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1.5 CE Test Hours

Pressure Injuries Caused by Medical Devices and Other Objects

A Clinical Update

Contrada, Emily

AJN The American Journal of Nursing: December 2017 - Volume 117 - Issue 12 - p 46,47
doi: 10.1097/01.NAJ.0000527461.70352.5d
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Figure.

Figure.

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Pressure Injuries Caused by Medical Devices and Other Objects: A Clinical Update

GENERAL PURPOSE:

To discuss the etiology and prevention of pressure injuries resulting from medical and other devices.

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LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing nursing education activity, you should be able to

  • outline the risk factors for pressure injuries and the bodily sites at which they most often occur.
  • identify current clinical practice guidelines and information about the staging of these injuries.
  1. The National Pressure Ulcer Advisory Panel recommends replacing the term pressure ulcer with pressure injury because
  2. ulcers can also be internal.
    some pressure injuries (PIs) have intact skin.
    trauma causes these injuries.
  3. Mucosal PIs cannot be staged because it is difficult to
  4. access them for a full examination.
    measure the depth of tissue injury.
    distinguish the degree of tissue loss histologically.
  5. The most recent International Pressure Ulcer Prevalence Survey showed a decline in acute care facility–acquired PIs from 6.4% in 2006 to what percentage in 2015?
  6. 3.6%
    2.9%
    1.4%
  7. In a 2009 study, VanGilder and colleagues found what percentage of PIs to be device related?
  8. 9.1%
    2.3%
    4.1%
  9. Device-related PIs were most commonly found on the
  10. coccyx.
    heel.
    ear.
  11. In a study by Black and colleagues, what percentage of hospital-acquired PIs resulted from medical device use?
  12. 15.3%
    22.8%
    34.5%
  13. According to Apold and Rydrych, for 63% of reported device-related PIs there was no documentation of
  14. the necessity of the device.
    periodic removal of the device.
    a safe duration for device use.
  15. Apold and Rydrych determined that 74% of the device-related PIs were discovered when the PIs were
  16. stage 1.
    stage 2.
    stage 3 or more.
  17. According to Schallom and colleagues, which type of oxygen delivery device had only a 2% incidence of PIs?
  18. full-face masks
    nasal cannulas
    nasal–oral masks
  19. Of the following devices used for ICU patients in Saudi Arabia, which had the highest incidence of PIs?
  20. indwelling urinary catheters
    traction equipment
    nasogastric tubes
  21. The Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline recommends inspecting the skin surrounding and under any medical device at least how many times each day for signs of pressure-related injury?
  22. 1
    2
    3
  23. The guideline also recommends increasing the number of daily skin inspections for signs of pressure-related injury when patients have
  24. hypertension.
    anemia.
    edema.
  25. Older adults are especially vulnerable to device-related PIs because of
  26. cellular attrition.
    thicker dermal layers.
    greater cutaneous blood flow.
  27. Bariatric patients are susceptible to PIs because they have
  28. drier skin.
    poor perfusion.
    less sweating.
  29. Scott and Delmore independently concluded that PIs that occur during surgery may not be detected until how long after surgery?
  30. up to 24 hours
    nearly 48 hours
    72 hours or more
  31. The risk of medical device–related PIs may be greater in surgical and ICU patients with a history of which of the following?
  32. neurologic disease
    musculoskeletal disorders
    gastrointestinal disease
  33. Keratinocytes are
  34. found in the oral epithelium.
    activated in healthy tissue.
    uniform in structure and differentiation.
  35. Long-term care facilities must complete the Resident Assessment Instrument of the Minimum Data Set upon patient admission and discharge and
  36. monthly.
    quarterly.
    annually.
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