Wound Care

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210 Nurse to Nurse Abnormal lung function (45% incidence more than 2 years after injury) Increased dead space/tidal volume ratio (up to 2.5 years after inhalation injury) Children with burns often fail to “catch-up” in growth relative to normal age-related growth. Burn Management • Requires a multidisciplinary management strategy and carefully choreographed plan of care — <strong>Wound</strong> care may be provided by the nurse, family member, or patient Pain control Odor control — Exudate containment — Infection prevention/treatment — Graft care — Debridement — Dressings: ideal properties Absence of antigenicity Tissue compatibility Absence of local or systemic toxicity Water vapor transmission similar to normal skin Impermeability to exogenous microorganisms Rapid and sustained adherence to wound surface Inner surface structure permits ingrowth of fibrovascular tissue Flexibility and pliability that permits conformation to irregular wound surfaces Resistance to linear and shear stresses Prevention of wound surface flora proliferation and reduction of bacterial density
Assessment of Other <strong>Wound</strong> Types 211 Tensile strength that resists fragmentation and retention of membrane fragments with removal Biodegradability (except for permanently implanted membranes) Low cost Indefinite shelf life Minimal storage requirements • Contracture and scar management • PT/OT/SLP • Medical social worker: long-term plan, vocational rehabilitation, financial planning • Chaplain • CHHA: home rehabilitation plan, restorative nursing plan • Supplies and DME coordination Irradiated Skin Management • All of the above for burn management as appropriate • Prevent trauma to skin that has been irradiated — No soap or mildest soap use only — Rinse soap thoroughly — Pat skin dry with soft, cotton, absorbent material; do NOT rub skin — No bathing or soaking in hot water — Do not use detergent soaps or bubble bath in bathing water — No perfumes, deodorants, or makeup on irradiated skin during treatment and only as needed after treatment is completed (some patients may never be able to use these product types) — No tight fitting clothing in the treatment field during treatment and as above as needed — No heating devices or ice packs or cooling devices on irradiated areas
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Nurse to Nurse WOUND CARE
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Nurse to Nurse WOUND CARE Donna Sce
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Professional Want to learn more? We
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xii List of Acronyms RBC Red blood
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2 Nurse to Nurse THE ROLE OF ETHICS
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4 Nurse to Nurse — Who does not h
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6 Nurse to Nurse • Specific amoun
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8 Nurse to Nurse disclosure of info
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10 Nurse to Nurse Remember Doing go
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12 Nurse to Nurse or guarantee anyt
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14 Nurse to Nurse Remember Provide
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16 Nurse to Nurse evaluation and ca
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18 Nurse to Nurse • The Hastings
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20 Nurse to Nurse Jacobs BB, Taylor
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22 Nurse to Nurse KEY POINTS • Su
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24 Nurse to Nurse Hair follicle Seb
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26 Nurse to Nurse Table 2-1 Common
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28 Nurse to Nurse — Brands of lig
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30 Nurse to Nurse • Acute wound:
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32 Nurse to Nurse Explicit chemoatt
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34 Nurse to Nurse • Diabetic foot
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36 Nurse to Nurse healing. This pha
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38 Nurse to Nurse or staples may be
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40 Nurse to Nurse increase in tempe
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42 Nurse to Nurse º If the wound i
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44 Nurse to Nurse º Linear wounds
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46 Nurse to Nurse Trauma Patient/ca
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48 Nurse to Nurse º Poor protein i
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50 Nurse to Nurse — Vitamin A: me
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52 Nurse to Nurse MULTIDISCIPLINARY
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54 Nurse to Nurse • Refer the pat
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58 Nurse to Nurse KEY POINTS • De
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Head Bony prominence Shoulder Sacru
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62 Nurse to Nurse • The proposed
