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NURS 101 QUESTIONS WITH VERIFIED ANSWERS. GUARANTED A+ GRADE. Braden scale Measures clients risk for skin & tissue damage in 6 factors: Sensory preception Moisture Activity Mobility Nutrition Friction/shear (6-23) Lower score, higher at risk Used daily or often in long term care Stages of pressure injuries Stage 1: nonblanchable erythema of intact skin. Painful area, differs in firmness and temp (erythema) Stage 2: partial-thickness skin loss, dermis exposed. Intact or ruptured blister. Stage 3: full-thickness skin loss; undermining & tunneling ( do not see bone) Stage 4: full-thickness skin and tissue loss (osteomyelitis) Unstageable pressure injury
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