.
Stage III: skin forms crater (open, sunken hole). Damage to tissue below the skin.

Front 11

What are 3 modifiable risk factors for pressure sores?

Back 11

1. smoking - decreases circulation
2. excess moisture - from sweating or incontinence. leads to tissue maceration and skin break down.
3. diet - healthy nutrition and hydration keep skin healthy and prevent skin break down. Also, loss of fat means less cushion between bones and wheelchair leading to increased friction.

Front 12

What are the non-surgical options for management of Pressure Ulcers?

Back 12

1. autolytic debridement - bodies enzymes + moisture to (selectively) rehydrate, soften and liquify necrotic tissue.
2. biological debridement - maggots.
3. chemical/enzymatic debridement. can be selective.
4. mechanical debridement - wet bandages are dried and then peeled off