The document discusses pressure ulcers, including defining them as lesions caused by unrelieved pressure that damage underlying tissue. It describes the pathology of pressure ulcers as resulting from pressure, blood vessel collapse, and tissue necrosis. It also lists factors that affect development of pressure ulcers such as aging, immobility, nutrition, hydration, moisture, warmth, poor hygiene, and incontinence. The document provides steps for preventing pressure ulcers, which include identifying at-risk patients, assessing skin daily, keeping skin clean and dry, avoiding massage over bony areas, minimizing friction, improving nutrition and mobility, and documenting prevention measures used.

1. PREVENTION OF
PRESSURE ULCER
www.drjayeshpatidar.blogspot.com
www.drjayeshpatidar.blogspot.in

2. PRESSURE ULCER
DEFINITION:-
Any lesion caused by unrelieved pressure
that results in damage to underlying tissue
www.drjayeshpatidar.blogspot.in

3. SYNONYMS
Decubitus ulcer
Bedsores
www.drjayeshpatidar.blogspot.in

4. PATHOLOGY
Pressure
Blood vessel collapse
Necrosis (tissue death)
www.drjayeshpatidar.blogspot.in

5. MECHANISM
External pressure –compress blood
vessels
Friction and shearing forces-tear and
injure blood vessel
www.drjayeshpatidar.blogspot.in

6. EXTERNAL PRESSURE
www.drjayeshpatidar.blogspot.in

7. FRICTION AND SHEARING FORCES
 Friction-two surfaces
rub against each
other
 Shearing-one layer of
tissue slide over
another
www.drjayeshpatidar.blogspot.in

8. FACTORS AFFECTING PRESSURE ULCER
DEVELOPEMENT
Aging
Immobility-paralysed,unconscious,lengthy
surgery,tranquilizers
Nutrition-malnourished,vit-c deficiancy
www.drjayeshpatidar.blogspot.in

9. FACTORS AFFECTING PRESSURE ULCER
DEVELOPEMENT
HYDRATION-DEHYDRATION,OEDEMA
MOISTURE-SWEATING
WARMTH-FEVER
POOR HYGIENE
INCONTINENCE
www.drjayeshpatidar.blogspot.in

10. PRESSURE ULCER STAGING
 STAGE I - Nonblanching
Erythema With Skin Intact.
STAGE II - Partial Thickness Skin
Loss(epidermis)- Blister / Abrasion
www.drjayeshpatidar.blogspot.in

11. PRESSURE ULCER STAGING
STAGE III – Fullthickness Skin Loss -
Necrosis Of Hypodermic Tissue
STAGE IV - Fullthickness Skin Loss -
Extensive Damage To Muscle,boneor
Supporting Structures
www.drjayeshpatidar.blogspot.in

12. STAGE I
www.drjayeshpatidar.blogspot.in

13. STAGE II
www.drjayeshpatidar.blogspot.in

14. STAGE III
www.drjayeshpatidar.blogspot.in

15. STAGE IV
www.drjayeshpatidar.blogspot.in

16. PREVENTING PRESSURE ULCER
1. Identify at risk patients
2. Assess their skin daily
3. Keep skin clean & dry always keep
pressure off skin
4. Avoid massage over bony prominences
www.drjayeshpatidar.blogspot.in

17. PREVENTING PRESSURE ULCER
5. Minimize injury from friction
6. Nutritional interventions
7. Improve mobility
8. Document measures used
www.drjayeshpatidar.blogspot.in

18. GIVING A BACK MASSAGE/
BACK RUB
www.drjayeshpatidar.blogspot.in

19. ACTION
1. Explain the procedure and offer back
massage to the patient.
www.drjayeshpatidar.blogspot.in

20. RATIONALE
Back massage can facilitate
circulation and promote
relaxation.
www.drjayeshpatidar.blogspot.in

21. ACTION
WASH YOUR HANDS.
Hand washing deters
the spread of micro –
organisms.
www.drjayeshpatidar.blogspot.in

22. ACTION
CLOSE THE CURTAIN OR
DOOR.
Privacy increases relaxation.
www.drjayeshpatidar.blogspot.in

23. ACTION
Assist the patient to the prone
position or side – lying position with
the back exposed from the shoulders
to the sacral area.
www.drjayeshpatidar.blogspot.in

