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You have evaluated a patient with a right medial lower extremity wound today. The wound bed is 80% granular, 20% yellow slough. There is moderate wound odor and copious blue-green drainage on the dressings. The border is irregular and macerated.  The periwound is moderately edematous, with moderate distal hemosiderin deposition.  The patient states that his leg swells up throughout the day and weeps into his sock and shoe. The patient has a right ABI of 0.95 and left ABI of 0.7.  Select the correct statement regarding wound etiology and treatment planning. 

A patient presents with this unstageable pressure injury to the posterior aspect of the heel.  Please select the best immediate treatment plan.  

You are evaluating a patient for a plantar diabetic foot ulcer, under the first metatarsal head. He has already seen a vascular surgeon who states that the patient has adequate blood flow for wound healing.  You test the patient’s sensation and he is unable to feel the 5.07 filament.  The wound has minimal drainage, no odor, and has 30% slough and 70% pink granular tissue.  His blood sugar this morning was normal.  What must be included in your plan for this patient in order to treat the underlying cause and allow the wound to close?

A patient presents with an open wound on the 1st MTP joint with a red, swollen and painful joint.  When you assess the wound, you note a white crystal appearance in the wound bed.  The likely etiology of this wound is: 

A 54 year old female presents to the wound clinic for a left lower extremity wound on her medial and posterior leg that is irregular in shape measuring 4.2 x 2.9 x 0.4 cms with dusky edges. Her PMH is significant for lung cancer, RA, tobacco use, and DVT to left leg. She reports she has compression socks at home that fit correctly but she has stopped wearing them because of pain. With this limited information you suspect the etiology of this wound may be: 

For the above patient, you would like to add compression to her plan of care. Which compression plan is best for her?

The dorsal pedis pulse is located: 

You are assessing your patient’s abdominal wound  3 days after abdominal surgery for a cholycystectomy. You note: erythema about 1 cm circumferentially around the wound, tenderness to palpation, moderate serosanguineous drainage, no odor, no fever. The patient has diabetes and their blood glucose this morning prior to breakfast was 80. Which of the following is most accurate?

At what ABI level is compression contraindicated? 

Open this file, add something to it, save it and upload it hl_app1.xlsx