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64 Nurse to Nurse Epidermis Muscle
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66 Nurse to Nurse Non blanchable er
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68 Nurse to Nurse — High intensit
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70 Nurse to Nurse • Elevated temp
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72 Nurse to Nurse • Corn starch s
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74 Nurse to Nurse • Diet and flui
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76 Nurse to Nurse — Occupational
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78 Nurse to Nurse — Use antifunga
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80 Nurse to Nurse — Keep the woun
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82 Nurse to Nurse • Stage III —
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84 Nurse to Nurse Apply hydrogel di
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86 Nurse to Nurse • The word “p
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88 Nurse to Nurse Table 3-3 Compone
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90 Nurse to Nurse Table 3-5 Categor
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92 Nurse to Nurse • Risk for pres
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94 Nurse to Nurse — If patient ha
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96 Nurse to Nurse • The Hartford
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98 Nurse to Nurse Hall JC. Sauer’
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100 Nurse to Nurse KEY POINTS • V
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102 Nurse to Nurse Deep leg veins E
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104 Nurse to Nurse Muscle contracti
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106 Nurse to Nurse • Trap hypothe
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108 Nurse to Nurse • Varicose vei
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110 Nurse to Nurse Nursing Alert A
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112 Nurse to Nurse formation due to
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114 Nurse to Nurse Measure 5 centim
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116 Nurse to Nurse • Some studies
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118 Nurse to Nurse — Stockings ar
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120 Nurse to Nurse Figure 4-4 Extre
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122 Nurse to Nurse • Provide thor
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124 Nurse to Nurse Table 4-5 Advant
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126 Nurse to Nurse Table 4-8 Indica
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128 Nurse to Nurse Table 4-10 Indic
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130 Nurse to Nurse • Treatment fo
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132 Nurse to Nurse Seaman S. Evalua
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134 Nurse to Nurse KEY POINTS • F
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136 Nurse to Nurse Chronic pain and
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138 Nurse to Nurse Aorta Superficia
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140 Nurse to Nurse Tunica initima E
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142 Nurse to Nurse Morphologically,
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144 Nurse to Nurse Carotid bifurcat
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146 Nurse to Nurse — These patien
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148 Nurse to Nurse ischemia from th
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150 Nurse to Nurse Table 5-1 Relati
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152 Nurse to Nurse DIAGNOSTIC PROCE
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154 Nurse to Nurse — Paint with a
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156 Nurse to Nurse º Enhanced work
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158 Nurse to Nurse • Cleanse gent
Page 176 and 177: 160 Nurse to Nurse Hilleman D. Mana
Page 178 and 179: 162 Nurse to Nurse KEY POINTS • P
Page 180 and 181: 164 Nurse to Nurse • 5% to 10% of
Page 182 and 183: 166 Nurse to Nurse — Hypertrophy
Page 184 and 185: 168 Nurse to Nurse Symptoms include
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Page 188 and 189: 172 Nurse to Nurse Table 6-2 Evalua
Page 190 and 191: 174 Nurse to Nurse — Antimicrobia
Page 192 and 193: 176 Nurse to Nurse — Erythrocyte
Page 194 and 195: 178 Nurse to Nurse Table 6-4 Wagner
Page 196 and 197: 180 Nurse to Nurse 3. Armstrong DG,
Page 198 and 199: 182 Nurse to Nurse Mayfield JA, Rei
Page 200 and 201: 184 Nurse to Nurse KEY POINTS • L
Page 202 and 203: 186 Nurse to Nurse — The most com
Page 204 and 205: 188 Nurse to Nurse Yoga, meditation
Page 206 and 207: 190 Nurse to Nurse MANAGEMENT AND T
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Page 210 and 211: 194 Nurse to Nurse — Contraindica
Page 212 and 213: 196 Nurse to Nurse Bryant RA. Acute
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Page 216 and 217: 200 Nurse to Nurse KEY POINTS • C
Page 218 and 219: 202 Nurse to Nurse • Solitary les
