Pressure Injury - Interactive Case
Patient Overview
Robert Jones, 68, post-op day 2 after left hip repair. History: Type 2 DM, peripheral neuropathy, obesity (BMI 32). Mostly bedbound, Foley catheter in place, partial incontinence. Morphine PCA for pain. Braden Score: 13 (high risk).
Found with a 5 cm area of non-blanchable redness on sacrum (skin intact). Stage 1 pressure injury suspected.
Assessment Findings
- Non-blanchable erythema over sacrum (Stage 1), intact skin
- High risk factors: immobility, incontinence, obesity, diabetes
- Neuropathy may limit pain sensation
- Needs frequent repositioning, skin checks
Priority Interventions
- Reposition off the sacrum at least every 2 hrs
- Apply barrier cream/protective dressing
- Keep skin clean, dry; manage moisture/incontinence
- Optimize nutrition/hydration for wound healing
- Monitor wound progression, consult WOCN as needed
By day 3, the area progressed to Stage 2 (open blister). By day 5, signs of infection appear (yellow drainage, foul odor, warmth, fever).
Interactive Quiz
Q1: The sacral area is intact, non-blanchable redness. How do you stage this injury?
Q2: Which interventions help prevent further skin breakdown? (Select all that apply)
Q3: You have an order for morphine 4 mg IV. The vial is 10 mg/mL. How many mL do you give?
Q4: By Day 5, the wound shows yellow drainage, foul odor, warmth, and the patient has a fever. Name two signs indicating infection.