Management of Pressure Ulcers: Nursing Considerations and Interventions

This essay discusses the management of pressure ulcers disease processes and the nursing considerations related to interventions such as repositioning of patient and support surfaces. Find guidelines, policies, and procedures for managing pressure ulcers. Learn about nutrition screening, use of vitamins and minerals, care planning intervention, and hydration. Understand the nursing considerations for repositioning and support surfaces.

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Introduction
Pressure ulcers are also known as bedsores, or pressure sores are lacerations to the skin
and elemental tissue, contingent on extended pressure on the skin (Bhattacharya and Mishra
2015, p.4). The essay discusses the procedure that explains the management of the disease
processes and the nursing considerations related to interventions like repositioning of patient and
support surfaces.
Search and find a guideline, policy or procedure that discusses the management of pressure
ulcers disease processes.
Nutrition screening is an intervention in management and treatment of pressure ulcers
(Posthauer, Banks, Dorner and Schols 2015, p.175) whereby the nutritional status of every
person with pressure ulcers is screened on admission to a hospital. A reliable and valid nutrition
screening tool is used to ascertain dietary risks. If poor outcomes are confirmed due to
malnutrition, there is a need to quickly identify and treat malnutrition as it affects the healing of
pressure ulcers. Moreover, energy intake and protein intake are essential in the management of
pressure ulcers where energy intake is adjusted based on the level of obesity or weight change
(Posthauer, Banks, Dorner and Schols 2015, p.180). Protein is vital for promoting nitrogen
balance, and its escalated levels are connected to enhanced healing rates.
The other intervention is the use of vitamins and minerals where people with pressure
ulcers are encouraged to eat a balanced diet that contains good sources of vitamins and minerals
(Posthauer, Banks, Dorner and Schols 2015, p.186). Care planning intervention helps in the
management of pressure ulcers where a registered dietitian should develop a document a
personalized nutrition intervention plan grounded upon the person's nutritional requirements,
objectives of care along with the route of feeding. Fluid in the body acts as a solvent for glucose,

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vitamin and minerals hence hydration helps in management and treatment of pressure ulcers.
Therefore, health providers need to monitor the hydration status of the person by checking the
signs of dehydration like skin turgor, urine output and changes in weight and if present provides
adequate fluid intake (Posthauer, Banks, Dorner and Schols 2015, p.185).
Discuss the nursing considerations related to interventions such as repositioning of patient
and support surfaces mentioned in guidelines.
Repositioning reduces the time and immensity of pressure over sensitive body parts and
to contribute to hygiene, functional ability and comfort. Pressure along with shear forces are
essential considerations, and therefore the registered nurses should choose a settled position
which is allowable for the person and that reduces the pressures and shears applied on the skin
(Engels et al., 2016, p. 271). Moreover, the person’s condition and the pressure redistribution
support surface in use when ascertaining if repositioning must be performed should be
considered. Regular positioning is not feasible for a few people due to their medical situation and
a substitute prevention policy like supposing a high-specification mattress have to be deliberate.
Support surfaces are specialized machines for pressure redistribution created for the
management of microclimate, tissue loads and other curative operations (Shi, Dumville and
Cullum 2018, p.e0192707). When using the nursing intervention of support surface, the
registered nurse should deliberate the person’s body dimensions guaranteeing that there is
sufficient area for repositioning (McNichol, Watts, Mackey, Beitz and Gray 2015, p.19). Another
consideration is the place the support surface or bed will be put. The support surface chosen
should be compatible with the hospital setting. Therefore, the weight of the bed, the breadth of
doors, the accessibility of undisturbed electrical power, secure place for the motor inclusive of
ventilation along with the structure of the building should be considered.

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Bibliography

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Bhattacharya, S. and Mishra, R.K., 2015. Pressure ulcers: current understanding and newer
modalities of treatment. Indian journal of plastic surgery: official publication of the Association
of Plastic Surgeons of India, 48(1), p.4.
Engels, D., Austin, M., McNichol, L., Fencl, J., Gupta, S. and Kazi, H., 2016. Pressure ulcers:
factors contributing to their development in the OR. AORN Journal, 103(3), pp.271-281.
McNichol, L., Watts, C., Mackey, D., Beitz, J.M. and Gray, M., 2015. Identifying the right
surface for the right patient at the right time: generation and content validation of an algorithm
for support surface selection — Journal of Wound, Ostomy, and Continence Nursing, 42(1),
p.19.
Posthauer, M.E., Banks, M., Dorner, B. and Schols, J.M., 2015. The role of nutrition for pressure
ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory
panel, and pan pacific pressure injury alliance white paper. Advances in skin & wound
care, 28(4), pp.175-188.
Shi, C., Dumville, J.C. and Cullum, N., 2018. Support surfaces for pressure ulcer prevention: A
network meta-analysis. PloS one, 13(2), p.e0192707.