NIGHTINGALE COLLEGE
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
Name: Denny Lee
Cours BSN-266
e:
Client Information (SBAR) Concept of the
Map
Mr. James Carter is a 78-year-old male admitted following a fall at home. Safety
He has generalized weakness, impaired mobility, and is at high risk for
Situation additional falls during hospitalization. Falls are a leading cause of injury
and hospitalization among older adults (Centers for Disease Control
and Prevention [CDC], 2025).
The pt has a h/o of hypertension, osteoarthritis, and mild cognitive
impairment. He lives alone and reports multiple falls within the past year.
He ambulates with a walker, but requires assistance due to weakness and
unsteady gait. On admission, vitals were: temperature 98.4°F, HR 88 BPM,
RR 18 BPM, BP 142/78 mmHg, and SpO₂ 96% on RA. These findings
Background
indicate hemodynamic stability; however, his impaired mobility and
history of falls place him at significant risk for injury. NKA. Older adults
with mobility limitations, chronic illnesses, and cognitive impairment have
a significantly greater risk for falls and injury during hospitalization
(Nicoli et al., 2024).
This pt is alert but occasionally forgetful. Pt demonstrates poor balance,
slow gait, lower extremity weakness, and requires assistance with
transfers. These findings indicate impaired mobility and increased
Assessment
vulnerability to falls. Fall risks increase when physical limitations are
combined with environmental hazards and cognitive deficits (Yang et
al., 2024).
Recommend implementing fall precautions immediately, maintain a safe
environment, assist with ambulation and transfers, educate the pt on
Recommendation safety measures, and monitor closely for changes in mobility or cognition.
Pt-centered fall prevention strategies have shown to improve safety
outcomes among hospitalized older adults (Hill et al., 2024).
Recognize Cues Analyze Cues
The pt reports feeling weak and unsteady when The pt’s advanced age, mobility limitations, and
walking and joint pain (6/10 when ambulating) plus cognitive impairment place him at increased
difficulty standing from a seated position. Pt added risk for falls and injury. Older adults with
, that he is afraid of falling again and occasionally impaired mobility, cognitive deficits, and a h/o
becomes dizzy when standing quickly. Shares needing of falls are at increased risk for injury during
furniture or wall for support while walking at home. hospitalization (Giddens, 2025). Weakness
Mentioned that he has difficulty performing ADLs and poor balance reduce his ability to safely
independently. ambulate independently. Previous falls indicate
a pattern of safety concerns and increase the
likelihood of future falls. Environmental hazards,
delayed reaction time, and impaired judgment
Objective findings include h/o of recent falls (twice
further contribute to pt safety risks. If
within the past year), use of walker for mobility,
interventions are not implemented, the pt may
unsteady gait and poor balance, lower extremity
experience fractures, head injuries, prolonged
weakness (⅗ muscle strength bilaterally), mild
hospitalization, and loss of independence
confusion and forgetfulness at times, requiring
(Nicoli et al., 2024).
assistance with transfers, slow gait and shuffling
steps, osteoarthritis affecting mobility, morse fall scale
score indicating high fall risk, and environmental
hazards present.
These cues are consistent with factors commonly
associated with falls among hospitalized older adults
(Yang et al., 2024).
Prioritize Hypotheses Generate Solutions
Risk for Falls: The pt will remain free from falls throughout
hospitalization through adherence to pt-
1. The pt’s age, impaired mobility, cognitive deficits, 1. centered fall prevention interventions(Hill
and previous falls significantly increase the et al., 2024).
likelihood of another fall. (Yang et al., 2024).
Risk for Injury The pt will demonstrate safe use of assistive
devices during all ambulation. Pt will safely
Falls can result in fractures, traumatic brain ambulate 50 feet with a walker and
injury, bleeding, and functional decline in older assistance within 48 hours without loss of
2. 2.
adults. Falls among adults 65 and older caused balance or injury (Nicoli et al., 2024).
over 38,000 deaths in 2021, making it the leading
cause of injury death for that group. (CDC,
2025).
Impaired Physical Mobility The pt will verbalize three fall-prevention
strategies, including use of the call light,
3. Musculoskeletal weakness, osteoarthritis, and 3. non-skid footwear, and requesting
balance deficits limit the pt’s ability to move assistance before ambulation before d/c
safely and independently. (Giddens, 2025). (Yang et al., 2024).
