Which nursing action indicates a need for further learning when repositioning a patient to reduce the risk of pressure ulcers?

• A. Teaching the patient to shift his or her weight every 15 minutes
• B. Encouraging the patient to sleep in a supine position
• C. Encouraging the patient to sit on a donut-shaped cushion
• D. Encouraging the patient to place the ischial areas on an air-filled pillow

Answer: (C)

Relieving pressure on vulnerable skin comes from distributing the patient’s weight and avoiding devices that concentrate pressure on bony areas. A donut-shaped cushion has a hole in the center and presses around the ring, which concentrates pressure on the surrounding tissue near the ischial tuberosities and perineal area. That concentrated pressure reduces blood flow to those tissues, increasing the risk of ischemia and pressure ulcers rather than preventing them. So using a donut-shaped cushion signals a need for more learning about effective pressure distribution.

In contrast, actions that promote pressure relief—shifting weight regularly and using cushions that spread the load across the buttocks and sit bones (such as appropriate air-filled or foam cushions)—are aligned with preventing ulcers.