Briefly discuss the two (2) standards that relate specifically to…

1. Briefly discuss the two (2) standards that relate specifically to wounds and infections (including pressure injuries) that organisations must use to shape policies and procedures for wound care.
2. Outline four (4) different time periods where progress or change has occurred in wound management strategies. (start in early Egyptian times and progress to current times).
3. Outline three (3) conditions or environments microorganisms need to cause/contaminate a wound.
4. Identify two (2) common fungal infections that may cause/contaminate a wound and identify a major reservoir for each.

Common viral infection	Major reservoir

 

   5. Identify two (2) common viral infections that may cause/contaminate a wound and identify a major reservoir for each. 

Common viral infection	Major reservoir

6. Briefly outline the different between an acute and chronic wound.

 

7. Identify three (3) common problems and complications of wound healing.

 

8. Jack Sparrow has a surgical wound with a Bellovac drainage system. Identify four (4) interventions nurses need to note in regard to post operative management of a surgical drain and wound drainage systems. 

 

Mr Jones who has a history of chronic venous disease and leg ulcers has returned from theatre after hip surgery and is fitted with elastic compression stockings (TED) and sequential compression device (SCDs).

1. Outline the benefit of elastic compression stockings (TED) and sequential compression device (SCDs)
    
2. Outline 4 relevant factors the Enrolled nurse must consider when developing an individualised wound care plan (in conjunction with the RN).

 

Many patients with a wound will need ongoing support in terms of wound management, lifestyle changes and prevention.

1. Provide two (2) names and contact / URL details for each of the following organisations that are associated with wound management and prevention.

Organisations	Names and contact / URL details
Local community organisations associated with wound management and prevention.
Australian educational resource organisations associated with wound management and prevention.
Professional Australian organisations associated with wound management and prevention.

Case study 1 Infected Surgical Wound (relates to questions 16 – 24)

Ms Joyce Barns is a 58-year-old female, admitted to the orthopaedic ward following a total right knee replacement. Post Staples were the method of wound closure. Ms Barns’ medical history states she is a heavy smoker, has osteoarthritis, is overweight, and a type 2 diabetic. Day 4 post-op: Joyce complains of pain in her right knee, she is febrile 38.7C and an increase in discharge from her wound on her dressings is apparent. On removal of the wound dressings, the wound appeared reddened and inflamed; staples are insitu; an open 1.3cm gap at the lower end of the wound was obvious and is oozing purulent fluid. A wound swab is taken, and results show a Methicillin-resistant Staphylococcus aureus (MRSA) infection.  On reading the surgeons’ instructions: “Antibiotics to be commenced; Wound cavity to be dressed daily with dressing as directed by wound specialist. Ms Barns is reviewed by the wound management nurse who documented the following:  “Nursing: Wound to heal by secondary intention. Wound cavity measures 13mm long x 10mm wide and 8mm deep, extending to the subcutaneous tissue layer. Wound bed consists of 100% granulation tissue; is malodorous and is oozing a moderate amount of haemopurulent exudate. Staples to remain insitu until day 10 post-op”.

    1. Surgical wounds are caused as part of a surgical intervention that involves an incision or intentional break in the skin (eg perforation).

Outline four (4) classifications of surgical wounds.

 

 

 

 

17. Chronic illnesses can impact the body’s wound healing processes. Discuss the effect of poorly controlled diabetes on wound healing.

 

 

18. The doctor has requested a wound swab for microbiology and cytology (MC&S). Outline the steps for collecting this swab.

 

 

This question has two (2) parts. Both parts must be attempted to support a successful result. 

1. a) Describe the difference between a contaminated and an infected wound
2. Identify five (5) clinical manifestations of a wound infection
3. To whom do you refer to in regard to interpreting and evaluating Joyces wound specimen results.
    

You have been asked by the RN to redo Joyces wound dressings following the medical officer’s review. This requires wound cleaning and the use of the non-touch aseptic technique.

1. Outline the importance of wound cleaning and one (1) example of a common wound cleaning solution. 
2. In regard to non-touch aseptic techniques, state what each of the following mean.

“The key part”

 

 

 

“The key site”

 

19. Outline four (4) principles of the aseptic non-touch technique (ANTT®)

 

  Joyces wound will require a moist environment to heal.

1. What are four (4) benefits of maintaining a moist wound environment?
    

Case study 2 Trauma (relates to question 25 – 26)

Michael is a 45-year-old man who works as a farmer on a rural property approx. 30 mins from the nearest hospital. He was out on his property on a quad bike when he hit a large hole and the bike tipped over onto him. He sustained a broken arm and a long, jagged wound on his right knee. His son who was on another quad bike wrapped his leg in a towel, managed to get back to the farmhouse and called for the ambulance who took him to the hospital emergency centre. The arm is set in a cast and the wound is cleaned, sutured. Michael is kept in the hospital overnight for observations and discharged home the next day on oral antibiotics and pain relief.

