hard · NCLEX-RN Basic Care and Comfort
A client has a Braden score of 14, albumin of 2.5 g/dL, and is incontinent of urine. Which findings represent 'Recognize Cues' priorities for skin integrity? Select all that apply.
- Old, well-healed scar on the elbow from a childhood injury.
- Nonblanchable erythema over the sacrum after being supine for two hours.
- Brief blanchable redness under the blood pressure cuff after measurement.
- Boggy, soft texture of the heels upon palpation.
- Maceration of the skin in the perineal area from moisture exposure.
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