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Wound Management


Table of Contents

Introduction. 3

Question 1. 4

Question 2. 4

Question 3. 5

Question 4. 6

Question 5. 6

Question 6. 6

Question 7. 7

Question 8. 8

Question 9. 8

Question 10. 8

Question 11. 9

Question 12. 9

Question 13. 10

Question 14. 10

Question 15. 11

Question 16. 11

Question 17. 13

Question 18. 13

Question 19. 14

Question 20. 15

Question 21. 16

Question 22. 16

Question 23. 16

Question 24. 17

Question 25. 18

Question 26. 18

Question 27. 18

Scenario one. 19

Question 1. 19

Question 2. 19

Question 3. 19

Question 4. 20

Question 5. 20

Scenario 2. 20

Question 1. 20

Question 2. 20

Question 3. 21

Question 4. 21

Question 5. 21

Question 6. 22

Question 7. 22

Question 8. 22

Scenario 3. 22

Question 1. 22

Question 2. 22

Question 3. 23

Question 4. 23

Question 5. 23

Question 6. 23

Conclusion. 24

References. 25


Treatment of an individual needs proper care and attention to many factors that are equally important to the patient. Patient can be considered as one of the primary factors which is linked to the service of the doctors. The doctors have the role of providing service to the patient so that care can be included into the sector of indulgence of the factors.

Question 1

Privacy and dignity are some of the significant issues that are to be kept in mind while providing treatment to an individual. Based on the Privacy act as per AHPRA, care is to be taken in storing of personal information by national regulations related to health practitioners. Some of these measures according to the Australian nursing guidelines and AHPRA can be understood with the help of the points discussed below.

  • Proper introduction to patients and acknowledgement of their issue
  • Taking care of patient accommodation with same gender along with proper protection.
  • Use of environments like separate rooms with curtains assuring privacy with permission of the patient while treating or discussing the healthcare needs of the patient.
  • Maintaining proper records of patient’s information.

Question 2







Basal Lamina



Stratum Basale



Stratum Basale






Stratum corneum


Sweat gland pore


Hair shaft


The above diagram shows the layers of the skin. Primarily divided into three parts namely, Epidermis, acting as a barrier and the outermost skin layer, Dermis, as the complex network of tissues, follicles and sweat glands and Hypodermis, consisting of connective tissues and fat. The skin can be named further based on the various parts (Posthauer et al., 2015). Starting with the hair shaft at the top of the first layer of skin, the next are the pores of sweat glands. The outermost layer, stratum corneum is then followed by capillary. The next is a stratum basale, also known as the layer, deepest of the 5 layers of Epidermis, ending with basal lamina as the next.         

Question 3

The stages present in the wound healing can be stated as the following:

  • Hemostasis Phase

Right after an injury, this stage starts with the vasoconstriction, allowing blood to slow down and eventually stop, wherein platelets and fibrin forms a clot that forms a protective shield for the injured vessels.   

  • Inflammatory Phase

This is the second phase after the injury, wherein a swelling is caused naturally with the help of vessels leaking transudate. This helps the body to move repairing cells to the wound, protecting it from infections and starting the process of healing in the body (Hommel & Santy-Tomlinson, 2018). Damaged cells and bacteria along with pathogens are removed from the wounded area to continue the healing process. Elongated or excessive swelling in this phase can be an issue.

  • Poliferative Phase

This phase witnesses wound contraction for the reconstruction of new tissues and blood vessels in the affected area, which is done with the help of collagen along with extracellular matrix. 

  • Maturation Phase

Also stated as the stage of remodeling, this takes care of the removal of the repair cells by apoptosis of cell deaths programmed by the body. The collagen is then remodeled to type I from type III, closing the wound completely (Gillam, 2016). The collagen forms a cross-link to the injured fibers aligning and absorbing water that can help the scar to diminish with time. Starting normally from the 22nd day in an average, this stage can continue even for a year.  

Question 4

The healing process of a wound is much faster in a moist environment, compared to that of a dry wound. Some of the key factors affecting the wound healing process are:

Nutrition is an important factor, whose absence can delay wound healing.

Hygiene has to be maintained in order to avoid contamination of the wound that can increase the chances of infection in the wound rather than healing it.

