Which of the following is not a primary risk factor for pressure ulcers?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Insomnia, or the inability to sleep, is not considered a primary risk factor for the development of pressure ulcers.
The pathophysiology of pressure ulcers involves direct tissue damage from prolonged pressure, shear, friction, and moisture.
While poor sleep can affect overall health and healing, it does not directly cause the mechanical or chemical skin breakdown that leads to pressure injuries.

Option A: A low protein diet leads to malnutrition, which impairs tissue integrity and the body's ability to repair itself, making the skin more vulnerable to breakdown under pressure.
Option B: Fever increases the body's metabolic demands and often causes diaphoresis (sweating). The resulting moisture macerates the skin, weakening it and making it more susceptible to injury from friction and pressure.
Option D: A lengthy surgical procedure involves prolonged immobility on a firm surface, often combined with anesthesia that reduces sensory perception. This combination of sustained pressure and inability to feel discomfort is a major risk factor.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk factors for pressure ulcer development as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in preventing pressure ulcers by regularly assessing at-risk patients using tools like the Braden Scale.
Key nursing interventions include frequent repositioning (at least every 2 hours), ensuring adequate nutrition and hydration, keeping the skin clean and dry, and using pressure-relieving surfaces.
What if the patient with insomnia also has restless leg syndrome? While insomnia itself isn't a primary risk, the constant movement from restless leg syndrome could increase friction and shear, thus elevating the risk. The nurse's assessment must consider the whole clinical picture.

How to Approach the Question

First, identify the core concept of the question, which is 'primary risk factors for pressure ulcers'.
Note the negative keyword 'not'. This means you are looking for the option that does NOT fit the category of a primary risk factor.
Evaluate each option against the known causes of pressure ulcers: pressure, shear, friction, moisture, and poor tissue tolerance.
Option A (Low protein diet) relates to poor tissue tolerance.
Option B (Fever) relates to moisture and increased metabolic demand.
Option D (Lengthy surgery) relates to pressure and immobility.

Concept Tested & Keywords

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E6 Gynecology Williams p. 64-86

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 69-71

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.