Nurse Mary is caring for a wheelchair-bound client. Which piece of equipment impedes circulation to the area it’s meant to protect?
A. Polyurethane foam mattress
B. Ring or donut
C. Gel flotation pad
D. Waterbed
Correct Answer: B. Ring or donut
Rings or donuts aren’t to be used because they restrict circulation. Selection of a device may depend on factors such as mobility of the individual, the results of skin assessment, the level of and site at risk, weight, staff availability and skill plus the general health and condition of the individual. It is also important that any device is able to be cleaned and decontaminated effectively. It is accepted that these devices should be used in conjunction with other preventative strategies such as repositioning.
Option A: Foam mattresses evenly distribute pressure. All studies showed a clinical benefit of higher specification foam mattresses (cubed foam mattress, soft foam mattress, pressure redistributing foam mattress), in reducing the incidence of pressure ulcers when compared to standard hospital mattresses.
Option C: Gel pads redistribute with the client’s weight. A gel-filled pad and a pressure-reducing cushion (designed to improve tissue tolerance in sitting by providing more surface area and reducing peak pressure) were clinically beneficial compared to foam cushions for reducing the incidence of pressure ulcers in people who use a wheelchair.
Option D: The water bed also distributes pressure over the entire surface. Both a bead-filled mattress and a water-filled mattress showed a clinical benefit for reducing the incidence of pressure ulcers when compared to standard hospital mattresses (type not specified).
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