What intervention should a nurse include in the care plan for a paraplegic client with nonblanchable erythema over the ischium?

The most appropriate intervention for a paraplegic client with nonblanchable erythema over the ischium is to teach the client to shift his weight every 15 minutes while sitting. This intervention is critical because it helps alleviate pressure on the affected areas, thereby reducing the risk of progression to more severe skin issues such as pressure ulcers.

Constant pressure on any area of the body can impair blood flow, and since this client is paraplegic, they may not have sensation to recognize discomfort. By shifting their weight regularly, it allows for redistribution of pressure, promoting better circulation and providing relief to the damaged skin.

While the use of a cushion can provide some relief and support, and increasing fluid intake can contribute to overall skin health, teaching the client proactive techniques to manage their sitting position is a direct method to minimize further injury. Daily application of topical antibiotics may be necessary if there is an infection present, but it does not address the underlying cause of the skin breakdown.