NR224 Fundamentals: Skills Exam 2 study guide A+ Guides Latest .

NR224 Fundamentals: Skills Exam 2 Study Guide 70 questions 1. What assessment data is needed for wound healing? Assess the patient NUTRITION. Nutrition role in healing  Calories: Cell energy  Protein: wound remolding  VIt. C, A, E  Zinc : Collage  Fluid: cell function a. Complications Nutrition: weight: any change recently (malnourished). Skin condition: turgor dehydration. Lab: albumen (normal is 3.5-5.0) Ask question: how much meat do you eat/protein? Necrosis Drainage Infection Perfusion (lack of O2) hypoxia Hemorrhage Hematoma Dehiscence: partial separation of wound layer. Evisceration: total separation of wound layered: organs exposure Laceration: cut. Can be bleeding more profusely Puncture: bleed in related to size. b. Healthy tissue: beefy red  Granulation tissue: red, moist tissue composed of new blood vessels.  No Induration( Edge hard is not good for wound heal)  Edge: well approximated  No tunneling  No undermining c. Drainage types and their characteristics  Serosanguineous : pale, pink, watery, mixture of clear and red fluid. *  Serous: clear, watery, plasma  Sanguineous: bright red, indicates, active bleeding.  Purulent: thick, yellow, green, tan, or red fluid. (infection)- bad news  Serosanguinous: This thin, pink-colored discharge is usually associated with normal wound recovery.  Purulent: Often a sign of infection, purulent discharge is generally thick and either green or yellow in color.  Seropurulent: Sometimes linked more mild infections, this is a yellow and especially cloudy form of drainage. This study source was downloaded by from CourseH on 12-01-2022 13