What is the greatest risk to a client with fecal impaction who remains seated for a prolonged period?

• A. Dehydration from poor fluid intake
• B. Breathing difficulty due to lung compression
• C. Injury from skin breakdown due to unrelieved pressure over a bony prominence
• D. Nutritional deficiency due to immobility

Answer: (C)

Prolonged immobility increases the risk of pressure injuries. When someone remains seated for a long time, constant pressure over bony prominences such as the sacrum and ischial tuberosities reduces capillary blood flow, leading to tissue ischemia and potential skin breakdown. Fecal incontinence can worsen skin damage by keeping the area moist, which weakens skin and speeds breakdown. This combination makes unrelieved pressure over a pressure point the most immediate and significant danger.

While dehydration, breathing changes, or nutritional deficiencies can be concerns in immobilized patients, they are not as critical in this scenario as the direct threat of pressure ulcers from sustained seating. Keeping the skin dry, using pressure-relieving supports, and frequent repositioning are key to preventing these injuries.