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Fundamentals of Nursing: The Art and Science of Person-Centered Care, 10th Ed., Taylor, Lynn & Bartlett
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Chapter 33: Skin Integrity and Wound Care

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Fundamentals of Nursing: The Art and Science of Person-Centered Care, 10th Ed., Taylor, Lynn & Bartlett | Registered Nurse (RN) School Study Aid

Chapter 33: Skin Integrity and Wound Care
15 Picmonics to Learn | 29 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
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2 mins
Chronic Venous Insufficiency (Venous Stasis Ulcer) Interventions
Frequently Elevate Legs
Avoid Standing/Sitting for Long Periods of Time
Elastic Compression Stockings
Bilayer Artificial Skin
Daflon
Wound Dressings
Proper Foot and Leg Care
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2 mins
Wound Drainage Types and Devices
Drainage Types
Serous
Serosanguineous
Sanguineous
Purulent
Drainage Devices
T-tube
Penrose
Jackson-Pratt (JP)
Hemovac
Considerations
Record Drainage Amounts
Check Device Function
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2 mins
Postoperative Care
Head to Toe Assessment
Complications
Hemorrhage
Clotting
Pain
Dehiscence or Evisceration
Respiratory Complications
Paralytic Ileus
Infection
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2 mins
Preoperative Care
Preop Education
Surgical Procedure
NPO
Turn, Cough, Deep Breathe, Incentive Spirometer
Lower Extremity Exercises
Compression Stockings or SCD's
Pain Management
Safety
Informed Consent
Physical Preparation
Preop Checklist
Handoff to Surgery
Universal Precautions
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2 mins
Colostomy Care
Wash with Warm Water
Cut 1/8 inch Around Stoma
Decreases Skin Irritation
Empty When 1/3 to 1/2 Full
Change 3-7 Days
Considerations
Avoid Odor Causing Foods
Irrigate at Same Time
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2 mins
Tracheostomy Care
Inner Cannula Removed and Cleaned
Clean Q8 Hours Around Stoma
One Finger Under Ties
Considerations
Speak with Deflated Cuff
Can Eat with Tube in Place
Keep Replacement Tube Nearby
Immediately Replace if Dislodged
Physician Does First Tube Change
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2 mins
Ileostomy Care
Antibiotics
Monitor Skin Breakdown
Drains Continuously
Fluid and Electrolyte Imbalance
Low Fiber Diet
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2 mins
Burns Assessment
Stage and Extent of Burn
Dyspnea
Singed Nasal Hairs
Pain
Initial Decrease Urinary Output
Paralytic Ileus
Signs of Inadequate Hydration
Shock
Hypothermia
Hyperkalemia
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2 mins
Types of Wound Healing
Types of Wounds
Acute
Chronic
Healing Process
Primary Intention
Approximated Edges
Secondary Intention
Edges Not Approximated
Tertiary Intention
Delayed Closure due to Infection and Necrosis
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2 mins
Skin Functions
Characteristics
Thermoregulation
Protection
Innate Immune Protection
Synthesize Vitamin D
Water and Salt Excretion
Dilated Capillaries are a Blood Reservoir
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2 mins
Skin Anatomy
Characteristics
Epidermis
Keratinocytes
Melanocytes
Dendritic Cells
Merkel Cells
Dermis
Sweat Glands
Hair Follicles
Sebaceous Glands
Hypodermis
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3 mins
Stages of Burn Care
Phase / Stage 1
Resuscitative/Emergent Phase
Injury to Return of Capillary Permeability
48-72 hours
IV Fluid Replacement
Phase / Stage 2
Acute Phase
Diuresis to Near Wound Closure
Phase / Stage 3
Wound Closure to Return of Optimal Level
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2 mins
Chest Tubes: Management and Care
Confirm suction order
Assessment
Crepitus
Kinking
Shortness of Breath (SOB)
Infection
Excessive bubbling
Quick Interventions
If tube dislodges from patient, use petroleum gauze taped 3 ways
If drainage system is damaged, place disconnected drainage tube in sterile water
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1 min
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
Management
Wound Care
Surgery
Considerations
Septicemia
Osteomyelitis
Prevention
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3 mins

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