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Wound Care
Braden Scale
Characteristics
Sensory Perception
Moisture
Activity
Mobility
Nutrition
Friction and Shear
2 mins
Interventions for Impaired Skin Integrity
Assessment
Signs of Skin Breakdown
Pain
Redness
Decreased Skin Turgor
Bleeding
Bony Prominences
Intervention
Reposition Q2H
Pressure Relief
Maintain Clean and Dry Skin
Adequate Nutrition and Hydration
2 mins
Pressure Ulcers
Risk Factors
Prolonged Immobilization
Neurologic Disease
Decreased Level of Consciousness
Classification
Stage 1: Intact Skin with Non-blanchable Erythema
Stage 2: Partial Thickness Skin Loss
Stage 3: Full-thickness Skin Loss without Fascial Involvement
Stage 4: Full-thickness Skin Loss with Fascial Involvement
Integrin-Fibronectin interaction--> signals that modulate growth, migration, etc
Post-Op Wound Complications
Hematoma
Increased risk with obesity and anticoagulation
Ice packs, compression
Surgery if in neck
Seroma
Results from disruption of lymph vessels
Most self-resolve in 6 weeks
Superficial Infection
Prevent with ABX 1 hour pre-op
Wound culture
Dehiscence
May feel popping sensation
Fascial dehiscence: "salmon" colored drainage
Early recognition: Return to OR to close
Late recognition: allow to heal by granulation
Enterocutaneous Fistula
TPN
Most self resolve
Surgery if not closed in 6 months
Necrotizing Fasciitis
Immobility
Assessment
Mobility Continuum
Complications
Cardiovascular
Respiratory
Musculoskeletal
Integumentary
Gastrointestinal
Urinary
Considerations
Turn, Cough, Deep Breathe (TCDB)
Range of Motion (ROM)
Skin Care
Fluids
Balanced Diet
2 mins
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
2 mins
Red Blood Cell Count (RBC) Lab Values
Women: 3.5-5.5 million cells/ MuL
Men: 4.3-5.9 million cells/ MuL
1 min
Hemoglobin (Hgb) Lab Values
Men: 13 - 17 g/dL
Women: 12 - 16 g/dL
47 secs
Hematocrit (Hct) Lab Values
Women: 36% - 46%
Men: 41% - 53%
1 min
Platelet Lab Value
150,000-400,000 Micro L
40 secs
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