Which client is at the highest risk for developing skin breakdown?

The 84-year-old client who has been NPO (nothing by mouth) for four days is at the highest risk for developing skin breakdown due to several factors. First, being NPO can contribute to dehydration and nutritional deficiencies, both of which are critical for maintaining skin integrity and promoting healing. When a person is not receiving adequate nutrition and hydration, their skin becomes less resilient and more vulnerable to damage.

Additionally, older adults generally have more fragile skin, which is more prone to loss of elasticity and moisture. This combined with the potential for reduced blood circulation can exacerbate the risk of developing skin breakdown. The lack of nourishment can impair the body’s ability to heal any existing skin issues and increase the likelihood of developing new ones.

While the other clients listed also have factors that could contribute to skin breakdown, such as age, immobility, or a history of skin irritation, the specific combination of age, nutrient deprivation, and the physiological changes associated with not eating for an extended period make the NPO client the highest risk. Proper assessment and intervention are essential to prevent skin complications in vulnerable populations, especially those who are elderly and not receiving adequate nutrition.