The client has extensive skin grafts from a chemical plant fire. Which support surface should the nurse choose to facilitate growth and development of the client's skin grafts?

Question

1. Rotokinetic bed
2. Air-fluidized bed
3. High-density foam
4. Gel mattress overlay

Answer 1

2
2. The most suitable support surface for the client with extensive skin grafts is one that minimizes client movement to allow the tissue grafts to adhere and development and to help prevent client pain, so the nurse chooses the air-fluidized bed to prevent shear damage to the skin grafts, maintain skin integrity of ungrafted skin, and to mi-nimize movement to reduce client pain. Because air-fluidized beds are associated with dehydration and burn victims already have a high risk of fluid loss from exten-sive areas of impaired skin integrity, the nurse must plan nursing care to maintain fluid and electrolyte balance.
1. The Rotokinetic bed is contraindicated for the client. Although the bed offers ske-letal support for the client, the continual motion is likely to apply varying pressure to the tissue grafts and exacerbate client pain with motion.
3. High-density foam is pressure reducing; this client needs pressure relief to facilitate skin grafting.
4. Gel mattress overlays are not suitable for the client because the lack of air flow promotes accumulating moisture and increases the risk of cutaneous fungal infections, potentially leading to devastating results. In addition, the gel mattress is pressure reducing; this client needs pressure relief.