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What are the key components of a multifaceted approach to preventing pressure injuries?
The key components include promoting optimal skin integrity, educating patients and caregivers, ensuring adequate nutrition, maintaining skin hygiene, and using supportive devices.
Why is nutrition considered a significant factor in the prevention of pressure injuries?
Nutrition is significant because inadequate intake of calories, protein, vitamins, and iron increases the risk of pressure injuries, necessitating nutritional supplements for compromised patients.
What specific nutritional aspects should be monitored for at-risk individuals to prevent pressure injuries?
Nutritionally at-risk individuals should have their weight, lymphocyte count, protein levels (especially albumin), and hemoglobin monitored regularly.
How does educating patients and caregivers contribute to the prevention of pressure injuries?
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What role do supportive devices play in pressure injury prevention?
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What frequency should skin reassessments occur in the hospital and at home?
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Why should hot water be avoided when bathing a patient?
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What type of creams or films are recommended to protect the skin from moisture?
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What is the best practice for treating dry skin after bathing?
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What is advised against the use of petroleum-based creams and ointments for skin protection?
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What position should the head of the bed be elevated to in order to reduce shearing forces on a bedridden patient?
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What type of products should be avoided to prevent skin damage due to abrasiveness and respiratory hazards?
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How often should a bedridden patient be repositioned to prevent pressure injuries?
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What should be done when lifting a patient to change their position?
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Which body positions are recommended to alleviate pressure on a bedridden patient?
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What should be used under a bedridden patient to prevent shearing forces during repositioning?
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How can patients who are able help reduce the risk of pressure injuries?
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What techniques are recommended for reducing friction and moisture on a patient's skin?
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How often should an at-risk patient be repositioned?
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Lateral positioning requires the patient to be placed directly on the trochanter.
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List three body positions that can be used for repositioning a bedridden patient.
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An elderly patient who is bedridden should be repositioned at least every __________ hours.
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Match the following body positions with their descriptions:
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What is the typical pressure limit for external pressure to prevent impaired blood flow?
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Specialty beds eliminate moisture and provide pressure relief.
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Name one type of support surface that can be used for pressure relief.
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Kinetic beds provide continuous __________ or oscillation therapy to counteract immobility effects.
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Match the following types of supportive devices with their functions:
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Which of the following support surfaces can assist in reducing pressure injuries by almost 60%?
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Pillows made of foam, gel, or air can be classified as pressure-reducing devices.
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What should be done to protect a bedridden patient’s heels from pressure injury?
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Study Notes
Preventing Pressure Injuries
- Multifaceted Approach: Prevention involves actively promoting skin integrity and educating patients, UAP, and caregivers.
- Key Preventive Measures: Nutrition, skin hygiene and protection, and supportive devices.
- Nutrition and Pressure Injuries: Inadequate calorie, protein, vitamin, and iron intake is a risk factor.
- Nutritional Supplements: Consider supplements for nutritionally compromised patients.
- Wound Healing Diet: Diet for at-risk individuals should be similar to one supporting wound healing (already discussed).
- Monitoring Nutritional Status: Nurses should monitor weight regularly to assess nutritional status.
- Lab Work: Monitor lymphocyte count, protein (especially albumin), and hemoglobin.
Skin Hygiene Assessment
- Use a validated risk assessment tool to obtain baseline data.
- Reassess a patient's skin at least twice daily in the hospital and weekly at home.
Bathing
- Use minimal force and friction when bathing a patient.
- Use mild cleansing agents to minimize irritation and dryness.
- Avoid hot water to prevent increased skin dryness and irritation.
- Apply moisturizing lotions to dry skin while it’s still moist after bathing.
Skin Protection
- Keep skin clean and dry.
- Prevent skin irritation or maceration caused by urine, feces, sweat, or inadequate drying.
- Apply skin protection measures as indicated.
- Dimethicone-based creams or alcohol-free barrier films are effective in preventing moisture and drainage from collecting on the skin.
- These can often be applied without a healthcare provider's prescription.
- Avoid petroleum-based creams and ointments due to their poor skin protection and interference with diaper or incontinence product absorption.
Preventing Skin Trauma
- Provide patients with a smooth, firm, and wrinkle-free area to sit or lie.
- Correct positioning, transferring, and turning prevent friction and shearing forces.
- Elevate the head of the bed to no more than 30 degrees to minimize shearing force.
- Excessive bed elevation can cause skin and superficial fascia to stick to the bed linens while the deep fascia and skeleton slide downward, leading to ischemic and necrotic tissues in the sacral area.
- Use moisturizing creams, transparent dressings, and alcohol-free barrier films to reduce friction and moisture.
- Avoid baby powder and cornstarch as they create abrasive grit and pose respiratory hazards.
- Frequent changes in position, even slight, are effective in changing pressure points.
- Encourage patients to shift their body weight 10 to 15 degrees every 15 to 30 minutes.
- Use a lifting device like a trapeze when repositioning patients to minimize shearing forces.
- Place a draw sheet under the individual from the chest to the buttocks, tucked under the mattress on both sides when not in use.
- Reposition bedridden patients at least every 2 hours, regardless of the type of support mattress used.
- Six body positions can be used: prone, supine, right and left lateral, and right and left Sims.
- When using the lateral position, avoid placing the patient directly on the trochanter, position at a 30-degree angle.
- Establish a written schedule for turning and repositioning.
Bedridden Patient Repositioning
- Bedridden at-risk patients, even with special support mattresses, need repositioning at least every 2 hours.
- This helps distribute weight to different parts of the body to reduce pressure.
- Six common positions for repositioning include prone, supine, right and left lateral, and right and left Sims positions.
- When using lateral position, avoid direct pressure on the trochanter. Instead, position the patient at a 30-degree angle.
- Implement a written schedule for turning and repositioning.
External Pressure and Blood Flow
- External pressure exceeding 32 mmHg for an extended period can impede blood flow to soft tissues.
- To prevent circulatory compromise and pressure injuries, external pressure on bony prominences should remain below capillary pressure.
Pressure Relief Strategies
- Pressure-reducing support surfaces can decrease pressure injury risk by nearly 60%.
- The WOCN support surface algorithm aids in choosing appropriate surfaces for high-risk patients and those with existing pressure injuries.
Support Surface Types
- Overlay Mattresses: Applied over standard bed mattresses, often made of foam and gel.
- Specialty Beds: Replace regular beds, offering pressure relief, shear/friction reduction, and moisture control. Examples include high-air-loss, low-air-loss, and kinetic beds.
- Pressure-reducing Devices: Used for both bed and chair confinement, often made of foam, gel, air, or combinations.
Additional Considerations
- When seated, distribute body weight evenly across the seating surface to prevent pressure concentration.
- In bed, use wedges or pillows to elevate heels completely, preventing heel pressure injuries.
- Avoid doughnut-shaped devices as they restrict blood flow and can cause tissue damage.
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Description
This quiz covers key concepts related to the prevention of pressure injuries, focusing on nutrition, skin integrity, and caregiver education. Learn about the essential preventive measures and the importance of monitoring nutritional status in at-risk patients. Test your knowledge on best practices and strategies to enhance skin health and promote healing.
