Esophageal Webs and Rings
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Regular repositioning at least every 2 hours is the cornerstone of pressure ulcer prevention by relieving pressure on bony prominences. The Braden Scale assesses risk: sensory perception, moisture, activity, mobility, nutrition, friction/shear. Prevention bundle: skin assessment; moisture management; nutrition; support surfaces; and repositioning. Techniques: 30-degree lateral tilt; pillow bridging; heel suspension; and small frequent shifts. High-risk areas: sacrum, heels, ischial tuberosities, trochanters. Nurses document skin condition and interventions. Other measures: pressure-redistributing mattresses; nutritional support (protein, calories, vitamins); moisture barriers; and minimizing shear/friction (lift don't drag). Patient/family education for home care. Early detection of non-blanchable erythema (Stage I) allows intervention before breakdown. Despite technology, regular repositioning remains essential. Prevention requires consistent, systematic approach by entire team. Pressure ulcers increase morbidity, length of stay, and costs.
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