Suggested Answers to Assignments, Chapter 32, Skin Integrity and Wound Care

Written Assignments / Learning Objectives
1. Wounds are classified as intentional, unintentional, open and closed, and acute and chronic. The following factors affect wound healing:
  • Age
  • Circulation and oxygenation
  • Nutritional status
  • Wound condition
  • Health status
/ 1, 3, 5
2. Discuss the cognitive, technical, interpersonal, and ethical/legal skills necessary to respond to patients with skin alterations. Some examples include:
  • Knowledge to prevent, diagnose, and treat pressure ulcers and other skin alterations
  • Ability to correctly use bandages and binders
  • Ability to interact effectively with patients and work collaboratively with other healthcare workers to meet patients’ need for wound care
  • Ability to document skin and wound care accurately and according to agency policy.
/ 6, 7
Group Assignments / Learning Objectives
1. Discuss the factors that predispose a patient to pressure ulcers (external pressure and friction and shearing forces) and review pressure ulcer prevention and care. Note the following risks for ulcer development:
  • Immobility
  • Nutrition and hydration
  • Moisture
  • Mental status
  • Age
/ 2, 3, 4
2. Psychological effects of wounds include pain, anxiety, fear, and changes in body image. You might want to discuss the following interventions for wounds:
  • Assessing the stage of the pressure ulcer
  • Eliminating pressure on the area of skin breakdown
  • Cleansing the wound with each dressing change
  • Applying a moisture-retentive dressing to wound
  • Monitoring for possible infection
Wounds are also likely to have broad effects on most of the patient’s activities of daily living. / 6, 8
Clinical Assignments / Learning Objective
1. Bandages and binders are used to secure dressings, apply pressure, and support the wounds. A roller bandage is a continuous strip of material wound on itself to form a cylinder or roll. The most commonly used binders are straight binders, T-binders, and slings. / 7
2. Positioning devices and techniques maintain posture and distribute weight evenly for patients. Using a trapeze or bed linens to assist in transfers and position changes prevents friction on the skin. Pressure-relieving support surfaces, such as a foam overlay, static flotation mattress, alternating air mattress, low-air-loss bed, and air-fluidized bed are available to prevent pressure ulcers in patients. / 6
Web Assignments / Learning Objective(s)
1. Despite preventive interventions, pressure ulcers may develop in high-risk patients. Aggressive treatment measures by the nurse or caregiver are the key to effective management. Discuss the following topics:
  • Cleaning the pressure ulcer
  • Dressing the pressure ulcer
  • Controlling infection
  • Removing exudate
/ 6, 8
2. Heat and cold are applied to a body part or the entire body to bring about a systemic change in body temperature. Physiologic responses to heat and cold are modified by the method and duration of application, the degree of heat and cold applied, the patient’s age and physical condition, and the amount of body surface covered by the application. / 9