CC Jan 2016 Pressure Ulcer Prevention

echoecho's version from 2016-03-28 00:09


Question Answer
The development of pressure ulcers in the hospital can do what 3 things?1) increase the length of stay 2) add to the patient management costs 3) increase patient morbidity
*** What scale is commonly utilized assessment tool designed to determine a patient's risk for developing a pressure ulcer. The assessment indentifies ____ domains of risk? 1) Braden scale 2) 6
*** Each domain of the Braden scale is scored 1-4 with 1 being the _____ leve of dysfunction and 4 being the _____?greatest; least
*** A lower score indicated an ______ risk for pressure ulcer?increased
*** A score of ____ or less indicates an increased risk of pressure ulcer development, although the presence of any risk factor may indicate that need for preventive measures?18
*** The American College of Physicians (AC) recommends that clinicans do what, however stipulate that the evidence of effectiveness is weak and of poor quality?perform a risk assessment to identify patients who are at risk of developing pressure ulcers
Regarding the Braden scale, list the 6 risk domains?1) sensory perception 2) moisture 3) activity 4) mobility 5) nutrition 6) friction & shear
Regarding the Braden scale, describe the risk domain of sensory perception?ability to respond meaninfully to pressure-related discomfort
Regarding the Braden scale, describe the risk domain of moisture?degree to which skin is exposed to moisture (e.g. perspiration, urine, fecal matter)
Regarding the Braden scale, describe the risk domain of activity?degree of physical activity (e.g. bed or chair confined, ambulation capacity)
Regarding the Braden scale, describe the risk domain of mobility?ability to change and control body position
Regarding the Braden scale, describe the risk domain of nutrition?usual food intake pattern, level of caloric or protein intake, need for IV fludis or dietary supplements
Regarding the Braden scale, describe the risk domain of friction and shear?skin compromise related to prolonged or repetitive contact with bedding or padded surfaces (e.g. immobile, sliding down)
For a urinary incontinent patient, what preventive measures can be used?1) absorbent pads 2) scheduled toileting
Elevated HgbA1c is a marker for what? but is not a factor for what?1) diabetes-associated complications from pressure ulcers 2) ulcer causation
Is BMi a part of the nutritional assessment in the Braden scale?no but a markedly elevated BMI may be associated with reduced morbility and may increase pressure/weight over areas of pressure
What are the preventive measure for those recovering from surgery and who have reduced mobility?frequent patient turnings and physical therapy
What does shearing result from?1) improper bed size 2) sitting in a prolonged upright position which may place pressure on the heels to maintain proper bed placement
What can contribute to poor skin integrity, impaired overall health and slow healing when a pressure ulcer does develop?1) poor overall nutrition 2) protein malnutrition 3) recent excessive weight loss
What patient types should get a nutritional consultation ordered?1) patients who have recent unintentional weight loss 2) patients that have evidence of protein deficiency (low pre-albumin) 3) low body mass index
What new advances can help staff identify specific areas of increased pressure on skin and bony prominences?use of continuous bedside pressure mapping
*** ACP recommends against what type of mattress. ACP recommends for what type of mattresses in hospitalized patients who are at risk for pressure ulcers?1) against air mattresses 2) for advanced static mattresses
Describe what an advanced static mattress is?it is made of foam or gel that does not move when a person lies on it
What is another option?an advanced static overlay (a material such as sheepskin or a pad filled with air, water, gel, or foam that is secured to the top of a bed mattress)
Comment on the alternating air mattresses commonly used in an attempt to reduce pressure?these are ineffective and are more expensive than the advanced static mattresses or overlays
While individual interventions attempting to prevent pressure ulcers (e.g. boots, pads, lotions, and dressing and frequent repositioning) failed to demonstrate significant benefit, what is recommended as part of an integrated team approach to prevention which is effective?the combined use of all the strategies
Is there good evidence to support the use of nutritional interventions to prevent pressure ulcers?no
*** SUMMARY = What should be used for predicting pressure ulcers as a standard part of care for patients with restricted mobility?risk assessment tools
*** SUMMARY = What 3 factors can contribute to the development of pressure ulcers?1) incontinence 2) poor nutrition 3) shear force effects
*** SUMMARY = Are alternating air flow mattresses effective as a prevention strategy for pressure ulcer prevention?no