Question

An elderly client has been hospitalized for two weeks and develops the beginning of a pressure ulcer on the coccyx. The nurse recognizes that pressure ulcers in older adults are considered: A. primary changes B. secondary changes C. normal changes D. expected changes when hospitalized

Short answer

Pressure ulcers in older adults are considered secondary changes.

Step-by-step solution

Understanding the concept of a pressure ulcer

Pressure ulcers, also known as bedsores, are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. They often develop on skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone. They can occur in any patient who is immobile, such as someone who is bedridden or confined to a wheelchair.

Differentiating between primary and secondary changes

Primary changes refer to those that occur as a direct result of aging and are characterized by intrinsic alterations in structure and function. Secondary changes are those that result not directly from aging but from environmental factors or disease processes, such as the development of pressure ulcers from prolonged bed rest or immobility.

Identifying the correct option

Since pressure ulcers in older adults are more associated with prolonged immobility and environmental factors rather than intrinsic aging processes, they are considered secondary changes.

Key concepts

NCLEX-RN Examination

The NCLEX-RN (National Council Licensure Examination for Registered Nurses) is a pivotal test for nursing graduates, determining their readiness to begin practice as nurses. A critical area of knowledge covered by this examination includes understanding and managing pressure ulcers, which are a significant concern in healthcare.

Prospective nurses are tested on their ability to identify risk factors, stages, and appropriate interventions for preventing and treating pressure ulcers. The examination assesses not only the recognition of the clinical manifestations of pressure ulcers but also the grasp of associated ethical and legal considerations. Essential concepts include skin assessment, mobility enhancement, and nutritional support for at-risk patients, especially the elderly. Knowledge of pressure relieving devices and the principles of wound care management is also evaluated.

To excel in the NCLEX-RN, a nursing candidate must be knowledgeable about how to implement effective care plans, which could help prevent complications like pressure ulcers in hospitalized older adults—a challenge that requires both theoretical knowledge and clinical competence.

Nursing Care Strategies

In the context of nursing care strategies, preventing and managing pressure ulcers are paramount, particularly in older adults. Nursing strategies to prevent pressure ulcers include regular skin assessments and implementing individualized care plans that address risk factors specific to each elderly patient.

Key interventions incorporate:

• Frequent repositioning to alleviate pressure
• Use of support surfaces like mattresses and cushions designed to distribute weight more evenly
• Meticulous skin care and maintenance of skin hydration
• Ensuring adequate nutrition and hydration to promote skin integrity and healing
• Education of the patient and family about the importance of movement and skin inspection

Incorporating these strategies into daily nursing practice can significantly reduce the incidence of pressure ulcers and improve the quality of life for elderly patients. Nurses must stay vigilant and responsive to the earliest signs of skin breakdown to initiate timely interventions.

Elderly Patient Care

Providing care for the elderly, especially those who are hospitalized or in long-term care settings, requires a comprehensive approach that integrates the physical, psychosocial, and environmental aspects of patient well-being.

For elderly patients, the risk of developing pressure ulcers is heightened due to a combination of factors such as limited mobility, fragile skin, and comorbidities. Effective elderly patient care strategies focus on proactive prevention. Nurses play a critical role in assessing the risk of pressure ulcers and implementing plans to prevent them. This includes educating the patient and caregivers on the importance of regular movement and position changes, maintaining good nutrition, and ensuring adequate hydration.

Collaborative care involving the interdisciplinary healthcare team—for example, dietitians, physical therapists, and social workers—is also a key component in the holistic care of elderly patients and can help tailor interventions to meet the unique needs of each individual. Personalized care plans and empathetic communication are essential in fostering an environment that promotes healing and minimizes the risk of adverse outcomes such as pressure ulcers.