The nurse is caring for a client who uses an orthotic device.Four days later,the client is noted to have a red area at the edge of the device which is padded and observed for 3 more days.Despite this intervention,the area is growing in size and is now open.Which nursing action is most appropriate in this situation?

Question

Quizplus · Accepted Answer

The red area on the client's skin has progressed to an open sore despite padding and monitoring. This indicates a possible pressure injury and should be reported to both the healthcare provider and the orthotist. Removing the orthotic device completely may not be necessary and reshaping the device or using a thicker pad may not address the underlying issue of pressure on the skin. It is important to involve the healthcare team and the orthotist in order to determine the best course of action and avoid further damage to the client's skin.

The Nurse Is Caring for a Client Who Uses an Orthotic