Page 220 and 221: 204 Nurse to Nurse — Place a shal
Page 222 and 223: 206 Nurse to Nurse All these agents
Page 224 and 225: 208 Nurse to Nurse º These product
Page 228 and 229: 212 Nurse to Nurse — No sun expos
Page 230 and 231: 214 Nurse to Nurse — Specific ref
Page 232 and 233: 216 Nurse to Nurse • Treatment
Page 234 and 235: 218 Nurse to Nurse (systemic lupus
Page 236 and 237: 220 Nurse to Nurse • In individua
Page 238 and 239: 222 Nurse to Nurse • Usually star
Page 240 and 241: 224 Nurse to Nurse 3. Pruitt BA, Le
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Page 244 and 245: 228 Nurse to Nurse KEY POINTS • E
Page 246 and 247: 230 Nurse to Nurse functional outco
Page 248 and 249: 232 Nurse to Nurse — Phase change
Page 250 and 251: 234 Nurse to Nurse — Provided is
Page 252 and 253: 236 Nurse to Nurse • Support clie
Page 254 and 255: 238 Nurse to Nurse º Dressings* º
Page 256 and 257: 240 Nurse to Nurse include the CNA
Page 258 and 259: 242 Nurse to Nurse client and careg
Page 260 and 261: 244 Nurse to Nurse the health-care
Page 262 and 263: 246 Nurse to Nurse — Consistency:
Page 264 and 265: 248 Nurse to Nurse Only when perfor
Page 266 and 267: 250 Nurse to Nurse • Certain woun
Page 268 and 269: 252 Nurse to Nurse — Safe to use
Page 270 and 271: 254 Nurse to Nurse — Wound contam
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Page 274 and 275: 258 Nurse to Nurse Infected wounds:
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260 Nurse to Nurse smaller wound di
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262 Nurse to Nurse — Delayed heal
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264 Nurse to Nurse of any injury to
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266 Nurse to Nurse — In the early
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278 Nurse to Nurse Table 9-16 Advan
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288 Nurse to Nurse • Stage IV: fu
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290 Nurse to Nurse Shows 30° sidel
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292 Nurse to Nurse Slide hand (palm
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294 Nurse to Nurse — Appropriate
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296 Nurse to Nurse — Diet and flu
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298 Nurse to Nurse — Home rehabil
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300 Nurse to Nurse Pressure Ulcer T
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302 Nurse to Nurse • Home rehabil
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304 Nurse to Nurse • Diabetes nur
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306 Nurse to Nurse — Two (2) inch
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308 Nurse to Nurse weight distribut
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310 Nurse to Nurse — Gravitationa
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312 Nurse to Nurse Hill-Rom Huntlei
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314 Nurse to Nurse • Cleanse gent
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316 Nurse to Nurse — Avoid use of
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318 Nurse to Nurse Cunningham D. Tr
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322 Nurse to Nurse KEY POINTS • S
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324 Nurse to Nurse with the ability
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326 Nurse to Nurse º Tensile stren
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328 Nurse to Nurse Melanocytes tran
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330 Nurse to Nurse PATIENT HISTORY
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332 Nurse to Nurse — Often darker
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334 Nurse to Nurse — Any changes
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336 Nurse to Nurse — Any thyroid
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338 Nurse to Nurse — The sclera m
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340 Nurse to Nurse • Symmetry, ul
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342 Nurse to Nurse • Senile lenti
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344 Nurse to Nurse • Document the
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346 Nurse to Nurse 9 O’ Clock Rig
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348 Nurse to Nurse Nursing Alert Al
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350 Nurse to Nurse • Provide supp
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352 Nurse to Nurse Whenever the pat
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356 Index Arterial ulcer, 33 Arteri
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358 Index Debridement (Cont.): cuta
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360 Index Hematopoietic system, in
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362 Index Multizoned support surfac
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364 Index Pressure ulcers (Cont.):
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366 Index Skin temperature, in lowe
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368 Index Wheelchair positioning, 9
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Wound Care

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