Keep  the  client's  bed clean,  dry  and  free from  wrinkles.    Change the  linens  as  ordered, and  if  they  become wet  or soiled. Keep incontinent clients  as dry  and clean  as possible. Use  pillows  and  pads to  help  position  clients comfortably  in  their beds  or  chairs.    Place the  pillows  so  that  they relieve  pressure  on bony  parts  of  the  body. Report  any  changes that  affect  a  client's skin  to  your  supervisor.   These  changes  include: dry  skin,  very  moist skin,  redness,  warmth, tenderness,  rashes, bruises,  new incontinence,  changes in  appetite  or  fluid intake,  and  complaints of  pain  or  discomfort. Encourage  your  clients (if  they  are  able)  to  shift their  position  every  15 minutes  or  so.    Explain to  them  how  important it  is  to  prevent pressure  sores. Avoid  "sheet burn"  by  not dragging  a  client across  the  bed.   Ask  the  client  to help,  if  possible, or  get  a  coworker  or family  member  to  assist you  move  the  client.   Always  move  on  the count  of  three  so  that you  are  all  working together. Whenever  you  reposition your  clients,  use  it  as  an opportunity  to  check their  skin! When  bathing  a  client, pat  the  skin  dry  with  the towel  instead  of  rubbing it. Points  to  Remember! One  square  inch  of  skin  has  approximately: 60 oil  glands and  400 sweat glands 100 pressure sensors and 800  nerve endings 4 yards of blood vessels and  16 yards of  nerves 48 heat  sensors and 8 cold  sensors...and 12 million  cells!! "Bony  prominences"  are  the  most  likely  areas  to  develop  a pressure  sore.    These  include  the  following  bony  body  parts: The tailbone, buttocks  and hips The elbows and knees The heels and toes The shoulder blades  and inner ankles You  might  hear  pressure  sores  called  Stage  1,  2,  3,  or  4  wounds. Stage 1:  Unbroken skin that is pink or red and warm  to the  touch Stage 2:  Cracked  or blistered skin with a reddened  area around it Stage  3:   A  deep  sore  that  goes  into  the  fat  layer  under  the  skin Stage  4:   A  very  deep  sore  that  goes  into  muscle  or  bone Tips  For  Preventing  Pressure  Sores Use  these  tips to  keep  your clients'  skin clean,  dry  and unbroken.