HLTENN006: Nursing Assignment on Wound Management and Care

This comprehensive nursing assignment delves into the multifaceted realm of wound management, encompassing acute and chronic wounds, and exploring essential terminologies like exudate, epithelialization, and cellulitis. It traces the evolution of contemporary wound management strategies, and discusses the National Safety and Quality Health Service (NSQHS) Standard relevant to wound management, emphasizing the importance of compliance and monitoring. The assignment further investigates the diverse causes of internal and external wounds, examines the pathophysiology and management of fungal and viral infections, and analyzes bacterial wound infections, categorized by their characteristics and treatment protocols. It also covers pressure sores, venous ulcers, and various categories of wound excretions, malignant injuries, and burn wounds. The principles of wound management, including hemostasis, cleansing, skin closure, and dressing, are highlighted, alongside preventative measures for pressure sores and burn wound disease. The assignment also discusses the role of community involvement, the chain of infection, and lines of defense against pathogens, providing insights into public resources, wound management experts, and educational materials. Finally, it includes a discussion of debridement, drainage systems, and the use of Doppler assessment, along with the benefits of multi-layered pressure treatment for venous ulcers.

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Professor
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1. Acute wound refers to the wounds that heal through routine progressions of inflammation,
formation of tissues and remodelling which takes place in a timely version. The wound heals at a
predictable time and a a set target that is given to the process of healing of a normal wound.
Acute wounds can be evident in any part. The injuries may vary from scratches to deep cuts in an
part of the body.
Chronic wound refers to the wound that does not heal in stages
Dermis: this is a layer of the skin that lies below the epidermis.

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Exudate: this is a term referring to a mass of cells and fluids that seeps out of the blood
capillaries or out of an orga.in most cases, the latter happens in inflammation.
Purulent: this is a term that is used with regards to drainage.it is a type of drainage that comes
from the wound. Purulent is milky and is used to show a sign of infection
Epithelialization: refers to a progression whereby the skin and mucous substitute the epithelial
cells which are damaged in a wound.
Granulation: this is the process whereby granules are formed from either a powdery or a solid
substance.
Erythema: this refers to the soreness of the surface of the skin or mucous membrane and it is
caused by hyperaemia.
Macerated: this mostly refers to a portion of the body or whole bod y having undergone a
reddening progression or loss of the skin.in most cases, it is used to refer to the distortion of
features of various features during the process of retaining in the uterus.
Cellulitis: this is a bacterial infection that affects the skin. The skin that has been affected
appears red and is in most cases, very painful.
2. Wound managing has advanced from enchanted balms to contemporary nanotechnology.
3. Managing strategies for patients with gashes are unswerving with the best practice. There is
proper documentation of the patient’s records in the health care institutions. The records are
keenly monitored for the compliance with the wound management plans. The info on the
management of wounds is also supposed to be availed in a clear manner (Barr et al. 2017,
p.154).
4. Factors prompting outside injuries:

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Wounds: Where an unswerving blunted draining can harm the little veins, physiques, and
vessels.
Hematomas: this is whereby a few wounds make reparations little platelets triggering blood
fusing in a limited space (Coley, 2015, p. 56).
Squash wounds: Prompted by persistent outside powers that press the one among two
surfaces. Reasons for inner injuries:
Neuropathy: this refers to the aggregates in metabolites and blood sugars. They harm the
sensory structure.
Hindered flow: Low supply of blood which is comenced by the compression or hindrance of
veins, prompts poor course and in this manner makes an injury.
Restorative ailment: They can hinder the insusceptible state's motivations; decreasing the course,
and harm frameworks and organs (Barr, 2017, p. 111).
5. Fungal infections refer to a condition whereby the tissues are invaded by some types of fungi.
The infections are sensed by use of a microscope or examination of slides. The management
of fungal infections can be done through the maintenance of clean environment and
observation of regular checkups. The infections can be treated by use of anti-fungal agents
with regards to the scope of infection. There are several categories of fungal taints including;
Fungal nail contagions: Taints of the fingernails
Ringworms: Fungiform skin contagion. (Boateng, 2018, p. 231).
6. Viral wound contagions are seen after bacteria have diseased the skin lacerations which are
created at the time the viral disease is taking over. The wounds are sensed through an up surged