Age is an important factor that can delay the process due to the thinning of the epidermal layer and reduced collagen formation, leading to an increased time span.

Medication and treatment are to be paid attention to.  

Psychological stress can also act as a factor in this case. The brain is responsible for all the actions within the body. Hence, a stressed mind can be responsible for delaying the process of healing.  

Question 5

  1. Necrotic- External factors like infection or toxins may cause death of living cells, unlike apoptosis. Removal of a necrotic tissue is important in order to fasten the healing process.
  2. Sloughy- is referred to the tissue that has already lost its life and is separating itself from the wound (Ysrraelit et al., 2018).  
  3. Granulating- is the newly formed connective tissues that can be seen while the wound is healing.
  4. Epithelizing- is the last tissue type that can be stated as a layer of protection covering the whole body. Often covering the Granulating tissues, this tissue may help improve the healing process of the body.  

Question 6

The clinical manifestations of wound infection are:

  • Delay in healing
  • Discolored tissues in the wounds
  • Wounds smelling abnormal
  • Fluid draining
  • Increased and constant pain

Prevention to minimize cross infection can be taken care of with the following:

  • Proper washing of the wound
  • Application of available antibiotic ointments that can be bought without a prescription
  • Bandage the wound properly.
  • No application of water on the wound for 24 hours to keep it dry.
  • Daily changing of the dressing.

This can be managed properly with the help of family involvement, wherein, significant information based on the treatment and the condition of the wound is to be shared by the practitioners (Halkett, Jiwa and Lobb, 2015). Inviting suggestions from the family members on the caring process of the wound with the help of follow ups arranged after the discharge of the patient. Educating the families and care givers regarding the necessities of the wound management can also help in the process.

Question 7

  1. Serous drainage or exudates is a normal sign of healing during inflammatory phase which can be an issue only in the case of excess discharge. Primarily made up of thin plasma and water, excess discharge indicates high growth of unsterilized bacteria on the skin surface.
  2. Haemoserous composed mainly of blood along with serum, this exudates can be explained as a normal discharge during the process of healing.
  3. Sanguinous is the process of draining fresh blood during inflammation that can be a concern if in excess or if experienced in other stages along with inflammation, as it may lead to delayed healing of the wound.
  4. Purulent with a milk like consistency, this discolored discharge may indicate the existence of an infection in the wound.

Question 8

In order to acquire an accurate assessment based on the exudates of the wounds various characteristics can be considered.

  • Color and Consistency
  • Odor
  • Amount discharged

A change in these characters as compared to the normal levels can help the healthcare practitioners understand the condition of the wound, helping in taking proper measures if required.

Question 9

Skin color- it is the first factor that can be taken into consideration in the process of wound assessment, where the practitioner can gain the knowledge regarding the normal tone of the skin compared to the changes (Oschman, Chevalier & Brown, 2015).

Turgor- patients with diseased connective tissue might have poor turgor due to age and dehydration. This can be considered as the second factor.

Moisture- touching the skin can provide the knowledge of the balance of moisture in the skin, making it a third factor of the assessment criteria (Willmott et al., 2016).   

Question 10

Some of the major factors causing wound related pain can be stated as the following:

  1. Skin damage
  2. Nerve damage
  3. Blood vessel injury
  4. Infection and
  5. Ischaemia

These factors can cause the growth of bacteria that can lead to infections causing the wound healing to delay. Cleansing and dressing of a wound may case stress to the area leading to nerve damages that can lead to an impact on the wound. A decrease in the tissues and oxygen can be4 a major cause of a wound related pain causing problems to the patient (Sorooshian et al., 2018). Inadequate blood flow to the wounded tissues can also be considered as another cause of the same that is known as ischaemia.

Question 11

Some of the ways an individual can be impacted psychosocially can be stated below:

Altered image of the body: this can affect an individual’s state of mind. Various reasons like amputation or major burns can lead to an alter image, leading to feelings like reduced self-esteem, guilt, etc.   

Depression can be another way in which an individual’s mental state might be impacted. Elongated wound healing and scars can be a major area of concern in this scenario.

Adjusting to a new life can be a tough situation for individuals going through a denial after an injury and recovering phase.

