The nurse understands that certain patients are more susceptible to pressure ulcer development. Which clients should the nurse identify as being at an increased risk for this health problem? Select all that apply.

A. Apply a moisture barrier ointment to the client's skin
Applying a moisture barrier ointment creates a protective barrier on the skin, preventing prolonged exposure to moisture, which can lead to skin breakdown in individuals with urinary incontinence. Keeping the skin dry and protected is essential in preventing skin irritation and breakdown.

B. Check the client's skin every 8 hr for signs of breakdown - Skin should be assessed more frequently, ideally every 2-4 hours, especially in clients with urinary incontinence, to detect signs of breakdown early.

C. Clean the client's skin and perineum with hot water after each episode of incontinence - Hot water can be harsh on the skin and exacerbate irritation. It's recommended to use mild, warm water and gentle cleansing techniques. Harsh cleaning methods can damage the skin.

D. Request a prescription for the insertion of an indwelling urinary catheter - Indwelling urinary catheters pose an increased risk of infection and other complications. Catheters should only be used when absolutely necessary, and preventive measures should be taken to manage incontinence without catheterization whenever possible.

A. Hypovolemic shock: Hypovolemic shock occurs when there is a significant loss of blood or fluids in the body, leading to insufficient blood volume to maintain normal circulation. Symptoms include rapid heart rate, low blood pressure, confusion, and cold, clammy skin. While hypovolemic shock is a concern in trauma patients, the symptoms described by the client (shortness of breath and chest pain) are not typical of hypovolemic shock.

B. Fat embolism syndrome: Fat embolism syndrome occurs when fat particles are released into the bloodstream, often after a long bone fracture or trauma. These fat particles can block small blood vessels, leading to symptoms such as respiratory distress, confusion, and petechial rash (small red or purple spots under the skin). While fat embolism syndrome is a concern in patients with long bone fractures, the symptoms described by the client are more suggestive of a pulmonary embolism.

C. Venous thromboembolism (VTE): VTE refers to the formation of blood clots in the veins. Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, usually in the legs, while pulmonary embolism (PE) occurs when a clot breaks loose and travels to the lungs. Symptoms of PE can include sudden chest pain, shortness of breath, rapid heart rate, and cough, which may produce bloody or blood-streaked sputum. Given the client's symptoms of shortness of breath and chest pain, VTE, specifically pulmonary embolism, is a significant concern.

D. Compartment syndrome: Compartment syndrome occurs when there is increased pressure within a muscle compartment, leading to reduced blood flow and potential nerve damage. Symptoms can include severe pain, swelling, and numbness or tingling. While compartment syndrome is a complication of fractures, the symptoms described by the client (shortness of breath and chest pain) are not characteristic of compartment syndrome.