Patrick is an 82-year-old black male admitted to the hospital for surgical repair of a fractured rig

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Patrick is an 82-year-old black male admitted to the hospital for surgical repair of a fractured right hip. He lives alone and his neighbors found him lying on his bathroom floor around 7 pm. James told them he had been lying there since the afternoon but could not reach the phone to call for help and was unable to move. James has a history of hypertension and diabetes.

As the nurse is performing an assessment on the second postoperative day, he documents an area on James’s right heel that is purplish in color and appears to be a bruise. The area is cooler to touch than the surrounding skin. There is no redness and there are no open areas; James denies any pain in the heel.

On the basis of the nursing study, develop a nursing care plan using the following procedure: (Identify a NANDA approved nursing diagnosis in the text or 4gcM0.pdf ( and identify possible and potential problems for this client. See this resource Nursing Diagnosis Guide for 2022: Complete List & Tutorial – Nurseslabs.

1) List the subjective data from the client’s case?


2) List information from the case study that provides objective data.


3) From these data, identify and state, using an accepted format, two priority nursing diagnoses you determine are most significant at this time with rationales on why you selected these diagnosis for this client.


4) Determine and state outcome criteria for each diagnosis. These must reflect some alleviation of the problem identified in the nursing diagnosis and must be stated in concrete and measurable terms. Example: The clients wound will not develop infection during the hospital stay. The goal must be measurable. You can not use the example. 


5) Plan and state one or more interventions for each diagnosed problem. Provide specific documentation of the source used to determine the appropriate intervention (see Chapter 13; Boxes 13-3, 13-8, 13-10, 13-12, 13-14, 13-15; and NPUAP Pressure Ulcer Guidelines).


Part 2: Critical thinking Questions and Activities

1. What risk factors for pressure ulcers are present in this situation? (see Box 13-11 for list of risk factors).


2. How does skin color affect the presentation of deep tissue injury?


3. What areas of the body are susceptible to pressure ulcer development and why?


4. What education needs to be provided to the patient, staff, and family?

a. Discuss risk factors for pressure ulcers and appropriate assessment of risk factors and skin (see Boxes 13-9, 13-10, 13-11, 13-12; Box 13-4 presents resources for education on prevention).


5. When James returns home, what interventions to enhance his safety would be appropriate?

 (Chapter 20).






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