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pain, swelling or an increase in the level of redness in the wound. The infections are severe and
can lead to nausea, chills and fever. Management of these wounds is done through taking care of
the infected area.
Types of viral contagions:
i. Foodborne illnesses
ii. Sexually Conveyed Virus-related Contagions.
7. Wound ailments caused by bacteria are the ones in which microscopic organisms have
populated and led to a deferral in mending of the damage or fall apart the harm. It is
identified by expanded soreness, supported agony and growth. The board of the injury
requires damp scenery for the appropriate functioning of cells at risk for mending. It is
proposed that covers should be better day by day.
Categories of the contamination of bacteria
i. Microbial skin contaminations
ii. Bacterial contaminations that are sexually transmitted
8. First category: They are immaculate functioning wounds whereby there is no disturbance
tolerated and there are also signs of ailment or aggravation. Models consolidate stomach
opening from the basic suspension of theoretical therapeutic method.
Second category: This category alludes to a usable injury is curbed.
Third category: Consist of of new, coincidental, open injuries, alongside activities with
critical clean procedure, e.g., a blade may debase an injury that medical procedure has
occurred or a gunfire contagion and hemorrhoidectomy.

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Fourth category: is a category polluted injury. These incorporate wounds presented to
fecal material or incessant injury debridement.
9. Phases of weight sores:
First stage: here, the injury is yet to open but the dermis appears discolored.
Second stage: in this stage, the sore appears to be fully divided and the lower layers are
uncovered.
Third stage: this is whereby the sores get through the dermis, epidermis and the greasy
tissue that lies underneath.
Fourth stage: is whereby the cells stretch out below the hypodermic fat and enters the
profound tissue including muscles tissues.
10. Venous ulcers are abrasions brought about by the ill-advised functioning of the arterial
valves. The risk parts join heaviness or being overheavy, prenatal period, obstructive attire,
and professions that need a great deal of standing.
11. The instigating parts for vein burns comprise diabetes mellitus, deprived footwear, weight,
obliged joint flexibility, and foot twisting. Demonstrative methods include Buerger's test,
transcutaneous oxygen estimation, and arteriography weight.

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12. Assorted ulcers refer to the tardy consequence of a blend of both intravenous and vein
sicknesses.
13. Categories of excretions from the wounds: plasma that is thin and water-logged then a some
blood which is mostly evident in deep lacerations and finally we have Serosanguineous
which is a pink watery linkage (Glickman Schantz, 2014, p. 156).
14. Malevolent injuries are caused by the entrance of destructive cells into the skin and
lymph arteries, inciting a misfortune in vascularity. Basics of overseeing threatening injuries
are side effect the board, management of wound, lastly, curing the growth if conceivable.
15. features of neuropathic ulceration:
Forfeiture of defensive consciousness
Sole nerve inclusion
Excruciating squandering of proximal quadriceps
16. Contemporary injury specialists incorporate provisions, for example, showers passed on for
gashes and dermatologic ailments, while sepsis is where the physique reacts to abrasions
making damage other body parts.
17. Categories of injuries are: First degree: this is the burn that impacts on the epidermis
Second degree: this affects both the epidermis and part of the dermis
layer.
Third degree: this is a burn that damages the epidermis and the dermis.
Fourth degree: Terminates the epidermis, dermis while scattering to other
body tissues like the bones.

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18. Deterrence and curbing of burn wound disease systems ought to incorporate legitimate
hand cleanliness while taking care of patients. Patients who have burns are supposed to be
disconnected, and the avoidance of human services related pneumonia ought to be given a
priority.
19. Fistula is a surprising association amid two organs and paths, which should not interface. A
visually impaired fistula has dual structures that are associated and has an opening on one
side whereas a total fistula is one that has has openings in and outside the physique.
20. Sinus refers to a disorder that leads to irritation of sinuses and some sections of nasal organs.
The best and most practicable techniques of dressing of sinus abrasions oversee releasing
sinuses.
21. The split-chunkiness unite incorporates the epidermis and portions of the dermis, whereas
full-chunkiness join comprises of epidermis and dermis.
22. Visceral injuries are lacerations brought about by infiltrating systems of damage. Viscera
wounds are caused by scratches in the stomach. The scratches can be overseen by appropriate
and early recognition as the objectives can be unexploited. Screening should be possible
utilizing mechanized innovation and ultrasounds (Fennell, Miller & Mor, 2014, p. 77).
23. The philosophies of the management of wound:
Hemostasis: is a progression that is meant to halt and prevent blood from bleeding.
Wound cleansing: lessens body contagions and endorses therapeutics
Skin closure: Aids wound healing.
Wound dressing: this leads to the reduction in infections and contamination.
24. The following can be used in healing and prevention of pressure sores.

