Module 2 NDNQI Wounds Questions And Answers Rated A+ New Update Assured Satisfaction
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Module 2 NDNQI Wounds
Institution
Module 2 NDNQI Wounds
Moisture Associated Skin Damage - ️️term used to describe skin conditions that
are the result of exposure to moisture.
Defined as inflammation of the skin and erosion from prolonged exposure to moisture
and its contents.
Common sources of moisture include urine and stool, perspiration, woun...
Module 2 NDNQI Wounds
Moisture Associated Skin Damage - ✔️✔️term used to describe skin conditions that
are the result of exposure to moisture.
Defined as inflammation of the skin and erosion from prolonged exposure to moisture
and its contents.
Common sources of moisture include urine and stool, perspiration, wound exudate, and
effluent from an ostomy.
Incontinence-Associated Dermatitis
Pressure Injury Classification - ✔️✔️If the deepest type of tissue is visible (or directly
palpable), the pressure injury can be classified as Stage 1, 2, 3 or 4.
If the deepest tissue is not visible, the pressure injury is classified as unstageable (i.e.
deepest tissue obscured by slough or eschar);
Deep Tissue Pressure Injury (DTPI) (i.e. deep red, maroon or purple discoloration); or
Non-Visible (a special NDNQI category for pressure injuries under non-removable
dressings or devices)
Pressure injuries on mucosal membranes are counted, but not staged
Wound/Skin Injury etiology - ✔️✔️disease, moisture and trauma
Arterial Ulcers - ✔️✔️A wound caused by impaired arterial blood flow to the lower leg
and foot esp. Toes, dorsum of the foot, lateral malleolus, distal lower leg
The impairment in blood flow results in tissue ischemia, necrosis, and loss.
Arterial Ulcer causes - ✔️✔️Atherosclerosis
Arteriosclerosis
History of arterial insufficiency to lower extremities:
Peripheral Arterial Disease (PAD)
Lower Extremity Arterial Disease (LEAD)(1)
Risks:
Age
Smoking
Diabetes Mellitus
Hypertension
Dyslipidemia
Obesity
, Family history of cardiovascular disease(2)
Venous Ulcer Associated Skin Assessment - ✔️✔️Hyperpigmentation of lower calf and
ankle skin from hemosiderin staining (leakage of red blood cells into the tissue)
Lipodermatosclerosis - thickening and fibrosis of skin and subcutaneous tissue from
chronic inflammation
Edema that may worsen with prolonged standing
Dry scaly skin that may be itchy
Weepy skin
Evidence of healed venous ulcers
Arterial Ulcer Associated Skin Assessment - ✔️✔️Cooler skin temperature
Thin, shiny skin
Decreased or absent skin hair
Decreased pulse strength in affected extremity
Skin pallor on foot elevation; dusky rubor on dependency
Dystrophic toenails
Low Ankle-Brachial Index (ABI)
Arterial Ulcer Characteristics - ✔️✔️Round and regular in shape
Pale wound bed
Can be shallow in depth or relatively deep
Smooth wound edges
Gangrenous/necrotic tissue may cover the wound
Minimal drainage
Severe pain
Venous Ulcer - ✔️✔️An open skin lesion of the leg or foot that occurs in an area
affected by venous hypertension.
Prolonged venous hypertension results in vein wall damage. This increases capillary
permeability and allows the extravasation of micromolecules and macromolecules into
the surrounding tissue. Damage to these tissues leads to venous ulcer development.
Venous Ulcer Location - ✔️✔️Lower calf and ankle (the gaiter area)
Pretibial and medial supra-malleolar area of the ankle near perforator veins.
Lower Extremity Venous Disease Risks - ✔️✔️Family history
Older age
Obesity
History of venous disease or thromboembolism
Trauma to the legs
Female
Pregnancy
Occupation that involves standing for a long period
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