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Exam (elaborations)

Wound Care exam Study Guide with Complete Solutions

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  • WOCN Wound Care
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  • WOCN Wound Care

Wound Care exam Study Guide with Complete Solutions List the principles of surgical asepsis and explain the rationale for each principle. - Answer--sterile object remains sterile only when touched by another sterile object -place only sterile objects on sterile field -sterile object or field o...

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  • October 15, 2024
  • 24
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • WOCN Wound Care
  • WOCN Wound Care
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EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED. FIRST PUBLISH OCTOBER 2024.




Wound Care exam Study Guide with
Complete Solutions

List the principles of surgical asepsis and explain the rationale for each principle. - Answer✔✔--sterile

object remains sterile only when touched by another sterile object




-place only sterile objects on sterile field




-sterile object or field out of range of vision or an object held below a person's waist is contaminated




-sterile object becomes contaminated by prolonged exposure to air




-a sterile object or field becomes contaminated by capillary action when a sterile surface comes in

contact w/ a wet contaminated surface




-b/c fluid flows in direction of gravity, sterile object becomes contaminated if gravity causes a

contaminated liquid to flow over surface of an object (keep wet hands up above elbows, dry from fingers

to elbows)




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-the edges of a sterile field or container are contaminated (1-inch border)


risk factors for pressure ulcer development and nursing interventions to reduce ulcer development -

Answer✔✔-SHEAR-keep HOB <30 degree angle. reposition frequency is determined by tissue tolerance,

lvl of activity, and mobility. std=every 1-2 hrs for bed bound, every 1 hr for chair. use support surfaces to

redistribute wt




FRICTION-minimal layers of bed linens between pt and the surface. keep heels off bed. teach pt's to

reposition wt every 15 min. use assisitive devices when transferring or turning pt.




MOISTURE-use an incontinence cleanser and moisture barrier cream, toileting schedule, fecal

incontinence collector or condom cath, use underpads or diapers that wick moisture AWAY from skin

rather than trap it




NUTRITION-nutrition assessment, ensure adequate intake of PROTEIN, fat, and carbs, consult RD, ensure

adequate fluid intake




INFECTION-




AGE-thin skin increases




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Partial-thickness wound - Answer✔✔-wounds that heal by primary intention and shallow wounds that

only involve loss of epidermis/dermis




heal by resurfacing of wound with new epidermal cells


Partial-thickness wound repair - Answer✔✔-Inflammatory response-[erythema/edema inc WBC to site].

usually subsides in <24 hrs




Epidermal repair-[epidermal cells migrate across wound]. moist env-heal in ~4days, dry env-heal in 7

days




Dermal repair-[epidermis thickens and anchors to cells]. resumes normal fxn. pink, dry, and fragile skin.

occurs concurrently w/ epidermal repair


Full-thickness wound - Answer✔✔-involve tissue loss and extend to at least


Sub Q layer. can be acute (surgical wound) or chronic (pressure ulcer)




can be healed by primary or secondary intention


Full-thickness wound repair - Answer✔✔-Hemostasis-[controls bleeding]. platelets cause coag and

vasocontriction, and break down and release growth factors (GF initiate entire wound healing process).

DOES NOT occur in wounds healing by secondary intention! (comprimises repair process)




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