1
pressure ulcer definition
- area of localized injury to the skin and/or underlying tissue, usually over a bony prominence
- result of pressure alone or pressure combined with shear or friction
2
Pathophysiology
- Constant pressure
- lessen the blood flow to tissues
- occlusion and tearing of small blood vessels
- Reduce tissue perfusion
- ischemic necrosis
- Pressure Sore
3
Risk factors
- Immobility
- Lack of sensory perception
- Poor nutrition and hydration
- Medical conditions affecting blood flow
4
Common pressure sites of ulcers
- tailbone
- heels
- hips
- shoulder blades
- ankles
- elbows
- ears
- back of the head
- buttocks
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Stages of pressure ulcer
- epidermis
- epidermis and dermis
- subcutaneous tissue
- muscle, bone, tendon, or joint
6
Pressure ulcers are a common complication in ICU patients who are
- Sedated and ventilated
- Bedridden for long periods
7
when to evaluation of ICU patient’s risk of pressure ulcer within how many hours of admission?
12 hr
8
energy needs
- IC
- 30 to 35 kcal/kg
- 35 to 40 kcal/kg (underweight or losing weight)
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General protein recommendations
1.25 - 1.5 g/kg of HBV
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Stage 2 protein recommendations
1.2–1.5 g/kg/day
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stage III and IV pressure ulcers protein recommendations
1.5–2.0 g/kg/ day
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Excess dietary protein in amounts greater than 1.5 to 2.0 g/kg per day can be a risk factor for
dehydration, especially in the elderly
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fluid requirements
- 30 - 35 mL/kg of actual body weight
- minimum of 1 ,500 mL/day
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important vitamins and minerals for pressure ulcers patients
- A -- stimulates epithelialization & immune system
- E
- C -- collagen synthesis
- K
- zinc
- copper
- iron
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micronutrient recommendations
- multiple vitamin and mineral supplement 100% DRI
- zinc deficincy -- supplementation for 2 - 3 weeks