Integumentary Conditions and Wound Care Flashcards

Which pressure injury stage is characterized by full-thickness skin loss with visible subcutaneous fat but no exposed bone, tendon, or muscle?

Answer: Stage III

Stage III pressure injuries involve full-thickness skin loss where subcutaneous fat may be visible but bone, tendon, or muscle are not exposed.

Which characteristic best describes a Stage IV pressure injury?

Answer: Full-thickness tissue loss with exposed bone, tendon, or muscle

Stage IV pressure injuries involve full-thickness tissue loss with exposure of bone, tendon, or muscle, often with undermining and tunneling.

A patient's wound bed appears red/pink, moist, and bleeds easily when touched. This finding indicates:

Answer: Healthy granulation tissue

Healthy granulation tissue appears red/pink, moist, and bleeds easily when touched, indicating active wound healing and adequate perfusion.

Which primary intervention is MOST effective for preventing pressure injuries in a non-ambulatory patient?

Answer: Repositioning every 2 hours

Regular repositioning every 2 hours is the cornerstone of pressure injury prevention by relieving sustained pressure over bony prominences.

Venous insufficiency ulcers are most commonly located on the:

Answer: Medial lower leg (gaiter area)

Venous insufficiency ulcers typically occur on the medial lower leg due to venous hypertension and pooling in that region from incompetent valves.

Which burn classification presents with erythema only, no blistering, and involves only the epidermis?

Answer: Superficial (first-degree) burn

First-degree (superficial) burns affect only the epidermis, presenting as erythema without blistering, similar to a mild sunburn.

The primary goal of maintaining a moist wound healing environment is to:

Answer: Promote cell migration and granulation tissue formation

Moist wound healing promotes cell migration, angiogenesis, and granulation tissue formation, leading to faster healing compared to dry wound environments.