Range of emotional responses can be seen in the individuals going through a recovery process, wherein the various emotions like fear of future, frustration and loneliness are common. Apart from this, an individual may feel a sense of guilt and reduced confidence in the process (Sorg et al., 2017).

Question 12

The ten factors that can be considered in the development of a wound management plan can be stated as follows:

  1. Nutrition various food groups can lead to worsening of wound conditions
  2. Age renders brittleness within the skin, affecting the wound further
  3. Obesity increased weight in patients can delay the healing process causing the chances of causing an infection to increase.
  4. Repeated trauma: multiple wounds and surgeries can lead to limited defense mechanisms within the body, affecting the healing of the wound
  5. Presence of infections, necrotic tissue and debris: can be caused by over accumulation of collagen, leading to systemic ischemia.
  6. Dry skin: can delay the healing process. An individual with dry skin can face an issue related to the healing of a wound within an average normal time span.
  7. Wound infection: can be caused due to contamination of the wound during an injury. Understanding the inflammatory signs within the individuals in relation to the age can help avoid the chances of an infection of the wound.
  8. Tissue hypoxia: an impaired oxygen supply affects the rate of wound healing.
  9. Systemic causes: presence of certain disorders like diabetes mellitus or immunodeficiency within an individual suffering from a wound needs special management of wound.
  10. Skin and moisture: proper healing of wounds needs adequate moisture and fluids in the skin.

Question 13

Three members in the team of wound management can be stated as follows:

General practitioner or Doctor: General Practitioner or Doctor is responsible for providing comprehensive care to each person seeking medical care and arranging referral to other health professionals as required.

Pharmacists: trained individuals prepare and dispense medical drugs according to a prescription from a medical doctor along with primary healthcare advices and support on wounds and wound care products.

General Practice nurses: Specialist nurses who have undertaken additional education and qualifications in wound management can help as a member of the team dealing with wound management in a hospital setting.

Question 14

Providing the family of the patient an idea regarding wound-damage prevention can be stated as follows:

Skin integrity includes gentle cleansing with a low-pH skin cleanser followed by the application of a moisture barrier to minimize the effects of excess moisture. 

Pain management includes taking care of moderate to severe pain experienced by patients with a wound.

Wound dressings includes comforting and reducing the pain with fewer dressing changes, so selecting a dressing that can remain in place for several days is advised.

Wound infection can be considered as a common factor that needs to be undertaken as all chronic wounds are considered to be colonized with bacteria.

Cleansing the wound can be cleansed at each dressing change using potable water, normal saline, or a noncytotoxic cleanser to minimize trauma to the wound and help control odor.

Question 15

Nutrition and genetics deficiency of vitamin K in individuals can lead to a slower healing of wounds.

Age reduced immunity within the body due to increased aging can lead to delays in wound healing.

Disorders like diabetes can act as a major factor in a delayed healing of wound. Special attention is to be paid to individuals suffering to diabetes.  

Immunodeficiency in individuals can cause a delay in wound healing process (Scovil et al., 2018).  

Skin type dry skin in an individual can affect wound healing as a wound needs moit environment for an effective healing.

