NUR 2206 FINAL EXAM
- Surgical Asepsis
"Sterile Technique"
Items are free of all microorganisms including spores & viruses When do you use?*Surgery *Urinary Catheterization *Wound Dressings
- Principles of Surgical Asepsis
-Sterile packages are sealed in a way that they can be opened without contaminating contents -Edges of wrapper (1 inch) would be considered NOT sterile -Raise working surface to waist height -Keep sterile items between your nipple line & waist -If there is any doubt about sterility than it is considered unsterile -NEVER turn your back on sterile field; considered contaminated if you do
- Factors Affecting Skin Integrity
-Developmental Level
*Infants
thinner skin; susceptible to infection; lower immune system
*Older Adults
thinner skin; less subcutaneous fat
-Circulation 1 / 4
*Mobility
more mobile = more circulation
*Nutrition/Hydration
heal better
-State of Health *Physical Stature -Medical Interventions
- Wound Healing
-Intentional-planned
Surgery
-Unintentional
Accidental
-Open
Skin surface is broken
-Closed
Injury under skin (surface is intact; Ex. Bruise)
-Acute
Short (surgical incision generally)
*Heals as expected 2 / 4
-Chronic
Non-healing or takes longer time to heal (Ex. Pressure Ulcer)
*Does NOT heal as expected
- Factors Affecting Wound Healing
-Pressure to wound (decreased blood flow)
-Desiccation (dry wounds do not heal) -Maceration (over hydrated skin; too wet) -Trauma to wound (makes problem worse) -Edema around the wound (slows down healing) -Infection (body focuses on infection & less on wound healing)
-Necrosis (Dead Tissue
does not ever heal!)
-Age (can effect immunity) -Circulation & Oxygenation
-Nutritional Status (protein is important) -Wound Condition -Medications & Health Status
- Types of Wound Healing
Primary Secondary Tertiary
- Primary Wound Healing
Clean cut wounds Wound edges are well-approximated (close together) Ex. Surgical Cut 3 / 4
- Secondary Wound Healing
Deep wound
Crater & skin fills back in as opposed to growing back together Ex. Pressure Ulcer & Burns
- Tertiary Wound Healing
Need to delay closing a wound Delayed primary intention
Primary + secondary *Start healing with secondary & then finishes with primary *Fills in first & then comes together Ex. Abdominal Wound kept open for drainage
- Wound Complications
Infection Hemorrhage Dehiscence Evisceration
- Infection
-Bacteria enters the wound
-Can be hospital-acquired -Sign & symptoms usually occur in 2-7 days *Redness, warmth, swelling, pain, purulent drainage, increased WBCS, increased body temperature -Wound infection can lead to osteomyelitis or sepsis *Need to treat ASAP
- Hemorrhage
-Bleeding
*External or internal
- / 4