Bed sores can be best prevented by?

WCL Staff Nurse - 2019

Medical & Surgical Nursing

Easy

Appeared in: WCL Staff Nurse - 2019

Explanation

Frequent change of position is the most critical intervention to prevent bed sores (pressure ulcers) as it directly addresses the primary cause, which is unrelieved pressure.
Repositioning relieves prolonged pressure on bony prominences, which restores blood flow (reperfusion) and prevents tissue ischemia and necrosis.
The standard of care is to implement a turning schedule, typically repositioning a bed-bound patient at least every 2 hours and a chair-bound patient every hour.

Option B: Massaging a reddened area is contraindicated. The redness indicates a Stage 1 pressure injury, and massage can cause further damage to the underlying capillaries and tissues.
Option C: A hard mattress increases and concentrates pressure on bony prominences, which significantly raises the risk of developing bed sores.
Option D: This option is incorrect because two of the listed interventions (massaging reddened areas and using a hard mattress) are harmful and directly contradict best practices for pressure ulcer prevention.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pressure Ulcer (Bedsore) Prevention as background academic context rather than a clinical decision trigger.
Nurses must use a validated risk assessment tool, like the Braden Scale, upon admission and regularly thereafter to identify patients at risk for pressure ulcers and implement a tailored prevention plan.
Patient and family education on the importance of repositioning, skin care, and nutrition is a key nursing responsibility to ensure continuity of care and prevent complications.
What if? The patient has a reddened, non-blanchable heel. The correct action is not to massage it but to 'float' the heel completely off the bed surface using pillows or a specialized boot, document it as a Stage 1 pressure injury, and notify the healthcare provider.

How to Approach the Question

First, identify the core concept of the question, which is the 'best' or most effective method for preventing bed sores.
Analyze each option based on the pathophysiology of pressure ulcers, which result from unrelieved pressure causing a lack of blood flow to tissues.
Evaluate 'Frequent change of position'. This directly addresses the root cause (unrelieved pressure) by relieving it periodically, making it a strong candidate.
Evaluate 'Massage the redden area'. Recall that redness is a sign of tissue injury (Stage 1). Massaging can worsen damage, so this is a harmful action and incorrect.
Evaluate 'Use of hard mattress'. This would concentrate pressure, increasing risk, not preventing it. This is also incorrect.
Since two options are incorrect and harmful, 'All of the above' must also be incorrect. Therefore, the most effective and correct intervention is frequent repositioning.

Concept Tested & Keywords

QEiaAH3zgaB-Cw1TOXuM4D

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 pp. 109-111, 111-113