24. RATIONALE
This position exposes an
adequate area for massage with
privacy and warmth maintained
www.drjayeshpatidar.blogspot.in

25. ACTION
Use the bath blanket to drape the
patient. Raise the bed to the high
position and lower the side rail closest
to you.
www.drjayeshpatidar.blogspot.in

26. RATIONALE
. Having the bed in the high
position reduces back strain for
the nurse.
www.drjayeshpatidar.blogspot.in

27. ACTION
Warm the lubricant or lotion in the
palm of your hand or place the
container in warm water.
www.drjayeshpatidar.blogspot.in

28. RATIONALE
Cold lotion causes chilling and
uncomfortable sensation.
www.drjayeshpatidar.blogspot.in

29. ACTION
Using light gliding strokes
(effleurage), apply lotion to
patient’s shoulders, back , and
sacral area.
www.drjayeshpatidar.blogspot.in

30. SUGGESTED MOVEMENTS
www.drjayeshpatidar.blogspot.in

31. RATIONALE
Effleurage
relaxes the
patient and
lessens tension.
www.drjayeshpatidar.blogspot.in

32. ACTION
Place your hands beside each other
at the base of the patient’s spine and
stroke upward to the shoulders and
back downward to the buttocks in
slow, continous strokes. Continue for
several minutes.
www.drjayeshpatidar.blogspot.in

33. RATIONALE
Continous contact is soothing and
stimulates circulation and muscle
relaxation.
www.drjayeshpatidar.blogspot.in

34. ACTION
Massage the patient’s shoulders, entire
back, areas over iliac crests, and sacrum
with circular stroking motion. Keep your
hands in contact with the patient’s skin.
Continue for several minutes, applying
additional lotion as necessary.
www.drjayeshpatidar.blogspot.in

35. RATIONALE
A firmer stroke with continous
contact promotes relaxation.
www.drjayeshpatidar.blogspot.in

36. ACTION
Knead the
patient’s skin by
gently alternating
grasping and
compression
motions
(petrissage).
www.drjayeshpatidar.blogspot.in

37. RATIONALE
Kneading increases blood
circulation to areas.
www.drjayeshpatidar.blogspot.in

38. FRICTION
www.drjayeshpatidar.blogspot.in

39. ACTION
Complete the massage with
additional long stroking
movements.
www.drjayeshpatidar.blogspot.in

40. RATIONALE
Long stroking motion is soothing
and promotes relaxation.
www.drjayeshpatidar.blogspot.in

41. ACTION
During massage, observe the
patient’s skin for reddened or
open areas. Pay particular
attention to the skin over bony
prominences.
www.drjayeshpatidar.blogspot.in

42. RATIONALE
Pressure may interfere with
circulation and lead to
development of decubitus ulcers.
Back rub stimulates circulation to
these areas.
www.drjayeshpatidar.blogspot.in

43. ACTION
Use the towel to pat the patient
dry and to remove excess lotion.
Apply powder if the patient
requests it.
www.drjayeshpatidar.blogspot.in

44. RATIONALE
This provides additional comfort
for the patient.
www.drjayeshpatidar.blogspot.in

45. ACTION
WASH YOUR HANDS.
www.drjayeshpatidar.blogspot.in

46. RATIONALE
Hand washing deters the spread
of micro – organisms.
www.drjayeshpatidar.blogspot.in

47. ACTION
Assess the patient’s response
and record your observations on
the patient’s chart.
www.drjayeshpatidar.blogspot.in

48. RATIONALE
This provides accurate
documentation of the procedure
and condition of the patient’s skin.
www.drjayeshpatidar.blogspot.in

49. Thank you
www.drjayeshpatidar.blogspot.in