Certified Wound Ostomy Nurse (CWON) Practice Test

Which local symptom is characteristic of phase 2 of necrotizing fasciitis?

1. Severe swelling

2. Blue-green skin discoloration

3. Redness without blisters

4. Multiple small ulcers

The correct answer is: Blue-green skin discoloration

Phase 2 of necrotizing fasciitis is typically characterized by systemic symptoms progressing to more localized effects, including changes in skin color. In this phase, the condition often manifests with a distinctive blue-green discoloration of the skin, indicating deep tissue involvement and necrosis. This change in color results from the presence of certain bacteria, such as those from the Vibrio or other organisms that can produce pigments. The blue-green discoloration is important, as it signifies a worsening of the condition and potential for further tissue damage. Early recognition of these symptoms is critical for initiating treatment, as necrotizing fasciitis can rapidly become life-threatening. The other symptoms listed, such as severe swelling or redness without blisters, can occur in various stages and presentations of infections, but the blue-green discoloration is specifically indicative of the deeper, more severe tissue involvement that characterizes phase 2 of this serious condition.