This report presents a nursing case study focusing on a 74-year-old patient, Frank Wright, who underwent a right total knee replacement. The study explores pre-operative assessment, including his medical history of hypertension, hypercholesterolemia, osteoporosis, and obstructive sleep apnoea, along with his smoking habit and current medications. Post-operative observations, including vital signs and prescribed medications, are detailed. The report identifies potential clinical issues such as acute pain, risk of infection, and impaired physical activity, proposing prioritized nursing interventions with rationales. These interventions include pain assessment and management, infection prevention through aseptic techniques, and promotion of physical activity. The report also considers the patient's history of smoking and its impact on breathing patterns, suggesting interventions to maintain airway patency, monitor lab data, and assess respiratory function. Finally, the report outlines a discharge plan, including medication management, physical therapy, and follow-up care, emphasizing the importance of addressing the patient's co-morbidities and providing support for his caregiving responsibilities. This assignment provides a comprehensive overview of evidence-based nursing care for surgical patients, integrating clinical reasoning and practical interventions to improve patient outcomes.