Asked by Vivian Perez on Jul 17, 2024

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A patient is admitted to the hospital with a pressure ulcer on the sacrum.The wound is open with exposed bone.The nurse should document this pressure ulcer at what stage?

A) Stage I
B) Stage II
C) Stage III
D) Stage IV

Sacrum

A large, triangular bone at the base of the spine, forming the upper part of the pelvis.

Exposed Bone

A medical condition where bone is visible through the skin or an open wound, often requiring immediate treatment to prevent infection.

Pressure Ulcer

An injury to the skin and underlying tissue, usually over a bony prominence, as a result of prolonged pressure or pressure in combination with shear.

  • Accurately distinguish and classify stages of pressure ulcers.
verifed

Verified Answer

CD
Carmen DalooJul 21, 2024
Final Answer :
D
Explanation :
Stage IV: Full-thickness tissue loss with exposed bone,tendon,or muscle; slough or eschar may be present; often includes undermining and tunneling
Stage I: Intact skin with nonblanchable redness of a localized area,usually over a bony prominence
Stage II: Partial-thickness loss of dermis presenting as a shallow open ulcer with a red-pink wound bed,without slough; may also present as an intact or open/ruptured serum-filled blister
Stage III: Full-thickness tissue loss; subcutaneous fat may be visible,but bone,tendon,or muscle is not exposed; slough may be present but does not obscure the depth of tissue loss; may include undermining and tunneling