Exam (elaborations)
WOCN WOUND EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
- Course
- Institution
WOCN WOUND EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
[Show more]
Content preview
WOCN WOUND EXAM QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
Goals of wound assessment - ANSWER 1. Determine etiologic factors
2. Assess systemic factors/comorbidities
3. Assess wound to determine phase of healing
4. Determine goals of topical therapy
Why does hyperglycemia affect wound healing? - ANSWER Impairs leukocyte function and negatively
impacts collagen syntehesis, development of tensile strength, epithelial resurfacing
What BG parameters should be maintained for wound healing? - ANSWER BG <180 for leukocyte
function; <140 for healing
A1C <7 for most, <8 if hx of severe hypoglycemia, advanced comorbidities, limited life expectancy
Why is nutrition relevant to wound healing? - ANSWER Muscle or SubQ wasting increases risk of
pressure/shear damage
malnourished pt unable to synthesize and cross-link collagen normally
protein deficiency increases risk of infection
What effect do low zinc levels have on wound healing? - ANSWER compromise collagen
synthesis/crosslinking
What amino acids are essential for collagen synthesis?
What is the effect of stress on these amino acids? - ANSWER Glutamine and l-arginine
Not adequately produced during times of physiologic stress
What weight trend suggests nutritional deficiency? - ANSWER Unplanned weight loss =>2.5% of usual
weight in 30 days or =>10% within 180 days
BMI <18.5
,What serum albumin level indicates malnutrition? - ANSWER <3.5 g/dl
What serum transferrin level indicates malnutrition? - ANSWER <100mg/dl
What serum prealbumin level indicates malnutrition? - ANSWER <19.5
What total lymphocyte count level indicates malnutrition? - ANSWER <1500
What are s/s of nutritional deficits? - ANSWER skin rashes, cracks in mucous membranes, edema, muscle
and subQ tissue wasting, nonhealing wounds, dry/pluckable hair, dry flaky itchy skin
What is the suggested caloric intake? - ANSWER 30-35 cal/kg body weight
What is the suggested protein intake? - ANSWER 1.25-1.5 g/kg body weight
What is the suggested fluid intake? - ANSWER 30ml per kg (unless fluid restriction indicated)
How do you assess perfusion/oxygenation? - ANSWER capillary refill, pulses, presence/absence of
edema, TcpO2 levels (at least 40), color of wound bed (bright pink/red), ABI for lower extremity ulcers,
systolic bp/episodes of hypotension, vasopressor administration
How do you assess for immunosuppression? - ANSWER Comorbidities/therapies such as HIV, steroid
tehrapy in doses >30mg/day for >30 days, and/or chemo resulting in neutropenia; high dose NSAIDs
What comorbidities compromise wound healing? - ANSWER renal failure, liver failure, multisystem
trauma, smoking, advanced age
What are the layers of the skin - ANSWER Epidermis
Basement Membrane Zone
Dermis
,Subcutaneous Tissue
Muscle/Fascia/Bone
What are the layers of the epidermis? - ANSWER Stratum corneum - keratinocytes filled with keratin
Stratum lucidum - only in palms/soles, thick areas
Stratum granulosum - odland bodies secrete ceramides, lipophilic
Stratum spinosum - desmosomes (cell to cell junctions)
Stratum germinativum - dermal-epidermal junction
What is the Basement Membrane Zone? - ANSWER Dermal-epidermal junction
What are the components of the dermis? - ANSWER Papillary dermis: papillae interlock with rete ridges,
capillary loops, sensitive to point pressure
Reticular dermis: mostly type 1 collagen, vasculars, and lymphatics
What structures of the skin can regenerate? - ANSWER Epidermis and parts of the dermis
What structures of the skin heal by scar formation? - ANSWER Epidermal appendages, Subcutaneous
tissue/fascia/muscle
How is newborn skin different? - ANSWER No scars up to 2nd trimester
30% thinner skin
Faster epidermal turnover
How is premature infant skin different? - ANSWER Very thin, increased fluid loss, functional stratum
corneum at 30-32 weeks
What problems may arise with infant skin? - ANSWER increased permeability, increased MARSI risk,
extravasation, diaper dermatitis
, How do you mitigate MARSI risk in infants/elderly? - ANSWER avoid tape or use hydrocolloid base or
silicone adhesive, no alcohol removers only mineral oil, petroleum, silicone (preferred), and citrus)
How do you mitigate extravasation in an infant? - ANSWER Hyaluronidase
OR
phentolamine if vasoconstrictor
How do you mitigate diaper dermatitis? - ANSWER Higher pH
Use petroleum base for mild erythema and zinc oxide for denuded skin
sever denudation - carboxymethylcellulose/petrolatum/zinc oxide (Ilex)
What bathing considerations must you take for premature infants? - ANSWER <30 weeks bathe with
water only for 2 weeks
What are common issues with older skin? - ANSWER Thinner, collagen shrinks and causes wrinkles
Rete ridges and dermal papillae flatten - increased risk for tears/stripping
Reduced sebaceous and sweat glands - dry skin
Erratic/decreased melanin production
Decreased sensation - increased trauma risk
Loss of SubQ tissue - increased shear and decreased insulation
Increased malignant lesions - refer to derm
Reduced blood flow, increased epidermal turnover - slow healing
Increased senescense
Maybe increased inflammatory mediators, decreased inhibitors
Increased capillary fragility (bruises)
What strategies keep skin healthy? - ANSWER pH balanced cleaners - no alkaline soaps
Superfatted nonalkaline soaps for dry skin
CHG reduces pathogens and sepsis
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Performance. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $20.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79271 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now