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Changing positions and keeping constant movements to evade remaining in a single place for
long.
Maintaining creaminess of the skin
Relieving direct pressure from the skin
25. Pressure-calming gadgets form the body, dispersing the weight normally. Cutting edge
gadgets models are air-fluidized beds or weight sleeping pads. Low tech gadgets resemble
pads and standard froth sleeping cushions (Ahn, 2017, p. 65).
26. The more established and fragile patients are slanted to abrasions and harms. The
administration program would help medicinal specialists to upsurge their capacity in taking
care of the wounds. Proper thought and the administrators of wounds stimulate their
patching.
27. Communal enthusiasm for management of wound assures self-guideline and tenability while
guaranteeing social hindrances towards wounds are dispensed with. The people group can
have the option to be answerable for work and money related assets for medicinal services
(Eaglstein, 2015, p. 255). Converging oral methodologies on wound administration
guarantees that various organizations are associated with the endeavors toward recuperating
and anticipation.
28. The elements of the chain of disease
They incorporate disease causing causing organisms that increase section after the
diminished resistance status of the body has been evidenced (Kingsley, 2014, p. 141)
29. Lines of guard in contradiction of disease causing organisms:

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i. Keeping intruders out.
ii. No explicit approaches to safeguard in contradiction of pathogens that have gotten
through the primary protection.
iii. particular obstruction.
30. Immune status assumes an essential job in ensuring against irresistible bacteria. It is the
fundamental obstruction against the manifestation of dispersed contagions.
Individuals taking medications have a possibility of getting some contagions. For instance,
Corticosteroids refer medicines that cure situations like arthritis and may cause fungal
contagions.
31. Public assets:
Wound managing experts.
Assets for wound managing
Didactic assets:
Progressive Tissue's edifying assets offer news, and exploration into the care for the wounds for
the care that is taken observed by the patient and nurses.
Preparation of specialists
32. Wounds Australia: are there to lessen the damage brought about by wounds by giving
facilities and data.
Wound advancements: Progresses admittance to master care for patients with incessant
injuries the nation over (Hess, 2015, p. 177).
33. The most proper time is subsequent to doing evaluation estimation. The categories in this
case include nonopioid analgesics, which incorporate the nonsteroidal mitigating
medications and opiate analgesics (Ankrom, 2015, p. 154).

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34. Debridement Wound refers to the disposal of the necrotic tissue, those aides in
recuperation procedure of a wound. There exist two types of injury debridement
comprising organic debridement, which uses maggots to trigger wound healing and
autolytic debridement that utilizes organic liquids to unstiffen wrong fabric to trigger
wound healing (Layden, Michaels, Bermingham & Higgins, 2014, p.143).
35. An open injury seepage framework opens substance to the environment while a shut
injury waste framework doesn't reveal elements to the air.
36. The significance is giving the physique a wellspring to heal wounds and vitality for
angiogenesis. Faculty may incorporate specialists, lab experts, and restorative aides
(Casey, 2017, p. 211).
37. Doppler appraisal system utilizes the speed and the heading of blood stream to decide
the blood vessel vessels are sound. In case of serious fringe blood vessel ailment and
when a patient experiences hypersensitivities to hosiery material and wrap, Doppler
appraisal should not occur (Lord & Hosein, 2015, p. 145).
38. The brilliant standard for the cureis the utilization of several layered pressure treatment to
treat venous ulcers. The advantages are that the procedure is financially savvy contrasted
with different strategies for treatment (Edlich and Reddy, 2014, p. 144).
39. Clinical photography upgrades the unwavering quality and exactness of the
documentation of the wound.

