Restorative CareQuestion 123 of 200

When positioning a bedbound resident, which technique BEST protects the heels from pressure injury?

a.Apply tight elastic stockings up to mid-thigh
b.Massage the heels vigorously with lotion every shift
c.Float the heels off the mattress by placing a pillow lengthwise under the calves
d.Place a thin pillow directly under the Achilles tendon

Explanation

Heels have minimal subcutaneous tissue and high pressure injury risk. The standard of care is to FLOAT the heels by placing a pillow lengthwise under the lower legs from below the knee to above the ankle, with heels completely off the surface. A pillow under the Achilles (a) still allows heel contact. Tight stockings (c) may impair circulation and require a physician order. Vigorous massage (d) is contraindicated — it can shear fragile capillaries and worsen tissue damage. 42 CFR §483.25(b) requires prevention of pressure ulcers when avoidable.

Law Reference: 42 CFR §483.25(b)

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