Question

A student nurse is preparing to perform a dressing change for a pressure ulcer on a client's sacrum area. The chart states that the pressure ulcer is staged as unstageable. Which of the following wound descriptions should the student nurse expect to assess?

a. Full-thickness tissue loss with visible bone.
b. Partial-thickness loss involving the dermis.
c. Presence of necrotic tissue obscuring the wound depth.
d. Superficial loss of epidermis with a pink wound bed.

Answer 1

When a pressure ulcer is staged as unstageable, the nurse should expect to assess the presence of necrotic tissue obscuring the wound depth.

Step-by-step explanation:

When a pressure ulcer is staged as unstageable, the student nurse can expect to assess the presence of necrotic tissue obscuring the wound depth. In other words, the wound will have dead tissue covering it, making it difficult to determine the extent of tissue loss. This is an important indication for proper wound care and management.

Learn more about Pressure ulcer staging