Which of the following actions could result in pressure ulcer formation?
A) Pulling a stroke client up in bed
B) Turning a client from side to side every 2 hours
C) Allowing a client to side up in a chair at mealtime
D) Applying powder to buttocks area when diaphoresis has become a problem
Ans: A
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Factors contributing to the development of pressure ulcers include external pressure that compresses blood vessels and friction and shearing forces that tear and injure blood vessels. Shearing forces are caused by the sliding of one tissue layer over another with stretching and angulation of blood vessels, causing injury and thrombosis. Shear occurs when the skeleton moves, but the skin remains fixed to an external surface, such as occurs with transfer from a stretcher to a bed or pulling a person up in bed. Whether a person is sitting or lying down, the weight of the body is borne by tissues covering the bony prominences. Moisture contributes to pressure ulcer formation by weakening the cell wall of individual skin cells and by changing the protective pH of the skin.
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