Reference no: EM133044035

HLTENN006 Apply principles of wound management in the clinical environment

Knowledge questions

Question 1. Define the following wound management terminologies in your own words (in at least a sentence each):

Acute wound
Chronic wound
Dermis
Exudate
Purulent
Epithelialisation
Granulation
Erythema
Macerated
Cellulitis

Question 2. Explore and briefly describe the historical development of contemporary wound management strategies in your own words.

Question 3. Explore and describe in your own words the National Safety and Quality Health Service (NSQHS) Standard relevant to wound management. How can compliance with this Standard be ensured and monitored?

Question 4. Discuss various causes of internal and external wounds in your own words.

Question 5. Discuss the pathophysiology and management of fungal infections. Your answer should include:
• What it is
• How it is detected
• How it is managed - consider PPE, medications, wound dressing etcetera.
• List three (3) different types of fungal infection.

Question 6. Discuss the pathophysiology and management of viruses which cause wound infections. Your answer should include:
• what it is
• how it is detected
• how it is managed
• list two (2) different types of viral infections

Question 7. Discuss the pathophysiology and management of two (2) bacteria which may can cause wound infections.

Your answer should include:
• what it is
• how it is detected
• how it is managed
• list two (2) different types of bacterial infections

Question 8. What are the classifications of surgical wound? Provide two (2) examples of each of the classifications of surgical wound (Class I - IV).

Question 9. Identify and briefly describe the stages of pressure ulcers.

Question 10. What are venous ulcers? Briefly describe the risk factors for venous leg ulcers.

Question 11. Research and summarise predisposing factors and diagnostic measures for arterial ulcers.

Question 12. Briefly describe what mixed ulcers are.

Question 13. There are different types of exudates commonly seen in wounds. Identify and briefly describe four (4) types of discharges from wounds.

Question 14. Briefly explain malignant wound. List three (3) principles underpinning malignant wound management.

Question 15. Briefly explain the important characteristics of a neuropathic ulceration.

Question 16. What is the difference between a topical wound infection and sepsis resulting from a wound? Outline general signs of wound infection.

Question 17. Identify and briefly describe the classification of burns.

Question 18. Briefly describe the strategies that are crucial in prevention and control of burn wound infection.

Question 19. What is a fistula? Briefly describe the difference between blind and complete fistulas.

Question 20. What is a sinus? Discuss the management of discharging sinuses.

Question 21. Briefly describe the difference between split thickness and full thickness skin grafts.

• Split thickness skin graft:
• Full thickness skin graft:

Question 22. What are visceral wounds? Outline the major causes, management and prognosis of visceral injuries.

Question 23. Briefly describe the principles of wound management.

Question 24. Briefly describe strategies that can be used in preventing pressure sores.

Question 25. Briefly describe the action of pressure relieving devices. Provide two (2) examples each of high-tech and low-tech pressure relieving devices.

Question 26. How could nurses working with elderly and frail clients benefit from a wound prevention program?

Question 27. Briefly describe how to apply the following primary health care principles in wound management.

- Community participation:

- Intersectoral approaches to health:

Question 28. Briefly explain the components of chain of infection (pathogens, reservoir, portal of exit, modes of transmission, portal of entry, and susceptible host) that you might discuss with the person, family or carer in relation to a wound.

Question 29. Briefly describe the three (3) lines of defence against pathogens.

Question 30. Describe, with the help of an example, how the following factors affect the susceptibility to infection:

a. Immune status:
b. Medications:
c. Comorbidities:
d. Age:

Question 31. Identify and explain two (2) community resources and two (2) educational resources associated with wound management in Australia.

Community resources associated with wound management in Australia:

Question 32. Discuss the roles of Wounds Australia and Wound Innovations.

Question 33. When is it most appropriate for a nurse to assess the person's pain and administer analgesics when implementing wound management? Identify two (2) examples of classes of analgesics that could be administered to a person when providing wound care management.

