8. Pressure Ulcers aka "Bed Sores" Proctored Exam Questions Fully Solved.

Most common sites from the waist down: - correct answer Iliac crests Sacrum Greater trochanters Ischial tuberosities Lateral malleoli Pressure ulcers occur mostly in patients - correct answer 70 years old From 15-20% of nursing home patients and 5-20% of - correct answer *hospitalized elderly patients have, or will develop, pressure ulcers during their stay* -Many already have pressure ulcers when they arrive When prolonged pressure on skin exceeds pressure in - correct answer *end-arterioles and capillaries causing ischemic necrosis of tissue* -More likely over bony prominences Critical factors that cause pressure ulcers include: - correct answer -*Pressure* -*Friction* -*Shearing* -*Maceration* of the skin (Due to excess moisture) Risk Factors - correct answer Immobility/inactivity Incontinence Malnutrition Medical problems Medical problems like - correct answer -PVD, DM (local ischemia) -Dementia (contributes to above risk factors) Identify at-risk patients - correct answer Examine these patients daily Protect pressure points - correct answer in bed and wheelchair Provide adequate - correct answer nutrition Avoid excessive - correct answer sedation Write orders for "turning schedule" for bed patients: - correct answer Every 2 hours is optimal Use special mattresses: - correct answer Foam ("egg crate") Static Flotation Alternating pressure Water or air-filled Check suspected pressure points Stages of ulceration: - correct answer *Stage 1* -non-blanching erythema of intact skin. -Warmth, edema, and induration are also indicators, particularly on persons with dark skin Stage 2 - correct answer partial thickness involving the epidermis and dermis, superficial. -Appears as a blister or abrasion Stage 3 - correct answer full thickness, deep crater involving necrosis of subcutaneous tissue that may extend to the underlying fascia Stage 4 - correct answer tissue necrosis and destruction that includes damage to bone, muscle, and/or supporting structures *with or without* full thickness skin loss Treatment for Stages 1 & 2 - correct answer clean and apply a protective dressing Treatment for Stages 3 & 4 - correct answer prolonged and expensive treatment by irrigation, debridement, healing by secondary intention, or surgical closure Complications-- Infection - correct answer Osteomyelitis, sepsis Increased medical costs...