Inspect pressure points and skin surfaces closely and routinely. Gently massage bony prominences or areas of continued stress. Use of emollient lotions and limiting use of soap for bathing may help. Edematous tissues are more prone to breakdown and to the formation of decubitus. Ascites may stretch the skin to the point of tearing in severe cirrhosis.
Encourage and assist patient with reposition on a regular schedule. Assist with active and passive ROM exercises as appropriate. Repositioning reduces pressure on edematous tissues to improve circulation. Exercises enhance circulation and improve and/or maintain joint mobility.
Recommend elevating lower extremities. Enhances venous return and reduces edema formation in extremities.
Keep linens dry and free of wrinkles. Moisture aggravates pruritus and increases risk of skin breakdown.
Suggest clipping fingernails short; provide mittens/gloves if indicated. Prevents patient from inadvertently injuring the skin, especially while sleeping.
Provide perineal care following urination and bowel movement. Prevents skin excoriation breakdown from bile salts.
Use alternating pressure mattress, egg-crate mattress, waterbed, sheepskins, as indicated. Reduces dermal pressure, increases circulation, and diminishes risk of tissue ischemia.