The patient has rheumatoid arthritis, is prone to skin breakdown, and is also somewhat immobile because of arthritic discomfort. Which of the following interventions is the best one for this patient's skin integrity?
a. Having the patient sit up in a chair for four-hour intervals
b. Keeping the head of the bed in a high Fowler's position to increase circulation
c. Repositioning the patient at least every two hours
d. Encouraging the patient to perform pelvic muscle training exercises several times a day
C
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A Patients able to sit in a chair should be limited to sitting for two hours or less.
B Elevating the head of the bed to 30 degrees or less will decrease the chance of pressure ulcer development from shearing forces.
C The frequency of repositioning should be individualized for the patient; however, patients should be repositioned at least every two hours.
D Pelvic muscle training may help prevent incontinence, but it is not the best intervention for maintaining the patient's skin integrity.
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