Pressure Sores Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Pressure ulcers occur when skin and underlying tissues are placed under pressure that impairs blood supply, leading to tissue damage. Which of the following can cause pressure ulcers?

1 - friction
2 - continuous pressure
3 - shearing
4 - all of the above

A

4 - all of the above

Friction = rubbing of skin against a surface

Shearing = 2 skins surfaces rub against one another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where do pressure sores most commonly occur?

1 - over boney prominences
2 - on sensitive skin (genitals)
3 - over commonly exposed skin
4 - over hairy surfaces

A

1 - over bone prominences

Typically location of thinnest subcutaneous tissue

Image shows most common sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When skin is exposed to continuous pressure, shearing and friction, which of the following can occur?

1 - compression of blood vessels
2 - ischaemia
3 - hypoxia
4 - tissue damage and cell death
5 - all of the above

A

5 - all of the above

They typically occur in this order

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which of the following is NOT a common condition associated with increasing the risk of developing pressure sores?

1 - immobility
2 - chronic liver disease
3 - dementia
4 - poor blood flow (HF and lung disease) 5 - increasing age

A

2 - chronic liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which of the following is NOT a common condition associated with thin skin and thus increasing the risk of developing pressure sores?

1 - older age
2 - dry skin with dehydration
3 - chronic kidney disease
4 - poor nutrition and thin SC tissue
5 - external irritants (sweat, urine, feaces)

A

3 - chronic kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

There are 5 stages of pressure sores. Which of the following is a stage 4 pressure sore?

1 - extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures, with or without full-thickness skin loss. Difficult to heal and increased risk of fatal infection.
2 - unstageable (depth unknown): full-thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed, resulting in the true depth, and therefore Category/Stage, being unable to be determined.
3 - reduced blood flow, warm and non-blanching erythema with intact skin.
4 - full-thickness skin loss (epidermis, dermis and SC tissue) damage or necrosis with drainage or slough, but not beyond the fascia.
5 - involvement of epidermis and/or dermis, superficial abrasion or blister.

A

1 - extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures, with or without full-thickness skin loss. Difficult to heal and increased risk of fatal infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

There are 5 stages of pressure sores. Which of the following is a stage 1 pressure sore?

1 - extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures, with or without full-thickness skin loss. Difficult to heal and increased risk of fatal infection.
2 - unstageable (depth unknown): full-thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed, resulting in the true depth, and therefore Category/Stage, being unable to be determined.
3 - reduced blood flow, warm and non-blanching erythema with intact skin.
4 - full-thickness skin loss (epidermis, dermis and SC tissue) damage or necrosis with drainage or slough, but not beyond the fascia.
5 - involvement of epidermis and/or dermis, superficial abrasion or blister.

A

3 - reduced blood flow, warm and non-blanching erythema with intact skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

There are 5 stages of pressure sores. Which of the following is a stage 5 pressure sore?

1 - extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures, with or without full-thickness skin loss. Difficult to heal and increased risk of fatal infection.
2 - unstageable (depth unknown): full-thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed, resulting in the true depth, and therefore Category/Stage, being unable to be determined.
3 - reduced blood flow, warm and non-blanching erythema with intact skin.
4 - full-thickness skin loss (epidermis, dermis and SC tissue) damage or necrosis with drainage or slough, but not beyond the fascia.
5 - involvement of epidermis and/or dermis, superficial abrasion or blister.

A

2 - unstageable (depth unknown): full-thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed, resulting in the true depth, and therefore Category/Stage, being unable to be determined.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

There are 5 stages of pressure sores. Which of the following is a stage 3 pressure sore?

1 - extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures, with or without full-thickness skin loss. Difficult to heal and increased risk of fatal infection.
2 - unstageable (depth unknown): full-thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed, resulting in the true depth, and therefore Category/Stage, being unable to be determined.
3 - reduced blood flow, warm and non-blanching erythema with intact skin.
4 - full-thickness skin loss (epidermis, dermis and SC tissue) damage or necrosis with drainage or slough, but not beyond the fascia.
5 - involvement of epidermis and/or dermis, superficial abrasion or blister.

A

4 - full-thickness skin loss (epidermis, dermis and SC tissue) damage or necrosis with drainage or slough, but not beyond the fascia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

There are 5 stages of pressure sores. Which of the following is a stage 2 pressure sore?

1 - extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures, with or without full-thickness skin loss. Difficult to heal and increased risk of fatal infection.
2 - unstageable (depth unknown): full-thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed, resulting in the true depth, and therefore Category/Stage, being unable to be determined.
3 - reduced blood flow, warm and non-blanching erythema with intact skin.
4 - full-thickness skin loss (epidermis, dermis and SC tissue) damage or necrosis with drainage or slough, but not beyond the fascia.
5 - involvement of epidermis and/or dermis, superficial abrasion or blister.

A

5 - involvement of epidermis and/or dermis, superficial abrasion or blister.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Above what grade pressure sores should be referred through to specialist care?

1 - >4
2 - >3
3 - >2
4 - >1

A

2 - >3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which of the following are key features of proper pressure sore management?

1 - adequate pressure redistribution
2 - good nutrition
3 - appropriate wound management
4 - prevent soiling and moisture
5 - all of the above

A

5 - all of the above

Reduce moisture and use lotions to help soften skin

Appropriate wound management is to reduce risk of infection and aid healing

Skin swabs are taken to guide antibiotic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How often should patients be encouraged to mobilise or assisted to mobilise?

1 - every 15-30 minutes
2 - every 1-2 hours
3 - every 3-4 hours
4 - every 6-8 hours

A

2 - every 1-2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly