NHM 412 Final Questions and Answers 2024
damage to the structure and function of tissue and can be a minor cut in the epidermis, or more severe, causing damage to subcutaneous tissue, including muscles, tendons, and bone ** Answ** wound
damage to the structure and function of tissue and can be a minor cut in the
epidermis, or more severe, causing damage to subcutaneous tissue, including
muscles, tendons, and bone ** Answ** wound
what are the 3 phases of wound healing? ** Answ** inflammation,
proliferation, remodeling
describe the pathophysiology of chronic venous ulcers ** Answ** chronic
venous ulcers are typically the result of insufficient circulation and venous
hypertension. they are typically shallow wounds, and signs of them include:
edema, varicose veins, and skin changes such as eczema and hyperpigmentation.
they consist of fibrotic cuffs that wrap around capillary vessels, which lead to
further degradation of tissue as these cuffs inhibit the transportation of oxygen and
nutrients to the dermal layer. leukocytes become trapped and release cytokines and
enzymes that damage endothelial tissue
list 3 common etiologies for diabetic ulcers ** Answ** peripheral neuropathy,
ischemia, trauma
describe how the inflammatory response may be different in patients with diabetes
compared to patients without diabetes ** Answ** in patients with diabetes,
cytokine concentrations may be abnormal, and these wounds may have decreased
levels of keratinocyte growth factor and insulin-like growth factor, as well as
,decreased nitric oxide production. hyperglycemia increases oxidative stress and
hinders the transport of ascorbic acid, which is necessary for collagen synthesis,
into leukocytes and fibroblasts. hyperglycemia affects neutrophil activity and cell
proliferation; granulation tissue formation is decreased, disrupting the healing
process
describe how hyperglycemia may contribute to poor wound healing ** Answ**
hyperglycemia increases oxidative stress and hinders the transport of ascorbic acid,
which is necessary for collagen synthesis, into leukocytes and fibroblasts.
hyperglycemia affects neutrophil activity and cell proliferation; granulation tissue
formation is decreased, disrupting the healing process
list 4 external factors that may contribute to the formation of a pressure ulcer (aka a
decubitus) ** Answ** compression, shear force, friction, moisture
list 6 areas which are particularly susceptible to the development of pressure ulcers
** Answ** heels, sacrum, coccyx, elbow, shoulder, back of head
list 5 clinical characteristics of the acute-phase response (aka the inflammatory
response) ** Answ** anorexia, fever, increased neutrophils and leukocytes,
hyperglycemia, anemia
compare and contrast the roles of positive acute-phase proteins and negative acute-
phase proteins ** Answ** positive acute-phase proteins are released by
hepatocytes and function to trap microorganisms and their products, activate the
complement system, bind cellular remnants, neutralize enzymes, scavenge free
hemoglobin and radicals, and modulate the host's immune response. other acute-
,phase proteins decrease in the acute-phase response and are called negative acute-
phase proteins. patients with pressure injuries and infections tend to have lower
serum levels of total proteins, albumin, transferrin, and hemoglobin, and higher
serum leukocytes and C-reactive protein. both positive and negative acute-phase
proteins are used as markers of inflammation
which of the following is prioritized during metabolic stress (aka the acute-phase
response) in a healthy individual?
-wound healing OR
-preservation of lean body mass ** Answ** wound healing
which of the following is prioritized during metabolic stress (aka the acute-phase
response) in an individual with pre-existing malnutrition?
-wound healing OR
-preservation of lean body mass ** Answ** preservation of lean body mass
the calorie needs for wound healing are _____ normal calorie needs ** Answ**
the same as
, the protein needs for wound healing are _____ than normal protein needs **
Answ** higher
your textbook states that arginine and glutamine are both "conditionally essential"
amino acids. what does this mean? ** Answ** when injury or trauma occurs,
the plasma and muscle stores of arginine and glutamine are quickly depleted,
making them "conditionally essential" amino acids. they are always essential, but
are especially essential in the case of injury
what is the role of arginine in wound healing? ** Answ** increases collagen
accumulation in wounds
what is the role of glutamine in wound healing? ** Answ** involved in
nucleotide synthesis in the cells involved in the healing process: fibroblasts,
macrophages, and epithelial cells; helps stimulate the inflammatory response
what is the role of B-hydroxy-B-methylbutyrate in wound healing? ** Answ**
increases cell proliferation and protein synthesis
what is the role of fat in wound healing? ** Answ** linoleic and arachidonic
acids needed for prostaglandin synthesis for cell growth and inflammation;
prostaglandins are critical for cellular metabolism and inflammation; phospholipids
are integral parts of cell membranes; omega-3 fatty acids can have possible actions
on pro-inflammatory cytokine production, and may help the wound healing process
through improved immune function and reduced infections and complications (not
much evidence)
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