Question 16

  1. Semipermeable film dressings are used on lacerations, abrasions, skin tears and other superficial wounds. They may also be used where there are areas of friction to decrease shearing forces between the dressing and the support surface.Tegaderm can be considered as a reputed brand of semipermeable films. They have an adhesive backing which enables them to adhere to the skin without damaging the skin or the wound bed. They are selecticvely permeable to oxygen and moisture content helping the wound to heal faster.
  2. Foam dressings The flexibility of foam dressings allows for a wide variety of clinical applications with wounds that have from moderate to heavy exudates.Cleaning the wound and avoiding any contaminated touches is the primary indication of use. Allevyn can be stated as a reputed brand.
  3. Hydrocolloid dressingssignificantly lower the risk of infection because they are impermeable to bacteria. It can be applied simply by cleaning the wound and using clean gauze to dab the area around the wound until it is as dry. Duoderm can be considered as a reputed brand of this dressing.
  4. Hydrogel dressings keeps wounds moist, protecting the body from wound infection, promoting efficient healing. Solugel can be undertaken as a reputed brand in this case.
  5. Alginate dressing provides a moist cover to prevent the wound from drying out and allowing the wound to heal more quickly. Place the alginate dressing on cleaned and pat dried wound.
  6. Multilayer absorbent pads provide absorbency of wound exudates while preventing the absorbent material from entering the wound. Aquacel can be considered as a well-reputed brand of this product.
  7. Odor absorbing dressing can help the save the patient from facing embarrassment problems for both patients and caregivers. Carbonet can be stated as a reputable brand in this dressing.
  8. Pressure reducing dressing includes an adhesive outer border keeps dressing in place, even over bony prominences. Comfeel is a reputed brand of this product.
  9. Silicone dressing prevents the outer dressing from sticking to the wound, minimizing patient trauma at dressing change. Mepitel is a well-renounced brand of this product.  
  10. Ionic silver wound dressings with silver are strongly antibacterial and help bring down wound bacteria count. Medline is a trusted brand in this section.  
  11. Haemostatic agent is used outside the body to control bleeding, minimize blood loss, shorten time of surgery and reduce post surgical complications. Tegaderm is a reputable brand name that can be considered to provide proper products.
  12. Manuka honey protects against damage caused by bacteria. Activon cvan be considered as a brand providing proper dressing products of manuka honey.
  13. Negative pressure therapy devices are non-powered devices indicated for the application of suction (negative pressure) to promote wound healing and for the removal of fluids such as wound exudates or infectious materials.Avelle can be stated as a trusted brand of this product.

Question 17

 Staples are stainless wires that are being used for the wound closure procedure. When developed a wound at that place the certain points and precautions should be taken in the first place which are the following:

  • Taking care of the wound in the first place and diagnose the type for the cure.
  • Once the diagnosis is done, the further procedure can get started.
  • The primary condition is to perform and maintain hand hygiene by using disinfectors.
  • Maintaining the privacy and the integrity of the patient.
  • Removal of the dressing and the inspection of the wound followed by the cleaning procedure.

The things that will be documented are the recovery status of the wound, the type of the wound, the medicines that are prescribed and the development and the different stages (Shelton IV, F. E., & Baxter III, C. O. (2018).

Question 18

The wound management is a distinct work of taking care of the wounds on the skin which is of 16% of the entire body. Skin is a sensory and dynamic organ of the body. Different factor for assessing unique type wound management is important (McQuail, P. M., B. S. McCartney, and P. McKenna., 2018).

Wound bed

The healthy tissue becoming the red and moist components forming new collagens can be identified as the wound bed. The surface might be black and hard also.

Wound measurement

The evaluation of wound over the time period and the continual healing process should be measured.

Wound edges

The colour of the healthy and unhealthy or infected wound edges differ. The pink edge indicates the growth of new tissues and the increasing pain should seek attention.


Increasing pain even after the introduction of the medicines can be the indicator of greater wound problem.

Question 19

 Cost effectiveness in health care and especially in wound management has been done by the economic evaluation and evidence based medicine. Dressing procedure also includes certain effective factor for the effective cost maintaining function (Iida et al., (2015).

Direct and indirect cost

The costs involved in diagnosis, wound examination, long term treatments.


The third party involvement should be included as a unique perspective in this case.


The discounting procedure should be done on the basis of the currency evaluation in Australian country.


This type of activity makes a difference into the policy of wound management and nursing care.

Economic approach

The economic approach of the patient and the institution should be taken under consideration.

Question 20

Leg ulcers are painful and can led to the reduction of the life of the patient or the quality of life of the patient. Diabetes can be a prominent reason behind the influence. The Doppler ultrasound is a kind of or the advanced stage of x-ray that allows the doctors to see what is going on inside the wound (Blott et al., (2015).

Arterial ulcer

This kind of ulcer is caused by the delivery of high nutrient blod also known as poor perfusion. It is an open wound causing several troubles for the patient to recover.

Venous ulcer

It is a skin ulcer that is caused by the poor blood circulation in the limb.

Mixed venous

It has the role to assess the critical patients with critical mixed venous condition in heart.

Neuropathic ulcerating wound

When a cut which is not treated well a foot can go to foot trauma causing the situation of Neuropathic ulcer wound.

