Which list describes signs of a developing pressure ulcer that should be reported?

• A. Redness that blanches with pressure, warmth or swelling, skin breakdown, or open sores.
• B. Redness that does not blanch, warmth or swelling, skin breakdown, or open sores.
• C. Warmth without any redness.
• D. Itching with dry skin.

Answer: (B)

Recognizing signs early where pressure is starting to damage tissue is essential. The most important cue is redness that does not blanch with pressure—normal skin reddens briefly when pressed and then returns, but non-blanching redness suggests compromised blood flow and potential tissue injury. Along with that, warmth or swelling can indicate inflammation, and skin breakdown or open sores show progression toward a true pressure ulcer. Reporting these signs allows timely interventions to relieve pressure, protect and inspect the skin, and prevent deeper damage. The described set—redness that does not blanch, warmth or swelling, skin breakdown, or open sores—best reflects what should be reported.