DIRECT-FOCUSED CARE: CONCEPT MAPPING ASSIGNMENT WORKSHEET
Name: Denny Lee
Cours BSN-266
e:
Client Information (SBAR) Concept of the
Map
Mr. James Carter is a 78-year-old male admitted following a fall at home. Safety
He has generalized weakness, impaired mobility, and is at high risk for
Situation additional falls during hospitalization. Falls are a leading cause of injury
and hospitalization among older adults (Centers for Disease Control
and Prevention [CDC], 2025).
The pt has a h/o of hypertension, osteoarthritis, and mild cognitive
impairment. He lives alone and reports multiple falls within the past year.
He ambulates with a walker, but requires assistance due to weakness and
unsteady gait. On admission, vitals were: temperature 98.4°F, HR 88 BPM,
RR 18 BPM, BP 142/78 mmHg, and SpO₂ 96% on RA. These findings
Background
indicate hemodynamic stability; however, his impaired mobility and
history of falls place him at significant risk for injury. NKA. Older adults
with mobility limitations, chronic illnesses, and cognitive impairment have
a significantly greater risk for falls and injury during hospitalization
(Nicoli et al., 2024).
This pt is alert but occasionally forgetful. Pt demonstrates poor balance,
slow gait, lower extremity weakness, and requires assistance with
transfers. These findings indicate impaired mobility and increased
Assessment
vulnerability to falls. Fall risks increase when physical limitations are
combined with environmental hazards and cognitive deficits (Yang et
al., 2024).
Recommend implementing fall precautions immediately, maintain a safe
environment, assist with ambulation and transfers, educate the pt on
Recommendation safety measures, and monitor closely for changes in mobility or cognition.
Pt-centered fall prevention strategies have shown to improve safety
outcomes among hospitalized older adults (Hill et al., 2024).
Recognize Cues Analyze Cues
The pt reports feeling weak and unsteady when The pt’s advanced age, mobility limitations, and
walking and joint pain (6/10 when ambulating) plus cognitive impairment place him at increased
difficulty standing from a seated position. Pt added risk for falls and injury. Older adults with
, that he is afraid of falling again and occasionally impaired mobility, cognitive deficits, and a h/o
becomes dizzy when standing quickly. Shares needing of falls are at increased risk for injury during
furniture or wall for support while walking at home. hospitalization (Giddens, 2025). Weakness
Mentioned that he has difficulty performing ADLs and poor balance reduce his ability to safely
independently. ambulate independently. Previous falls indicate
a pattern of safety concerns and increase the
likelihood of future falls. Environmental hazards,
delayed reaction time, and impaired judgment
Objective findings include h/o of recent falls (twice
further contribute to pt safety risks. If
within the past year), use of walker for mobility,
interventions are not implemented, the pt may
unsteady gait and poor balance, lower extremity
experience fractures, head injuries, prolonged
weakness (⅗ muscle strength bilaterally), mild
hospitalization, and loss of independence
confusion and forgetfulness at times, requiring
(Nicoli et al., 2024).
assistance with transfers, slow gait and shuffling
steps, osteoarthritis affecting mobility, morse fall scale
score indicating high fall risk, and environmental
hazards present.
These cues are consistent with factors commonly
associated with falls among hospitalized older adults
(Yang et al., 2024).
Prioritize Hypotheses Generate Solutions
Risk for Falls: The pt will remain free from falls throughout
hospitalization through adherence to pt-
1. The pt’s age, impaired mobility, cognitive deficits, 1. centered fall prevention interventions(Hill
and previous falls significantly increase the et al., 2024).
likelihood of another fall. (Yang et al., 2024).
Risk for Injury The pt will demonstrate safe use of assistive
devices during all ambulation. Pt will safely
Falls can result in fractures, traumatic brain ambulate 50 feet with a walker and
injury, bleeding, and functional decline in older assistance within 48 hours without loss of
2. 2.
adults. Falls among adults 65 and older caused balance or injury (Nicoli et al., 2024).
over 38,000 deaths in 2021, making it the leading
cause of injury death for that group. (CDC,
2025).
Impaired Physical Mobility The pt will verbalize three fall-prevention
strategies, including use of the call light,
3. Musculoskeletal weakness, osteoarthritis, and 3. non-skid footwear, and requesting
balance deficits limit the pt’s ability to move assistance before ambulation before d/c
safely and independently. (Giddens, 2025). (Yang et al., 2024).