Question 21

The five stages of the assessment of the pressure injury wounds are following

Stage one is to identify or the observation of the sores which are not the open wounds.

In the next following stage the breakage of skin takes place.

In the next stage the sore becomes worse and the tissue under the skin stats forming craters.

Question 22

Bedsore is one of the causes of the pressure injury. The other two main causes of the pressure injuries are spinal cord injury and poor health.

Bedsore develops the pressure injury as it is decubitus ulcer in nature. It contributes as the termination of the cells due to pressure of the body over particular skin.

The spinal cord injury is being developed by the pressure because of the misbalance of the load in an unbalanced way.

The above mentioned causes develop a poor health phenomenon.

Question 23

The age is one of the intrinsic factors for the development of the pressure injury as the skin breakdown happens with ageing.

The immobility of a human body can also be considered as the intrinsic factor of the development of pressure injury.

Any sort of chronic illness might cause this development.

Question 24

  The classification system is to be done on the basis of the following factors which are:

Location of the skin tear

The measurement and the duration of the skin tear problem

The severity of flap necrosis

The bleeding phenomenon or hematoma

Developing infection

The amount of exudates

  the three categories of skin cares are rthe following

Category 1a

It is the kind of skin tear where the edges are not pale but dusky.

Category 1b

This kind includes the type of skin care where the normal anatomical position is pale.

Category 2a

It is the situation where the skin edges cannot get back to the normal anatomical posirionb.

Category 2b

Here the skin cannot get back to the normal potion along with another symptom of developing new pale skin color.

Category 3

It is the kind of the skin tear where the skin flap remains absent.

  the use of silicon coated dressings for the skin tears where the flap has grown can be effective.

Hydrocolloid dressings are useful for category 3.

Question 25

The AHPRA registered nurses will be performing the dressing of the patient who is days five post left lower skin graft and is in need of intensive care.

Question 26

According to Van Onselen & Gardner (2016), the article on the wound dressings and wound management are the subjects of intensive care, proper protocol, and the duties of the different managerial segments and members. The ethical outline of the registered nurses and the proper knowledge of the different types of wounds will be helping the contribution and the service to the care taking approach to the patients.

Question 27

            Drain tube is a surgical tool that allows the bodily fluid to pass out. It works in a very effective way. The doctor puts a tube into the area from where the fluid is to be collected. After that the rubber channel will be carrying out the fluid outside.

Scenario one

Question 1

source of E. coli in this case in the first patient suffering from diarrhea. Infectious agent is E coli, since it is the one causing the Escherichia. The reservoir in this case can be considered as Mary as well as the old woman suffering from gastrointestinal disorder. Portal of exit is the first patient since the infection occurred due to the condition of diarrhea. Susceptible host and immunity can be stated as the second patient due to the present immune compromised condition of the patient.

Question 2

  1. cleaning of hands by Mary
  2. Availability of more healthcare individuals in order to avoid situations as this.
  3. Arrangements of specific interventions for handling diarrhea patients.

Question 3

There are basically three type of clinical manifestation which are prevailing in recent times. The wound infection name and the symptom and the effect it has are explained below:

  • Abrasion: The abrasion directly occurs when the skin of the patient scrapes and rubs against the hard or the rough surface. One of the basic example which can be stated here is the road rash. They is usually not so much bleeding which is seen in the wound. On the other hand the wound needs to be scrubbed and cleaned periodically. The patient in the event does experience some pain.
  • Laceration: The wound can be considered as an tearing or deep cut of the skin which is one of the symptoms in the wound. It is mainly done while accidents with the knives or tools and machinery which are common cause of laceration. In severe cases of laceration deep bleeding is seen which directly impact the blood count in an patient. The patient sometimes is admitted in hospital.
  • Avulsion: The avulsion can be seen as cutting of the skin and the issue which is seen beneath. The main occurrence of the wound is done during violent accident such as body accident crushing, gunshot and explosion. The patient in the event experiences high amount of pain and in most of the cases has to be admitted into the hospital.

Question 4

National safety and quality health service standard which can be matched in the scenario is related to the patient identification and procedure management (Knight, Lineaweaver & Thibault, 2017). This is mainly focused eub ot the engagement which different patient at a time for Mary. She should be able to handle different sector of working so that there are no problem  seen in the execution of the record of the patient.

