The patient requires prone positioning for a severe respiratory condition. Which areas are at risk for developing a pressure ulcer and require pillow bridging as a prevention strategy?

Question

a. Ears and toes
b. Nose and elbows
c. Occipital area and knees
d. Sacrum and coccyx

Answer 1

A
In the prone position, the nurse positions the patient face down on the bed with the head turned to the side or with a special face pillow that has a hollow center. Because of the severe respira-tory problem, the nurse most likely positions the patient with the head to the side to provide easy access to the endotracheal tube and the patient's airway for suctioning. This positioning exposes the dependent ear and the toes of both feet to an increased risk of pressure ulcers from concen-trated pressure on a small area; therefore the nurse supports these areas with padding or pillows to distribute the weight over a larger surface evenly. The nose is not at risk with the head turned to the side, and pressure on the elbows is distributed along the length of the ulnar and radial bones. The sacrum and coccyx are not in contact with a hard surface when the patient is prone. The back of the head is in an independent position with the patient in the prone position with the head facing down or to the side, but prone positioning exposes the anterior aspect of the knees to excessive pressure and requires padding to prevent a pressure ulcer.