1. Immediately after a traumatic injury the wound to undergoes a process of haemostasis. Provide a definition of a traumatic wound and an explanation for the three (3) components of Haemostasis.

Definition of a traumatic wound

 

Vasoconstriction
Platelet response
Biochemical response

Following haemostasis the wound healing process commences and there are 3 stages.

1. For each of the phases in the table, identify how long each phase lasts and what occurs in each phase.

Three (3) phases	Length of each phase	What occurs
Inflammation
Reconstruction
Maturation

Case study 3 Diabetic Neuropathic Ulcer (relates to questions 27-38)

Hillary Swan is a 78-year-old woman scrapped the side of her foot while gardening 6 weeks ago causing a small wound that has increased in size and pain. She treated it herself, but it is not healing and has gotten bigger and begun to ulcerate with some parts turning dark brown. Finally, she went to her GP, and he admitted her to hospital where she was facing cleaning and debridement of the wound which was diagnosed as a diabetic neuropathic ulcer. Comorbidities include type 2 diabetes (inadequate control), hypertension and mild renal insufficiency and obesity.

 

1. Outline the pathophysiology of peripheral neuropathy in a diabetic that may result in the formation of a neuropathic ulcer.
2. You are required to use a handheld doppler on Hillary. What is a doppler and what is its purpose. 
3. When the nurse is assessing Hillary’s wound, what do you measure and provide one example of a measurement tool.
4. Outline the benefit to taking a photo of Hillary’s wound. 
5. Outline the rationale for wound tracing.
6. Identify 2 common risk assessment tools/charts used in Australia that would be appropriate for Hillary’s needs.
7. Provide a rationale for the use of risk assessment tools. 
8. Identify three (3) pressure relieving strategies that may be utilised for Hillary while in the health care facility to prevent further pressure injuries. 

Wound care needs may vary during the different phases of wound healing. Therefore, a variety of products may be used.

1. In the table below, identify the indications and provide one (1) example for each of the dressing types. 

Dressing type	indications	One example
Gelling cellulose fibre dressings
Hydrocolloids
Foam dressings

 

1. Hillary will require a primary and secondary dressing to her ulcer, outline what each represents.
2. Discuss two (2) aspects for each of the factors below in how they would impact on Hilary’s wound healing.

Factor	Two (2) potential impacts
Chronic Illness, eg Diabetes
Nutrition
Vascular Insufficiency
Obesity
Age
Psychosocial Impact

 

This question has two (2) parts. Both need to be attempted to support a successful result.

1. Hilary is almost ready for discharge but needs further education regarding her wound.
2. In relation to this scenario, describe the rationale for providing this education to Hilary on discharge.
3. Identify six (6) aspects of her health and lifestyle that you could provide education and guidance.

Case study 4 Traumatic Burns Injury

Ash Carter aged 34 was admitted to the burns unit after sustaining burns to the front and back of her left lower leg and foot. Ash had been cooking in her kitchen when she accidently knocked a saucepan full of hot oil over herself. Ash’s husband called the ambulance who transported Ash to the hospital for assessment. In the emergency room, Ash was conscious and in evident distress. Her admission notes were: areas of variable depth of injury over her posterior lower leg and foot only; dark pink discoloration with sluggish capillary refill, blistering is evident; an area on her inner left ankle has an area of blotchy red/white with sluggish to absent capillary refill, patient is complaining of pain on her lower leg, but states that her ankle is somewhat pain free. After consultation with the Burns team, the burns are to be surgically debrided, and a small Autograft (skin graft taken from Ash’s healthy skin) will be applied to her inner ankle injury.

 

1. When a patient suffers a burn injury it is important to classify the wound and extent of the burn.

Provide a description for each of the classifications in the table below along with the burn percentage. 

Classification	Description
Superficial
Partial thickness
Full thickness

 

Use the Rule of Nines to identify the extent of Ash’s burn	224297740 / stihii / shutterstock.com
Burn percentage:

1. Using the information from the case study regarding Ash’s wound, identify the likely classifications which may apply and provide a rationale for your choice.

 

It was noted in the case study for Ash that she required “surgical debridement” to her burns 

1. Define surgical wound debridement and state why debridement is undertaken.
2. Explain how the skin heals when a skin graft is in place.
3. Provide a rationale for each of the following nursing actions that maybe used by the Enrolled nurse to provide comfort and manage Ash’s pain. 

Nursing Action	Rationale
Implement prescribed therapy.
Provide ordered medication prior to dressing changes
Change of position
Promote rest and sleep
Check dressings

2. Provide two (2) ways the Enrolled nurse can help Ash with psychosocial issues she may face in her recovery from her burns.

Explanation & Answer

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.