Pressure ulcers are injuries to the skin that develop as a result of too much pressure applied on the skin and underlying tissues.  The application of either prolonged pressure to a part of the skin for a short period or less pressure over a prolonged period helps develop pressure ulcers.  They are ulcers known as decubitus ulcers or bed sores that affect people indiscriminately, but the commonly affected are the aged, bed ridden and severely sick persons. The pressure exerted on the skin from singular positioning of the body breaks the blood circulation cycle and blood supply to these body parts (Morison, 2001).  This paper aims to expound on the causes of pressure ulcers, identify the most vulnerable persons as well as integrate the symptoms of Maria Borg, a patient suffering from pressure ulcers.

Studies indicate that patients suffering from arterial occlusion disease suffer potential risk to develop pressure ulcers. They experience difficulties in the course of the healing process. From the patient’s records and diagnosis, Maria Borg is an aged lady of 92 years who was confined to a generic residence away from her family due to the dependency levels she portrays. Increased levels of stress and depression have led her to loneliness as she pulls away from the society preferring to stay in bed.  The development of pressure ulcers in Maria is influenced by various factors and symptoms. It is evident that her age shows that her skin is weak and fragile and easy to be wounded from pressure ulcers. Her age also plays a part to her immobility that she is not as active as the young would be and with this enhances her condition.

Reasons why Maria Borg sought medical advice

On admission to the Geriatric residence, she was identified to be in stage 3 of pressure ulcers with her severe dry skin. She is also diabetic, suffers from osteoarthritis which make her unable to change positions rendering her immobile. Diabetic patients are prone to suffering from pressure ulcers as they suffer from poor blood circulation, which is an influencing factor to the pressure ulcers. The poor blood circulation affects oxygen delivery to and carriage of toxins from the affected areas (Cervo et al., 2000). These results to large amounts of pressure exerted to her skin in the various parts that she places her body.

Maria’s condition worsens as she suffers from dementia that makes her not able to respond normally to the pain and discomfort that she experiences. It causes her to forget drinking of water leading to her dehydration that accelerates the severity of pressure ulcer formation. Withdrawal from society caused her depression and chronic heart failure with transient ischemic attacks was caused by reduced blood supply to the brain (Louise, 1995). Pressure ulcers develop mostly in bony and cartilaginous surfaces where covered by thin soft tissue, for example, ankles, heels, elbows, iliac crest and the trochanters (Harris et al., 1996). This explains why she had a severe grade 3 pressure ulcer on left heel on admission to the Geriatric residence. It is reported she developed another ulcer on her right ankle.

The discoloration and dryness of the skin, as well as scabs with lack of proper nutrition, has helped propel the risk to enhance the development of pressure ulcers. This is another reason why she chose to seek medical examination. The amount of pain, itching, and skin discolor is evident to make her notice the disorders symptoms. Dehydration played a significant role to the depletion to the fragmentation of the skin. Nutrition is vital to propelling how fast the pressure ulcers develop and affect a person. Maria’s nutrition is deficient in vitamins and proteins which are the vital ingredients to build and replenish the ailing body parts. Weight loss from poor nutrition may exert pressures on the bony areas, such as, the elbow and ankles causing pressure ulcers. Skin anergy and immobility is related to malnutrition, which leads to muscle wasting ((Cervo et al., 2000).


The diagnoses made from the symptoms Maria portrayed showed that she was in the developed stage of pressure ulcer manifestation. Pressure ulcers form from placing force on the body for either longer period or shorter periods depending on the amount of force applied. They mainly develop from external pressure on the body tissue and are propelled to full development by other factors including, diseases, malnutrition, immobility and disorders that affect the normal functioning of body systems. With proper care from the Geriatric institution, Maria Borg should overcome this disorder. From the discussed pathophysiology of pressure ulcers, it is evident that blood circulation is not only essential to prevention, but also to healing of pressure ulcers. It is challenging to note how difficult she would have to fight the skin disorder with the many enhancing factors against her.

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