1. Bone Anatomy and Pressure UlcersBy
Manuel A. Gallegos RN, BSN

2. Objectives: 1. Introduction to function and anatomy of the skeleton
2. Define pressure ulcer
3. Identify stages and risk areas
4. Prevention of Decubitus Ulcers

3. Function of Bones
Vital organs: brain, heart, lungs are protected by the skeletal system (bones)
Blood cells are produced by bone marrow
Bones serve for structure and locomotion (movement)

4. Bone Marrow

5. Skeleton / Bones

7. Question 1 Answer: 1. B and C Only 2. A and D. 3. All of the above
Bones have which functions?
A. Assist with movement of blood
B. Bones produce blood cells
C. Protects vital organs that include brain and heart
Answer:
1. B and C Only
2. A and D.
3. All of the above
4. None of the Above

8. Define Pressure Ulcer
A pressure-induced ulceration of the skin occurring in persons confined to bed for long periods of time

9. Other Names for Pressure Ulcer
Bed Sore
Decubitus Ulcer
Pressure Sore
Ulcer

10. Causes of Pressure Ulcers
Client is in one position for too long
(in bed, wheelchair, or chair) and may be under-nourished
Constant pressure against the skin reduces blood supply to skin and underlying tissue

11. Happens in areas that are not well padded with muscle or fat such as sacrum, heels, hips, shoulder blades, elbows
Pressure sores are more likely to occur if client is immobilized by illness, or injury – stroke / brain injury
Spinal cord injuries – paraplegia / quadriplegia

12. All of the following cause Pressure Ulcers except?
1. Client is in one position for too long
2. Happens in areas that are well padded with muscle or fat
3. Constant pressure against the skin reduces blood supply to skin
4. Spinal cord injuries – paraplegia / quadriplegia
ANSWER:
2. Happens in areas that are well padded with muscle or fat

13. Stages of Pressure Ulcers

14. Stage I, Skin intact

15. Stage II

16. Stage III

17. Stage IV

18. Deep Tissue

19. Unstageable – deep and dead

20. Pressure Ulcer on Sacrum

21. Heel ulcer with black dead tissue

22. Pressure ulcer risk areas

23. Multiple Ulcers in the Sacral Area

24. Prevention of Pressure Ulcers
Change position frequently or every (two-six) hours if client has a pressure ulcer or cannot move by themselves
Pad boney areas with padding or pillows
Daily skin inspection for pressure sores
Report any new red areas or new skin breakdown – keep pressure off the area

25. Question 2
An 83 year old woman in your care cannot walk and is confined to her bed.
You make sure she does not develop skin breakdown by:
A) Checking patient’s skin at least once a day.
B) Changing position at least every ten hours.
C) If an area of skin is red or discolored, keep pressure off the area
D) A and C only
E) None of the above
Answer? D
answer?

26. Summary 1. Bones provide protection of vital organs,
allow movement, produce red blood cells
2. Pressure ulcers are areas of damaged skin and tissue that develop when sustained pressure cuts off circulation (blood) to skin areas
especially the skin on sacrum and heels
3. Prevent ulcers by checking the patient everyday,
changing position often, reporting damaged skin promptly

27. Websites