The client requires prone positioning for a severe respiratory condition. Which areas are at risk for development a pressure ulcer and require pillow bridging as a prevention strategy? (Select all that apply.)

Question

1. Ear
2. Toes
3. Nose
4. Elbows
5. Occipital region
6. Medial aspect of knees

Answer 1

1, 2
1 and 2. In the prone position, the nurse positions the client 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 respiratory problem, the nurse most likely positions the client with the head to the side to provide easy access to the endotracheal tube and the client's airway for suctioning. The positioning exposes the dependent ear and the toes of both feet to an increased risk of pressure ulcers from concentrated pressure on a small area; therefore, the nurse supports these areas with padding or pillows to dis-tribute the weight over a larger surface evenly.
3. The nose is not at risk with the head turned to the side.
4. In the prone position, pressure on the elbows is distributed along the length of the ulnar and radial bones.
5. The back of the head is in an independent position with the client in the prone po-sition with the head facing down or to the side.
6. Prone positioning exposes the anterior aspect of the knees to excessive pressure and requires padding to prevent a pressure ulcer.