Pressure Ulcers: A Case Study

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A major focus of many hospitals, national organizations, and insurers is preventing pressure ulcers.
a. Describe the pathophysiology of pressure ulcer formation.
Pressure ulcers are “ischemic ulcers resulting from unrelieved pressure, shearing forces, friction, and moisture. The most significant cause is pressure that consistently interrupts arterial and venous blood flow to and from the skin or deeper tissue”(McCance & Huether, 2014, p. 1625). Prolonged compression can lead to muscle ischemia and necrosis. The main factors contributing to pressure ulcers are:
- Pressure: Soft tissues are compressed between bony prominences and contact surfaces, microvascular occlusion with tissue ischemia and hypoxia occurs; if compression is not relieved,
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Appropriate patient and family education
Patient and family education is imperative in order to avoid recurrent and new ulceration. Position changes should be frequent to avoid stress on the skin and minimize pressure on vulnerable areas. The following approaches can prevent pressure ulcers:
- Wheelchair patients: Shift the body weight frequently and lift the body up if possible. Use a cushion (gel, foam, air) to ensure proper position.
- Bed confined patients: Reposition frequently, using devices if indicated and allow caregivers to assist with bed linens to reduce friction and shearing. Use specialized mattress and cushioning to protect bony areas and elevate the head of the bed (no more than 30 degrees) to prevent shearing.
- Clean and protected affected skin and manage incontinence promptly. Inspect skin daily for early signs pressure sores.
- Eat a healthy diet and drink enough fluids to keep skin hydrated. Quit smoking.
- Limited mobility is a key factor in causing pressure sores therefore, daily exercise can improve blood flow, build vital muscle tissue, stimulate appetite, and strengthen the body.
(Mayo Clinic Staff, 2014, p. 9).
The goal is to prevent formation of pressure ulcers by elimination any possible causes and correcting systemic

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