WELLCOME I START WITH THE GREATEST NAME OF ALLAH WHO IS REHMAAN UR RAHEEM
A lesion caused by unrelieved pressure A constant compressing downward force on body or an area of the body result in damage to underlying tissue is called decubitus ulcer . Also called pressure ulcer bed sore pressure sore or distortion sore. Decubitus ulcer
The primary contributing factors for bed sore are:- Pressure:- On any part of your body can lessen the blood flow to tissues Friction:- Friction occurs when the skin rubs against clothing or bedding Friction will damage the superficial tissue such as the skin Shear:- Shear occurs when two surfaces move opposite direction Shearing forces will damage to underlying tissue such as the fat and muscles Etiology Or Causes Of Pressure
Nursing intervention to prevent bedsores:- The predisposing factors for bedsores develop Turn patient regularly. Monitor nutrition and dehydration. Skin condition check at least twice a day. Inspect for dry , moist skin and break skin. Assess for presence of incontinence. Educate patient and caregivers on prevention Nursing Intervention
Pressure ulcer are also known as Bedsores or Decubitus ulcers. They form because of sitting or lying in one position for too long . This leads to cutting off blood circulation over parts of your body and damaging surrounding tissue Pressure Ulcer
Pressure ulcer forms predominantly over skin that covers bony areas of the body. common places. Back of head Shoulder Back Elbows Hips Ankles Heels
Non- blanch able erythema of itact skin. Its discolors the upper layer of your skin, commonly to a reddish color. No break and or tears in the skin. Temperature and texture will be different forms surrounding tissue. Stage 1 does not include purple or maroon discoloration . Mild burning or itching. Stage 1
Partial thickness skin loss with explore dermis. The sore area of skin has broken through the top layer (Epidermis) and some of the area below (dermis ). Ulcer may appear as a serum filled ( clear to yellowish fluid) blister that may or may not have burst . The break typically creates a shallow, open wound and you may or may not notice any drainage from the site Stage 2
Full thickness skin loss. Sores that have progressed to third stage have broken completely through the top two layers of skin and into the fatty tissue below. Fat tissue is visible but not muscle, tendon or bone. Granulation tissue and eschar ( dark , hard ,dead tissue) may also be present . Foul smell ( pus and fluid may be present) Stage 3
Full thickness skin and tissue loss Sore extend below the subcutaneous fat into your deep tissue like muscle, tendon, and ligaments . In severe cases it extends to bone or cartilage High rish of infection at this stage . Drainage dead skin tissue , muscle, tendon and bone . Skin may turn black also eschar formation (dark , hard dead tissue) Stage 4