A nurse is planning care for a client who is comatose and has a stage II decubitus ulcer on the coccyx. Which of the following interventions is appropriate to include in the plan of care?

Choice A reason: Massaging the area of a pressure ulcer is contraindicated. Massage can damage fragile capillaries and tissues, worsening the ulcer and increasing the risk of further breakdown. It may also cause pain and inflammation. Therefore, this intervention is inappropriate for a stage II ulcer. Choice B reason: An alternating pressure mattress is an evidence-based intervention that helps redistribute pressure across the body and reduces the risk of further skin breakdown. For a comatose client who cannot reposition themselves, this intervention is especially important. It promotes circulation and prevents worsening of the ulcer, making it the most appropriate choice. Choice C reason: A sterile, dry gauze dressing is not the recommended treatment for a stage II ulcer. Stage II ulcers involve partial-thickness skin loss and require a moist wound environment to promote healing. Dry gauze can adhere to the wound bed, cause trauma during removal, and delay healing. Moist dressings such as hydrocolloids or foam dressings are preferred. Choice D reason: Donut-shaped cushions are not recommended because they concentrate pressure around the wound edges, worsening ischemia and tissue damage. They can increase the risk of ulcer progression rather than prevent it. This intervention is inappropriate for pressure ulcer management.