CWCA (Other exams) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Hemostasis phase

Immediate response to injury in which blood vessels constrict, platelets aggregate, and a fibrin clot forms, providing a scaffold for later repair.

Inflammatory phase timing

The inflammatory phase begins at injury and lasts roughly 3 to 4 days; neutrophils arrive first for bacterial clearance and macrophages follow.

Macrophage role in healing

Macrophages peak around 48 to 72 hours, clear debris and bacteria, and secrete growth factors such as PDGF and TGF-beta that recruit fibroblasts.

Proliferative phase

Proliferative phase spans days 4 to 21, when fibroblasts make collagen, new capillaries form, and granulation tissue fills the wound while epithelium migrates across.

Remodeling phase

Final phase starting near day 21 and lasting up to two years; type III collagen is replaced by stronger type I and tensile strength plateaus near 80 percent of normal skin.

Secondary intention healing

Wound left open to fill with granulation tissue and contract, producing a larger scar; used when infection or contamination prevents immediate closure.

Non-blanchable erythema

Persistent redness over intact skin that does not blanch when pressed, identifying a Stage 1 pressure injury caused by unrelieved pressure over a bony prominence.

Stage 3 pressure injury

Full-thickness skin loss with subcutaneous fat visible; bone, tendon, muscle, and cartilage are not exposed, though slough or eschar may be present.

Unstageable pressure injury

Full-thickness wound whose base is completely obscured by slough or eschar, so true depth and stage cannot be determined until debridement occurs.

Deep tissue pressure injury

Intact or non-intact skin with a persistent deep maroon or purple area, reflecting damage to underlying soft tissue from pressure and shear.

Braden Scale

Six-item pressure injury risk tool covering sensory perception, moisture, activity, mobility, nutrition, and friction/shear; scored 6 to 23, with 18 or below indicating risk.

Ankle-brachial index interpretation

Ratio of ankle to brachial systolic pressure; 0.9 to 1.3 is normal, below 0.9 suggests arterial disease, and above 1.3 suggests calcified non-compressible vessels.

Wound measurement technique

Measure the greatest head-to-toe length and the greatest perpendicular width in centimeters, plus depth, using the same technique and units each time.

Autolytic debridement

Uses the body's own enzymes under a moisture-retentive dressing such as a hydrocolloid or film; selective and painless but slow and unsuitable for infected wounds.

Sharp debridement

Removal of devitalized tissue with a sterile scalpel or scissors; the fastest method, requiring training, perfusion assessment, and bleeding precautions.

Wet-to-dry dressing

Gauze moistened with saline, packed into the wound, and removed after it dries; non-selective, painful, and strips new tissue, so it is no longer recommended.

Compression therapy

Graduated or multi-layer system delivering roughly 30 to 40 mmHg at the ankle to heal venous leg ulcers; contraindicated when arterial perfusion is inadequate.

Negative pressure wound therapy

Applies controlled subatmospheric pressure, usually -125 mmHg, to promote granulation; contraindicated over malignancy, untreated osteomyelitis, exposed vessels, and unexplored fistulas.

Total contact cast

Gold-standard offloading device for neuropathic diabetic foot ulcers; it molds to the leg and redistributes pressure, requiring frequent cast changes and skin monitoring.

PUSH tool

Pressure Ulcer Scale for Healing scores surface area, exudate amount, and tissue type; totals range from 0 to 17, and falling scores indicate improvement.

Levine technique

Culture method in which a swab is rotated over a cleaned one-square-centimeter area of viable wound bed for five seconds to sample tissue fluid rather than surface exudate.

Biofilm

Structured, polymicrobial community encased in a protective matrix that adheres to the wound bed, resists antibiotics, and requires debridement plus antimicrobial therapy.

Critical colonization

Intermediate state with increased exudate, dull friable granulation tissue, delayed healing, and new pain, but without the systemic signs of true infection.

C. difficile hand hygiene

Spore-forming organism that alcohol does not kill; use soap-and-water handwashing plus contact precautions with dedicated equipment for infected patients.

Asepsis in wound care

Hand hygiene and clean gloves are required for all wound care; sterile gloves and a sterile field are added only for procedures entering sterile body areas.

Teach-back method

Learner restates the information in their own words or demonstrates the skill, giving the clinician a reliable check on comprehension.

Protein needs in pressure injury

Guidelines recommend 1.25 to 1.5 grams of protein per kilogram of body weight daily for adults with pressure injuries who have adequate renal function.

Diabetic foot self-care

Daily inspection of the feet including the soles with a mirror, no barefoot walking, well-fitting shoes, and prompt reporting of blisters or skin breakdown.

Pressure injury prevention bundle

Combines repositioning, support surface selection, moisture and incontinence management, nutrition screening, heel offloading, and daily skin inspection documented each shift.

Chain of command

Documented hierarchy for escalating unsafe conditions or unresolved clinical concerns from charge nurse to supervisor and administration, protecting both patient and clinician.

Never event

Serious, largely preventable adverse event such as a Stage 3 or 4 hospital-acquired pressure injury; it is reportable and not reimbursed.

Negligence elements

Duty, breach of duty, causation, and damages; all four elements must be proven for a malpractice claim arising from wound care.