Cognitive Reflection Test (CRT) Practice

In an older client with Alzheimer type dementia who sleeps in a semi-Fowler position, which area is at higher risk for pressure injuries?

1. Heels

2. Elbows

3. Shoulders

4. Sacrum

The correct answer is: Sacrum

In the context of an older client with Alzheimer type dementia sleeping in a semi-Fowler position, the sacrum is at a higher risk for pressure injuries due to several factors related to body mechanics and pressure distribution. In this position, which is characterized by the head of the bed being elevated, the weight of the torso tends to be directed downwards towards the mattress, creating significant pressure in the sacral region. The sacrum is a bony prominence, and when a client is in a semi-Fowler position, the body weight can compress the skin and underlying tissues against the bony structure, especially if the client remains in the same position for an extended period. This can reduce blood flow to the area, increasing the risk of skin breakdown and the development of pressure injuries. In contrast, while the heels, elbows, and shoulders are also vulnerable to pressure injuries, they are not as significantly impacted as the sacrum in this specific position. The heels may be less at risk because they are often elevated off the bed, and the elbows and shoulders, while they can experience pressure, usually do not bear as much weight in semi-Fowler compared to the sacrum. Therefore, the sacrum is identified as the area with the highest risk for developing pressure