FREE Certified Wound Specialist Test Question and Answers
Which type of barrier protection is the best for intact skin to keep it safe from exudate and adhesive stripping?
Depending on the product, skin sealants are film-forming barriers that are made of polymer in a quick-drying solvent and applied every one to four days. The solvent, which is frequently isopropyl alcohol, dissolves when the sealant is applied to the skin, leaving the clear plasticized polymer barrier over the tissue. Broken skin may experience some irritation from the alcohol solvent, but undamaged or inflamed tissue may be treated with skin sealant. Skin can be shielded by sealants from exudate, feces, urine, chemicals, and adhesive peeling. Applying sealants requires the use of wipes, wands, or sprays.
What kind of preparation is required for a patient who will be receiving a chemical debridement with collagenase and who has a persistent leg ulcer covered in black eschar?
Chronic wounds (burns, ulcers) with necrotic tissue and eschar are treated with chemical debridement. Before administering the enzyme, the eschar must be cross-hatched through the upper layers since the enzymes (collagenase and papain/urea) need a moist environment. The pH must stay between 6 and 8 to prevent the enzyme from becoming inactive. Burrow's solution, heavy metal ions, and hexachlorophene are further inactivation reasons. For deep wounds, collagenase is given directly to the wound; for minor wounds, it is applied to gauze packing.
The best course of action for a patient who is dying and has begun to build pressure on the sacral area but who groans loudly and resists when the nurse assistant tries to turn him is to:
Comfort comes first when a patient is on the verge of passing away, even if this necessitates forgoing some standard patient care, including turning the patient. As much as possible, the patient should be permitted to lie still. As a patient gets closer to passing away, pain medication is typically reduced because increasing it could have worsened side effects. A patient could feel uncomfortable and distressed during the process of being moved to a different bed.
A patient with controlled bilateral peripheral pitting edema and brownish staining of the skin near the ankles and anterior areas should be given the following advice to lessen the risk of ulcerations:
When edema is under control or when there are no ulcers present but there is stable venous insufficiency (indicated by brownish staining), therapeutic compression stockings (Class II, 30 to 40 mm Hg) are used to avoid ulceration. Additionally, patients should sit with their feet up. The damaged limb may need to be elevated above the heart for 1-2 hours twice day and at night as part of therapy. Everyone should give up smoking, but individuals with peripheral arterial insufficiency need to do so more urgently.
For a big open post-surgical abdominal incision that contains a fistula in the posterior aspect, which fistula care strategy is likely the best to prevent wound contamination from drainage?
Fistula drainage can be stopped by bridging, which also shields the incision from exudate. Small wafer pieces are layered to create a bridge that spans the depth of the wound. Following the application of barrier paste to the incision, an ostomy pouch is subsequently cut to fit the fistula's entrance. On one side, the bridge receives the ostomy pouch, and on the other, the intact skin.
What is the best dressing to use when a deep ulcerated area has a lot of exudate and the drainage is caused by tumor necrosis?
Alginate, which is derived from seaweed, absorbs exudate and inflates the cavity to provide comfort. External dressings are used to cover the alginate. Managing the exudate is crucial because uncontrolled drainage can be upsetting for the patient and harmful to the tissue surrounding the lesion. To prevent injury to the skin and adhesive stripping, top dressings may occasionally be taped to ostomy skin barriers after applying them around the perimeter of the wound.
Which sort of insert relieves pressure when contemplating orthotics and shoe inserts for patients with a neuropathic foot?
Inserts that are semi-rigid offer some cushioning and pressure alleviation. Soft inserts are mostly utilized for cushioning and shock absorption. To preserve alignment or restrict anomalous motion, rigid inserts, often formed of plastic, are utilized. Inserts with numerous layers that have been compressed in half are accommodative. Soft leather and enough depth in the soles should be the standard for shoes. Rocker soles, heel wraps, lateral flares, and mid-foot bolsters are examples of additional changes.