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Medicinal leech therapy

New life for an ancient treatment

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doi: 10.1097/01.NURSE.0000473088.92352.0f
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INSTRUCTIONS Medicinal leech therapy: New life for an ancient treatment


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Lippincott Williams & Wilkins, publisher of Nursing2015 journal, will award 2.0 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours.

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Medicinal leech therapy: New life for an ancient treatment

GENERAL PURPOSE: To provide information about the risks and benefits of hirudotherapy. LEARNING OBJECTIVES: After completing this continuing-education activity, you should be able to: 1. List the indications for hirudotherapy. 2. Identify contraindications for hirudotherapy. 3. Explain the nursing care associated with hirudotherapy.

  1. Which statement about hirudotherapy is accurate?
    1. The Hirudo medicinalis species produces the most extended postbite bleeding time.
    2. Leeches typically ingest 30 to 50 mL of blood per feeding.
    3. The FDA approved use of commercial leeches in 1974.
  2. Bioactive ingredients in leech saliva cause
    1. anticoagulation.
    2. pain and pruritus.
    3. conversion of fibrinogen to fibrin.
  3. The substance in leech saliva that reduces scar tissue density and adhesions is
    1. hyaluronidase.
    2. collagenase.
    3. hirudin.
  4. Leech therapy is used primarily
    1. after heart surgery to prevent clotting in coronary arteries.
    2. for burns to reduce inflammation and prevent infection.
    3. after microvascular and plastic surgeries to relieve venous congestion.
  5. One of the classic signs of venous outflow insufficiency is
    1. paresthesia.
    2. edema.
    3. pallor.
  6. Hirudotherapy is not FDA-approved for
    1. skin grafting.
    2. reattachment surgery.
    3. pain management.
  7. The most common reason for failure of replantation and flap surgeries is
    1. venous insufficiency.
    2. arterial insufficiency.
    3. necrosis.
  8. Which is not a contraindication for hirudotherapy?
    1. bleeding disorders
    2. immunocompromise
    3. asthma
  9. The most serious complication of hirudotherapy is
    1. thrombocytopenia.
    2. infection.
    3. hepatitis.
  10. Which bacterial species causes most of the infections associated with hirudotherapy?
    1. A. hydrophila
    2. Serratia marcescens
    3. Vibrio fluvialis
  11. Which of the following is an option for treating Aeromonas infections?
    1. aminoglycosides
    2. first-generation cephalosporins
    3. penicillins
  12. Excessive bleeding from hirudotherapy can be controlled by all except
    1. topical thrombin.
    2. manual pressure.
    3. topical lidocaine.
  13. Before hirudotherapy, teach your patient that
    1. pain medication will be administered.
    2. a leech could migrate off the attachment site during therapy.
    3. ginseng will increase the effectiveness of therapy.
  14. Which of the following can increase the risk of bleeding?
    1. nonsteroidal anti-inflammatory drugs
    2. acetaminophen
    3. caffeine
  15. Prepare the site by washing the attachment area with
    1. chlorhexidine.
    2. betadine.
    3. soap and water.
  16. Which statement about initiating hirudotherapy is correct?
    1. After cleaning the attachment site, rinse it with distilled, nonchlorinated water.
    2. After donning gloves, grasp a leech using forceps.
    3. When placing the leech, put the wider end at the attachment site.
  17. If a leech won't attach, place a drop of which substance on the site?
    1. 100 U/mL heparin
    2. 0.9% sodium chloride solution
    3. sucrose
  18. During hirudotherapy, assess the application site every
    1. 2 hours.
    2. 8 hours.
    3. 12 hours.
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