CNA Certification (Written Exam)Restorative SkillsHard
A resident has a stage 2 pressure injury on their sacrum. The CNA is assisting with repositioning. What is the most appropriate position to place the resident to relieve pressure on the sacrum?
- ALateral position, avoiding direct pressure on the sacrum.
- BFowler's position with the head of the bed elevated 60 degrees.
- CSupine position with a pillow under the sacrum.
- DProne position for extended periods.
Show answer & explanationAnswer & explanation
Correct answer: A. Lateral position, avoiding direct pressure on the sacrum.
To relieve pressure on a sacral pressure injury, the resident must be positioned off of the sacrum. The lateral (side-lying) position, with appropriate support pillows, effectively shifts weight away from the sacral area. A pillow directly under a pressure injury (like in option A) is contraindicated as it can increase pressure rather than relieve it.
Why the other options are wrong
- B. Fowler's position, especially at 60 degrees, can increase shearing forces and pressure on the sacrum due to sliding down in the bed.
- C. Placing a pillow directly under a pressure injury can worsen the injury by concentrating pressure on the edges of the pillow and increasing moisture.
- D. While the prone position does relieve sacral pressure, it is often poorly tolerated, can cause respiratory distress, and is generally not the first choice for long-term pressure relief unless specifically ordered and carefully monitored.
Sacral Pressure Relief
To relieve pressure on a sacral injury, position the resident off the sacrum, typically in a side-lying (lateral) position with supportive pillows.
- Avoid direct pressure on the wound.
- Use lateral position effectively.
- Avoid donut cushions or pillows directly under injury.
Memory trick: Offload the wound, keep pressure unbound.