Question 5

Negative pressure therapy devices can be used in this case so as to stop the flow of semi-purulent haemoserous devices.  

Scenario 2

Question 1

There are mainly three stages of burn treatment which are stated below:

  • First degree burn: non blistered skin
  • Second degree burn: some thickening relating to the skin
  • Third degree burn: wide spread thickness relating to white leathery appearance.

The main dressing which is included into the burn area includes simple dressing with the gauze impregnated with paraffin which is also known as the Jelonet. Application of gauze pas over the dressing is also one of the areas which can be included.

Question 2

Chances of internal injuries along with psychophysical state due to the surgery undertaken on the patient due to scar tissue formation causing embarrassment to the individual. Hypersensitive to certain drugs and conditions and an immune compromised state post operation might pave way to certain infections y opportunistic pathogens which might degrade his quality of life in the long run.  

Question 3

Doctors, nurses, physical and occupational therapists, nutritionists and others work together as a team with patients and their families to ensure comprehensive care from the time of injury through discharge and rehabilitation (Lippel et al. 2016).    

Question 4 

The equipment list which can be used in the sector of specimen collection are stated below:

  • Field sheet or note book for the data recording
  • Gloves which are clean and powered.
  • AR grade solvent of the choice
  • Swabbing material of choice
  • Labeling sample container from the material appropriate contaminant of interest.
  • Commercial test kits including templates which are pre cut.

Question 5

  • Preparing the patient
  • Preparing the specimen
  • General specimen collection
  • Serum preparation
  • Plasma preparation
  • Urine collection
  • Vacuum tubes containing additives (gel barrier and anticoagulants)

It is very much advisable to clean the wound before as well as after the collection of sample which would be helping in the sector of preventing virus and infection.

Question 6  

The prevention and nostril of infectious diseases among the burn patient presents a specific problem. The burn patient has a resistant organisms. There are vicious circle increased risk of infection in several burned patient.

The main reason of the infection is due to the factor of generation of resistant organism which can affect the sector of infection being generated.

Question 7  

One of the National safety and quality health service standard which is seen in the sector is related to the recognizing and responding to the deterioration of clinical in acute health care disease. these factors are very much crucial in the domain of treatment of burn patient (Bliss et al., 2017).

Question 8

The different information which should be included is the record of the patient and how the patient treatment are being made. In this context there are various documentation which needs to be done which is related to the management of treatment and the response of the patient to the treatment.

Scenario 3

Question 1  

  • Diabetics: The main symptoms which is linked to the sector is related to the pain in hand and severe headache
  • Venous: The main symptoms which is linked to the disease is fever and body pain
  • Ulcer: There are swelling in the pati9entb body.

Question 2  

Some of the common procedure which can be included into the treatment of ulcer are stated below:

  • Upper GI (gastrointestinal) series (barium swallow)
  • Esophagogastroduodenoscopy
  • Blood test
  • Breath test
  • Stomach tissue tests

Question 3  

  • Diabetics: the patient should be treated with fasting glucose test which is taken in the morning before anything is eaten.
  • Venous: one of the treatment which is related to the disease is avoid long period of sitting and standing. Walking is especially beneficial.
  • Arterial ulcer: The treatment in the sector is trying to restore the blood circulation to be affected area. There are underlying cause of antibiotics.

Question 4  

Three health care professional which could be included into the sector are stated below:

  • The doctor which is linked to the sector of engagement and the criteria of treatment.
  • Wounding specialist which is included into the domain of execution
  • Treatment specialist which is included into the sector of indulging into the wound.

Question 5  

The education life style should be including the clean area of the wound which would be helping in the domain of restricting the flow of the bacteria. This indulges sector of working in most of the cases.

Question 6  

A slough is an layer of mass or dead tissue which is separated from the living tissue which is in the wound.

It can be considered as an shed or removed v. sloughed, sloughing and sloughs.


The main factor which can be considered here is that the doctors have a very crucial role in the service which is given by them towards the customers. The patient are highly depend on the service of the doctor to incur cure and living an healthy and good life. The profession of the doctors is considered as one of the Nobel profession which is one of the primary factor for the high importance in the society.


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