Causes of bed scores are?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Fundamental of Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Explanation

The development of pressure injuries (bed sores) is multifactorial, involving several external and internal factors.
Friction is a mechanical force where skin rubs against a surface (e.g., bedsheets), causing superficial damage to the epidermis.
Moisture from incontinence, perspiration, or wound drainage leads to skin maceration, which weakens the skin's integrity and makes it more prone to breakdown.
The presence of pathogenic organisms, particularly from fecal or urinary incontinence, contributes to skin breakdown and can cause secondary infections, worsening the injury.
Because friction, moisture, and pathogenic organisms are all contributing causes, 'All of the above' is the most complete and correct answer.

Option A: This option is incomplete. While friction is a significant cause of skin surface damage, it is not the only factor involved in the development of bed sores.
Option B: This option is incomplete. Moisture is a critical risk factor that weakens the skin, but it acts in concert with other forces like pressure and friction.
Option C: This option is incomplete. Pathogenic organisms are typically a complicating factor or a contributor to breakdown in the presence of other factors like moisture, rather than a primary initiating cause like pressure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology and risk factors for pressure ulcers (bed sores) as background academic context rather than a clinical decision trigger.
Preventing pressure injuries is a key nursing responsibility and a major indicator of quality of care. It involves meticulous skin assessment and management of risk factors.
Nurses use risk assessment tools like the Braden Scale, which specifically evaluates factors like moisture, friction, and shear, to identify at-risk patients and implement preventative measures.
Interventions include frequent repositioning (e.g., every 2 hours), using pressure-relieving mattresses, managing incontinence promptly with barrier creams, and ensuring adequate nutrition and hydration.

How to Approach the Question

First, recognize the likely typographical error in the question stem. 'Bed scores' should be interpreted as 'bed sores' or 'pressure ulcers,' a common topic in nursing.
Next, analyze the question's intent, which is to identify the causes of these skin injuries.
Evaluate each option individually based on your knowledge of pressure ulcer pathophysiology.
Recall that friction (rubbing), moisture (weakening the skin), and pathogens (from incontinence) are all well-documented contributing factors.
Since multiple options are correct individual factors, look for a comprehensive option like 'All of the above.'
Conclude that because all listed items contribute to the formation or worsening of bed sores, 'All of the above' is the most accurate and complete answer.

Concept Tested & Keywords

Concept Tested: Etiology and risk factors for pressure ulcers (bed sores).
Stem keywords: Causes, bed sores
Lead-in keywords: are
Clinical cues: The term 'bed scores' is a common typo for 'bed sores', a key concept in fundamental nursing care.

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E6 Nursing Fundamentals Taylor p. 555-557

E6 Nursing Fundamentals Potter Perry 12e Part 6 pp. 68-70, 67-69