Question 34. Define wound debridement. Identify and briefly describe two (2) types of wound debridement.

Question 35. Briefly explain open and closed wound drainage systems and provide an example for each.

• Open drainage system
• Closed drainage system

Question 36. Why is it important to assess and interpret albumin and glucose values in a person with a wound? Provide three (3) examples of personnel you could collaborate with in interpreting laboratory results relating to wound care management.

Question 37. Briefly describe the significance of Doppler assessment in wound management. Identify two (2) conditions where Doppler assessment of the wound is contraindicated.

Question 38. What is the golden standard for the treatment of venous ulcers? Briefly describe this therapy and outline its benefits.

Question 39. Briefly describe the benefits of clinical photography of a pressure ulcer of a person at the time of admission.

Question 40. Briefly explain the process of wound tracing.

Question 41. Outline the factors to be included in the holistic assessment of a person with a complex wound. Include in your response detailed information on skin assessment and various risk assessments a nurse must perform for a person with a wound.

Question 42. What factors need to be considered when choosing a wound dressing? Describe the difference between a primary and secondary wound dressing, listing examples of each.

Question 43. A film dressing was applied on a Stage 1 pressure injury. However, the injury progressed to Stage II due to mismanagement of the person at home.

a. Identify two (2) goals you should set for this person.

b. Which wound care product is most appropriate for this stage of pressure injury.

Question 44. Read the case study excerpt and answer the discussion questions.

Elder abuse inquiry: Man dies in hospital after Gold Coast nursing home staff fail to properly treat wounds
RN Exclusive by David Lewis for Background Briefing Updated Tue 27 Sep 2016, 8:35am
An elderly man developed gangrene and later died in hospital after staff at a Gold Coast nursing home failed to properly monitor and treat pressure wounds on his buttocks and feet, according to the Aged Care Complaints Commissioner.
Zdenek Selir, who was known to friends and family as Danny, moved into the
Leamington nursing home in Southport in
June 2015 after suffering a stroke.
The 88-year-old had minor pressure
wounds when he arrived, but the operator of the facility acknowledges his condition deteriorated during his stay.

A family member was first alerted to the situation when she visited the home and noticed a foul odour.

"She could smell something in the room and she couldn't work out what it was and she pulled the covers up because she thought maybe he needed changing or something," said Mr Selir's daughter-in-law, Yvonne Selir.
It turns out the situation was much more serious than that.

"He had pressure wounds to the lower buttocks and his back and it had eaten into his skin and it was actually going to go gangrene," she said.
"The other pressure sore he had was on his heel and his heel was that badly affected it had already gone to gangrene."

Ms Selir claims the visiting family member asked nursing home staff to call for an ambulance but they instead insisted his wounds were manageable. The operator of the facility disputes this.

a. Discuss the preventative steps which should be taken in caring for the skin of a patient who has had a stroke. Consider the whole person.

b. What is gangrene? Discuss who is at risk of developing gangrene and how it is managed.

c. Discuss sepsis and the impact that this may have on a patient with gangrene. Consider what changes may be noticed on the patient's observation chart and what action you need to take as an Enrolled Nurse.

Question 45. Research and describe the common wound cleansing techniques used in various healthcare facilities.

Question 46. Explain the best practice for collecting a wound swab for analysis.

Question 47. Research and briefly describe the wound measurement techniques used in healthcare settings.

Question 48. Briefly describe the principles and advantages of moist wound healing.

Question 49. Briefly describe the significance of developing individualised wound management plans. What should be considered and included in the plan for each person?

Question 50. Briefly describe the steps a nurse should consider when implementing a problem solving framework when managing wounds (i.e. problem solving approach to wound care).

Question 51. Briefly describe the importance of observing the following wound characteristics:
• Wound location
• Temperature
• Presence of necrotic tissue
• Wound hydration
• Maceration.