Most effective way to prevent bed sore in bedridden patient is?

HPSSC Staff Nurse - 2021

Fundamental of Nursing

Medium

Appeared in: HPSSC Staff Nurse - 2021

Explanation

The most effective way to prevent pressure ulcers is to relieve the pressure that causes them.
Repositioning a bedridden patient at least every two hours redistributes pressure from bony prominences (like the sacrum, heels, and hips), allowing blood to flow back into the tissues.
Sustained pressure that exceeds capillary closing pressure (approximately 32 mmHg) obstructs blood flow, leading to tissue ischemia (lack of oxygen) and eventual necrosis (cell death), forming a pressure ulcer.
While other measures are important, they are supportive; only repositioning directly counteracts the primary cause of pressure ulcers.

Option B: A daily bed bath is important for hygiene and skin assessment but does not relieve the underlying pressure that causes bed sores.
Option C: Avoiding moisture is crucial as it prevents maceration, which weakens the skin. However, even dry skin will break down if subjected to constant pressure.
Option D: Good nutrition, particularly adequate protein, is vital for maintaining healthy skin and promoting healing if an ulcer does develop. However, it does not prevent the initial injury caused by pressure.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pressure Ulcer (Bedsore) Prevention to guide bedside assessment, documentation, and the next nursing action.
Nurses are directly responsible for assessing pressure ulcer risk (using tools like the Braden Scale) and implementing and documenting a turning schedule.
Failure to prevent pressure ulcers can lead to significant patient pain, infection, increased length of hospital stay, and is considered a serious reportable event in many healthcare systems.
What if the patient cannot be turned every 2 hours due to a specific medical condition (e.g., unstable spine)? The nurse must then prioritize the use of specialized pressure-redistributing surfaces (like alternating pressure mattresses or air-fluidized beds) and make small, frequent weight shifts to offload pressure as much as possible.

How to Approach the Question

First, identify the core issue in the question: preventing bed sores in a bedridden patient.
Next, analyze the keywords 'most effective'. This signals that you must choose the single best intervention, even if other options are also beneficial.
Consider the pathophysiology of a bed sore: it is an injury caused by prolonged, unrelieved pressure.
Evaluate each option based on how directly it addresses this root cause.
Option A (position change) directly relieves pressure. Options B, C, and D address contributing risk factors (hygiene, moisture, tissue health) but do not eliminate the primary cause.
Therefore, the intervention that directly counteracts the cause (pressure) is the most effective.

Concept Tested & Keywords

Concept Tested: Pressure Ulcer (Bedsore) Prevention
Stem keywords: prevent bed sore, bedridden patient
Lead-in keywords: Most effective
Clinical cues: The patient is bedridden, which implies immobility and high risk for pressure-related skin injury.

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 109-111

E6 Nursing Fundamentals Potter Perry 12e Part 6 pp. 88-90, 112-114