A nurse is caring for a client who has been bedridden for an extended period. The client has developed a pressure ulcer on their sacrum.

Which of the following statements best describes the pathophysiology of pressure ulcers?

Choice A rationale:

"Advanced age is the primary risk factor for pressure ulcers in individuals with diabetes." While advanced age is a risk factor for pressure ulcers, it is not the primary risk factor in individuals with diabetes.

Diabetes itself presents several risk factors, including compromised blood flow and oxygenation, which increase the susceptibility to pressure ulcers.

Choice B rationale:

"Sensory deficits in diabetes make patients more resistant to pressure ulcers." This statement is incorrect.

Sensory deficits in diabetes, such as neuropathy, make patients more vulnerable to pressure ulcers.

These deficits can lead to reduced awareness of discomfort or pain, allowing pressure to be applied to areas without the patient's awareness.

Choice C rationale:

"Poor nutrition and hydration do not contribute to the development of pressure ulcers in diabetic patients." This statement is not accurate.

Poor nutrition and hydration can significantly contribute to the development of pressure ulcers in diabetic patients.

Adequate nutrition and hydration are essential for maintaining skin integrity and supporting the healing process.

Choice D rationale:

"Individuals with diabetes are more prone to pressure ulcers due to compromised blood flow and oxygenation." This statement is correct.

Diabetes can lead to compromised blood flow (peripheral vascular disease) and oxygenation (due to vascular damage), making individuals with diabetes more prone to pressure ulcers.

Choice A rationale:

"Pressure ulcers occur due to excessive friction on the skin." This statement is not accurate.

While friction can contribute to the development of pressure ulcers, it is not the primary pathophysiological factor.

Pressure ulcers primarily result from tissue ischemia and hypoxia, as well as pressure on the skin and underlying tissues.

Choice B rationale:

"Damage to the skin and underlying tissues in pressure ulcers is primarily caused by a lack of proper hygiene." Hygiene is essential in preventing pressure ulcers, but it is not the primary cause of their development.

Pressure ulcers are mainly caused by sustained pressure on bony prominences, leading to reduced blood flow and oxygenation to the affected area.

Choice C rationale:

"Ischemia and tissue hypoxia play a significant role in the development of pressure ulcers." This statement is correct.

Ischemia (reduced blood flow) and tissue hypoxia (inadequate oxygen supply) are key pathophysiological factors in the development of pressure ulcers.

Prolonged pressure on the skin and tissues leads to compromised blood flow, tissue damage, and ultimately, pressure ulcer formation.

Choice D rationale:

"Pressure ulcers result from a hyperactive immune response in the affected area." This statement is not accurate.

Pressure ulcers are not primarily caused by a hyperactive immune response.

While inflammation may occur in response to tissue damage, it is not the root cause of pressure ulcers.