Which of the following patients is at greatest risk for developing pressure ulcers?
A. An alert, chronic arthritic patient treated with steroids and aspirin B. An 88-year old incontinent patient with gastric cancer who is confined to his bed at home C. An apathetic 63-year old COPD patient receiving nasal oxygen via cannula D. A confused 78-year old patient with congestive heart failure (CHF) who requires assistance to get out of bed.
An 88-year old incontinent patient with gastric cancer who is confined to his bed at home. Pressure ulcers, also known as bedsores, happen when a single area of the skin is subjected to pressure over a long time. The major risk factor is immobility: if someone can’t move or change positions, they’re likely to develop pressure ulcers on the skin areas that are in contact with the bed or chair.
Options A and C, as described, are both mobile, so they are not at a particularly high risk of developing bedsores. There’s a slightly higher risk with option D, the 78-year-old who requires assistance to get out of bed. But the risk is still not as high as someone who is completely confined to bed.
An 88-year old incontinent patient with gastric cancer who is confined to his bed at home.
Pressure ulcers are most likely to develop in patients with impaired mental status, mobility, activity level, nutrition, circulation and bladder or bowel control. Age is also a factor. Thus, the 88-year old incontinent patient who has impaired nutrition (from gastric cancer) and is confined to bed is at greater risk.