9/13/26, 5:30 AM Skin Integrity & Wound Care Flashcards | Quizlet
An immobilized patient in this position is prone to skin -left side of head including ear
breakdown in which areas? Select all that apply! -left shoulder
-left ileum and greater trochanter
-left malleolus (medial and lateral)
What are two risk assessment tools used to evaluate a Braden and Norton
patient's risk for skin problems? Choose all that apply.
When changing the soiled linen on the bed of a patient position the patient on her right side
who is comatose, the nurse notices an unblanchable,
reddened, intact area on her left buttock. The nurse's
immediate, initial skin breakdown intervention is to:
A 25 year old patient suffers a spinal cord injury and -immobility
paraplegia due to a motor vehicle accident. The nurse -impaired sensation
recognizes the patient is at risk for pressure ulcers due to -pressure
which of the following factors? Pick all that apply.
A patient with limited mobility presents with an ischial partial thickness wound
wound that extends to the epidermis. When documenting
the depth of the wound, how would the nurse classify it?
What stage is this pressure ulcer? exposed dermis red stage 3
This pressure ulcer should be documented as which of the stage 1
following stages? redness of the skin
What stage is this pressure ulcer? redness of the epidermis stage 1
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An immobilized patient in this position is prone to skin -left side of head including ear
breakdown in which areas? Select all that apply! -left shoulder
-left ileum and greater trochanter
-left malleolus (medial and lateral)
What are two risk assessment tools used to evaluate a Braden and Norton
patient's risk for skin problems? Choose all that apply.
When changing the soiled linen on the bed of a patient position the patient on her right side
who is comatose, the nurse notices an unblanchable,
reddened, intact area on her left buttock. The nurse's
immediate, initial skin breakdown intervention is to:
A 25 year old patient suffers a spinal cord injury and -immobility
paraplegia due to a motor vehicle accident. The nurse -impaired sensation
recognizes the patient is at risk for pressure ulcers due to -pressure
which of the following factors? Pick all that apply.
A patient with limited mobility presents with an ischial partial thickness wound
wound that extends to the epidermis. When documenting
the depth of the wound, how would the nurse classify it?
What stage is this pressure ulcer? exposed dermis red stage 3
This pressure ulcer should be documented as which of the stage 1
following stages? redness of the skin
What stage is this pressure ulcer? redness of the epidermis stage 1
https://quizlet.com/572704791/skin-integrity-wound-care-flash-cards/?funnelUUID=328e3da5-73da-433e-97b4-0e4ea2ec01a0 3/5