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40. Wound following procedure: Cleanse the base layer. Spot the straightforward part
contrary to the damage at that point follow the scar completely (Mast and Schultz 2016,
p. 155).
41. Factors that are supposed to be considered comprise; the type of the tissue, torment level,
size of the injury, wound exudate, and the condition of the peri-wound. An extensive,
comprehensive patient evaluation ought to be done, trailed by an injury appraisal (Mayet,
2014, p. 243).
42. Factors that should be viewed when picking an injury dressing are; Adjoining tissue, the
sort of wound being dressed, seepage and edges.
The essential injury dressing is the principal dressing that forms the basis of an injury. It
is set straightforwardly over the damage to cover it and to deal with any overflowing or to
drain, e.g., mortars and wraps, while an auxiliary injury dressing incorporates the
essential injury dressing, together with tapes and bandage dressings (Towler, 2016, p.
113).
43. Avert the advancement of level III damage.
a) Decrease the degree of the damage to the level I
b) Saltwater is the finest item in this level.
44. Wound purging methods:
i. Immersing part of the wound in warm water. The latter helps in removing slough
ii. Showering (Watret and Armitage, 2017, p .122).
iii. Moistening the injury to remove filaments from the damage (Towler, 2016, p.
143).

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45. The best rehearsal for gathering an injury swab for examination is spinning sterile
calcium amid the fingers and getting liquid from wound tissues.
46.
a) Retain the skin creamy consistently and eat a solid eating regimen. Ordinary checkups
ought to be done to recognize any wounds (Lord and Hosein, 2015, p. 67).
b) . Gangrene is where an absence of oxygen-rich blood makes the tissue bite the dust in
certain pieces of the body. Diabetic individuals, smokers, and large individuals are in
danger of being tainted. Careful expulsion of the utilization of anti-infection agents is an
administration exercise utilized (Okan, Ayello and Sibbald, 2017, p. 143).
c) Sepsis is a destructive condition started by the body's response to contaminations. Sepsis
on a patient with gangrene might be deadly. There is an expanded pulse, fever strange
white platelets, and low circulatory strain. Anti-infection agents ought to be given after
conclusion, insulin to balance out the glucose, and vasoactive drugs (Routt, Simonian and
Mills, 2017, p. 23).
47. Wound estimation systems utilized in medicinal services settings:
i. Clock technique: A clock is utilized to screen estimation.
ii. Photo certification: Photographs report recuperating.

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iii. Wound following: utilization of a pen to follow the recuperating (Townsend et al.,
2016, p.143).
48. A wet injury recuperates quicker, and a muggy injury setting empowers every one of the
three phases of mending.
49. Individualized injury the executive plans consider exact evaluations and can plan for the
patients adequately. Contemplations incorporate mental, physical, way of life, and
nourishing components.
50. Problem-comprehending approach:
Evaluate the entire patient for other foundational issues.
Evaluate the injury, which may incorporate the area or the size of the damage.
Evaluation of the contamination or the aggravation done (Zinn and Swofford, 2014, p.
28)
Making a sodden injury interface on the injury is done to quicken its recuperating.
Evaluation of the edges is then done to investigate if the injury is mending or not.
51. Wound area assistants in what determination to pursue or take.
Wound temperature influences the pace of enzymatic advancements happening inside the
injury during recuperation.

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Putrefaction tissue is quite often hindering to the soundness of the patient and can be
lethal and ought to be expelled from an injury to cause it to mend.
Damp injuries mend quicker than dry injuries.
Maceration is the place there are extraordinary amounts of liquid left over in return with
the outside of an injury for extensive stretches, which may slow the mending procedure
(Zinn and Swofford, 2014, p. 58).

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REFERENCES
Ahn, C., 2017. Necrotizing fasciitis: reviewing the causes and treatment strategies. Advances in
skin & wound care, 20(5), pp.288-293.
Ankrom, M.A., Bennett, R.G., Sprigle, S., Langemo, D., Black, J.M., Berlowitz, D.R., and
Lyder, C.H., 2015. Pressure-related deep tissue injury under intact skin and the current pressure
ulcer staging systems. Advances in skin & wound care, 18(1), pp.35-42.
Barr, N., Holmes, M., Roiko, A., and Lord, W., 2017. A qualitative exploration of infection
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Casey, G., 2017. Chronic wound healing: Leg ulcers. Kai Tiaki: Nursing New Zealand, 17(11),
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