Difficulty: Medium
Average Score: 93%
Simulated
The nurse is caring for an immobilized client who is at risk for breakdown in skin integrity. Which pathophysiological process should the nurse note early in the development of a pressure injury?
Correct answer
D
Rationale
Early pressure injury involves ischemia and inflammation, causing erythematous skin (D). Epidermal fragility (A) is later. Blisters (B) suggest friction. Necrosis/eschar (C) indicates advanced stages.