What complication should the nurse observe for in a long-term care client who has been immobile for 4 weeks?

In a long-term care client who has been immobile for four weeks, a primary complication to observe for is the development of pressure ulcers, which often manifest as reddened areas over bony prominences, such as the sacrum. Extended immobility reduces blood circulation to the skin, making the tissue more vulnerable to damage. When the skin is subjected to prolonged pressure without movement, it can lead to localized areas of ischemia, resulting in skin breakdown and the formation of pressure sores. This makes the observation of a reddened area over the sacrum a key indicator that the client may be experiencing skin integrity issues related to immobility.

While weight gain, increased appetite and thirst, and generalized muscle strength are important factors in overall health assessment, they are not direct complications associated with prolonged immobility. Weight gain can arise from various factors not necessarily related to immobility, and increased appetite and thirst may suggest other underlying conditions. Generalized muscle strength is likely to decline due to disuse and inactivity, which is a consequence of immobility rather than a complication in itself. Thus, focusing on changes in skin condition and monitoring for pressure ulcers is essential in managing the health of immobile clients.