Med-Surg - Integumentary System, part 3: Diagnostic Tests

by Cathy Parkes February 14, 2023 Updated: August 10, 2023 2 min read

Full transcript and video captions coming soon!

Full Transcript

Hi. I'm Cathy with Level Up RN. In this brief video, I will be going over key diagnostic tests that are used for wounds as well as other integumentary system disorders, and at the end of the video, I'm going to give you guys a little quiz to test your knowledge of some of the key points I'll be covering, so definitely stay tuned for that. And if you have our Level Up RN medical-surgical nursing flash cards, definitely pull those out so you can follow along with me.

A culture and sensitivity is frequently used to diagnose a wound infection or other integumentary disorder. So the culture identifies the causative pathogen, and the sensitivity determines what medication, such as an antibiotic, can be used to address that pathogen. We always want to obtain a specimen for a culture and sensitivity before the patient starts on antibiotics. So as the nurse, if you are ordered to obtain a wound culture, you want to first clean the wound with normal saline. So we wouldn't want to clean the wound with an antibacterial wound cleanser because that can kill off some of the bacteria that we are trying to identify. And then, after cleaning the wound, you want to take the swab and you want to swab an area of viable tissue in the wound bed. So I see a lot of new nurses, when they are ordered to get a wound culture, take the swab, and they see some pus or maybe some necrotic tissue and they think, "Ooh, I'm going to get a sample from there." But that's actually not what we want to do because that can produce inaccurate results. So we want to swab in a viable area of the wound bed for about five seconds, and then we want to be careful not to touch the skin surface as we are placing that swab in the tube. A few other tests to be familiar with include a Tzanck smear, which is used to help diagnose viral infections, such as herpes, and a potassium hydroxide or KOH test, which is used to help diagnose fungal skin infections, such as ringworm.

Okay. It's quiz time. I've got three questions for you, and they are all true or false. Question number one. It is best to obtain a culture from a wound prior to the initiation of antibiotics. True or false. The answer is true. Question number two. A potassium hydroxide or KOH test is used to help diagnose viral infections. True or false. The answer is false. This test is actually used to help diagnose fungal infections. Question number three. A Tzanck smear can be used to confirm a herpes infection. True or false. The answer is true because a herpes infection is a viral infection. Okay. That's it for this video. I hope you have found it helpful. Take care, and good luck with studying.


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