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19 Cards in this Set
- Front
- Back
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definition - pressure ulcer
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Any lesion caused by unrelieved pressure, usually over a bony prominence that results in damage to underlying tissue
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What are the types of ulcers
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Venous
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This ulcer is:
-caused by stasis, DVT, varicose veins, deep venous incompetence -Located in the gaiter area -has Irregular borders -has a pink red base -are painless (unless infected) or minimal pain -pain relieved with leg elevation -associated with firm/brawny edema -arteries are normal, veins are abnormal -Diagnostic options: venous Doppler |
Venous ulcer
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-Associated with Diabetes
-Often plantar foot -Hyperkeratotic appearance -Frequently associated with osteomylitis -Healthy/pale wound base -Tendon or bone frequently exposed -Arteries maybe normal or abnormal -Veins are normal -Neither dependency nor elevation relieves the pain |
Neuropathic Ulcers
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-Most problematic wounds
-Caused by vascular insufficiency or trauma -Seen distally -Wound have discrete edges -Pain is severe and relieved with dependency -Usually presents with gangrenous changes -Skin is thin, shiny and dry -Pale wound base -Distal pulses are not palpable -Diagnostic test: Doppler, angiograms |
Ischemic Ulcers
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-Chronic wounds resulting from increased pressure or shearing force over a susceptible area (ie, bony prominence)
-Results when skin and underlying tissues are deprived of oxygen and other nutrients necessary for cell growth and proliferation -80% pelvic girdle: ischium, sacrum, coccyx, trochanter -Prevalence 2.5-24% |
Pressure ulcers
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Principles of Wound Healing
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-Ensure adequate tissue oxygenation
-Treat infection -Know the extent of the wound -Remove necrotic tissue -Eliminate/limit mechanical trauma -Control edema -Facilitate healing with appropriate treatments -Correct extrinsic factors that impede healing -Educate and involve patients and their caregivers |
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These are ________
-Poor tissue oxygenation -Immunosupression -Malnutrition -Obesity -Age -Medications -Wound dessication -Infection |
Factors That Delay Wound Healing
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How did they found out the time for ulcers getting worse?
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Army Doctors rounding during WWII. It took 2-3 hours to finish rounds. When they saw patients again, the wounds were worse.
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List comorbid conditions that affect healing: (13)
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-Malnutrition and dehydration
-Diabetes Mellitus -End stage renal disease -Thyroid disease -Congestive heart failure -Peripheral vascular disease -Vasculitis -Immune deficiency states -Malignancies -COPD -Contractures at major joints -Depression and psychosis -Drugs that affect healing |
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Patient has a non-blanchable area of redness (erythema).
What stage is this ulcer have? |
Stage 1 ulcer
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Patient X has a skin lesion that that is blistered & shallow with disrupted epidermis.
What stage ulcer does patient X have? |
Stage 2 ulcer
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Patient Y has a skin lesion that is penetrated the full thickness of the skin, with underming.
What stage ulcer does patient Y have? |
Stage 3 ulcer
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Patient Z - has their humorus, triceps tendon and muscle exposed.
What stage ulcer does patient Z have? |
Stage 4 ulcer
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What is the most common ulcer?
What is the second |
MCU is Pressure Ulcer
2ndMCU is venous ulcer. |
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Defn Stage 1 Ulcer
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Non-blanchable area of erythema
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Defn Stage 2 Ulcer
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Blister or shallow ulcer; epidermis disrupted
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Defn Stage 3 Ulcer
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Full thickness, undermining, tunneling common, involving subcutaneous tissue
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Defn Stage 4 Ulcer
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Bone and/or tendon/muscle exposed
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