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28 Cards in this Set

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  • Back
what ABX have anerobic coverage and are used for bowel surgery?
cefoxitin and flagyl
or
clinda and flagyl
what ABX have anerobic coverage and are used for vascular procedures?
ancef
or
clinda and vanco
what are the 4 wound phases and their time frames? what is the most important?
inflamm 24 hrs
epithelialization- 48
fibroplasia- 72
contraction > 5 days
**24-48 hours most impt.
what is granulation tissue?
the initial tissue deposited within the forming scar and lays the matrix for giving the scar its strength
how long does it take for a wound to have granulation tissue and achieve strength?
one month
what is primary intention?
closing the wound using simple tissue approximation: sutres, staples
what is secondary intention?
wound is allowed to close with out sutures etc, this lets the wound epithelialize and granulate on its own
what is the MC mechanism of wound closure?
wound contraction
what is delayed primary closure?
performed by leaving surgical dressing and wound to heal by secondary intent. usually done at 72-96 hours post op
what type of wound is delayed primary closure best for?
a wound that was infected/contaminated initially
name 7 inhibitors of wound healing?
nutrition
anemia
cancer
steroids
radiation
hypoxia
bacteria
give examples of dressings (5)
wet to dry
aquagel
dakins solution
acetic acid
VAC dressings
describe the body's response to a burn?
injury-->
release of vasoactive substances: histamine, PG, arachnidonic acid-->
increased vascular permeability-->
edema formation-->
intravascular vol decrease-->
decreased blood flow to renal, GI, skin leading to multi system organ damage-->
decreased CO = decreased O2 to organs
why do burn patients get hypothermia?
skin barrier is lost, edema forms, and fluid is lost from the wound surface
a burn that extends into the dermis (not through) ?
2nd degree
in this class of burn, healing occurs within a few days as the injured epidermis peels off and reveals new skin?
first degree
this type of burn involves only epidermis?
1st degree
this class of burn the epidermis and dermis are destroyed, blisters may form and SC tissue may be damaged?
2nd degree
these burns are full-thickness burns with SC fat damage. nerve endings have been destroyed.
3rd degree
in this type of burn: SC tissue, fat, muscle and bone may be injured?
4th degree
what determines burn severity?
depth and total body surface area
what are the values according to the rule of 9's?
arms 9% each
torso: front and back 18% ea
head and neck 9%
legs 18% each
genitalia/peri. 1%
what is the tx for first degree burns?
pain rx: dilaudid, morphine
keep wounds clean and covered
what is the tx for 2nd degree burns?
remove blisters if infected.
appl silvadene antimicrobial cream
what are some tx options for burns?
"CAP"
Cadaveric graft
acticoat
pig skin
what is the tx for 3/4th degree burns?
perform excision and escharotomy early to avoid compartment syndrome:
split thickness skin graft
normal urine output goal?
.5cc/kg/hr
what type of fluids should be avoided in burn patient?
D5W because blood fluid levels are generally elevated secondary to the burns