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NURS 5354 Final Exam With Complete Questions and Answers
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NURS 5354 Final Exam With Complete Questions and Answers What is a single suture strand called? - ANSWER Monofilament; more resistant to harboring microorganisms. What are several filaments twisted or braided together called? - ANSWER Multifilament; They are less stiff, have greater tensile strength but fluid may be absorbed along the filament to introduce pathogens. Infection risk! What are absorbable sutures? - ANSWER Two types: Natural-surgical gut; plain or surgical gut chromic (treated with chromium salt) Synthetic polymers-Vicryl (braided suture) or monocryl (monofilament) What are non-absorbable sutures? - ANSWER Two types: Natural-Surgical silk Synthetic-Nylon (Ethilon) or Polyprolene (Prolene) How do you determine the diameter of a suture? - ANSWER The smaller the number, the larger the strand. Ex: a 2-0 is larger than 5-0 suture. What size suture would you use for the face? - ANSWER 5-0 or 6-0 What size suture would you use for the scalp? - ANSWER 4-0 What size suture would you use for the upper body? - ANSWER 4-0 What size suture would you use for the hand? - ANSWER 4-0 or 5-0 What size suture would you use for the lower body? - ANSWER 4-0 What size suture would you use over a joint? - ANSWER 4-0 What suture pattern would be used for a laceration with irregular edges? - ANSWER Interrupted What suture pattern is best for high tension wounds, palms/feet or over joint areas? - ANSWER Horizontal mattress What suture pattern is best for loose/thin skin? - ANSWER Vertical mattress What suture pattern would be used on lacerations with low risk for infection and low wound tension? - ANSWER Continuous How far apart should two sutures be from one another? - ANSWER No closer than 2 mm in a fine plastic closure. The distance between sutures should equal half the total distance across the incision. When should sutures be removed from the face? - ANSWER 4-5 days When should sutures be removed from the scalp? - ANSWER 10-14 days When should sutures be removed from the upper body? - ANSWER 7-10 days When should sutures be removed from the hand? - ANSWER 7-10 days When should sutures be removed from the lower body? - ANSWER 10-14 days When should sutures be removed over joints? - ANSWER 14-21 days Consult/referral should be done for...? - ANSWER Deep wounds of the hand or foot, lacerations of the eyelid/lip/ear, lacerations involving tendon, nerves, arteries, bones or joints, penetrating wounds of unknown depth, severe crush injuries, severely contaminated wounds requiring drainage, wounds for which the patient or clinical is strongly concerned about cosmetic outcome. and galea What are other methods of wound repair/closure? - ANSWER Tape, adhesives or staples What needs to be documented/coded when suturing? - ANSWER Lesion location, lesion size, benign/malignant (discuss path report), and closure. What needs to be documented for wound repair? - ANSWER laceration length and location, any neurovascular damage distal to the injury, laceration clean or contaminated, anesthetic medication used, how the wound was cleansed, suture size, number and layer sutured (skin, dermis, fascia) and discussion of potential for infection or impaired function. What should be considered for post procedural care? - ANSWER Cleansing, antibiotics (if needed), use of steri-strips after suture removal to decrease wound tension and applying sunscreen to the area for at least 6 months to reduce scarring. What history should be obtained with laceration injuries? - ANSWER When did it occur (greater than 12-24 hours)? Where did it occur (dirty vs. clean)? Any foreign body? What was the mechanism of injury (sharp, blunt, animal bite, human bite, puncture?) What are present symptoms and care prior to arrival? Any history of impaired healing (HIV, DM, PVD, allergies, tetanus exposure, malnutrition, chemo, alcoholism, chronic steroid use, obesity)? What should ALWAYS be checked distal to the injury? - ANSWER Movement, circulation and sensation. With hand injuries, what should always be documented? - ANSWER Hand dominance and occupation. What are the goals of laceration/incision repair? - ANSWER Achieve hemostasis, prevent infection, preserve function, preserve cosmetic appearance, minimize discomfort. What is primary closure/intention? - ANSWER Direct approximation of the wound edges by suture, tape, adhesives, etc. What is secondary closure/intention? - ANSWER Wound is left open to heal by the formation of granulation tissue and contraction. What is delayed primary closure or tertiary intention? - ANSWER Wound is left open and would benefit from closure in a few days. Irrigation, packings and/or may be done while wound is left open and then by the 3rd day, definitive closure occurs.The benefits of buying summaries with Stuvia:
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