Table 5 – Plan of Care for Nursing Diagnosis #1: Impaired skin integrity related to extremes of age and chronic prednisone use and evidence by skin tear on left arm.
Expected Outcomes Nursing Interventions Rationales Evaluation
Patient will maintain skin integrity and continue to show improvement of healing by end of shift. a) The nurse will assess nutritional status and ensure patient is receiving adequate nutrition.
b) The nurse will encourage patient to get up as much as possible
c) The nurse will assess the skin over the bony prominences and the back of the head
d) The nurse will assess for fecal and urinary incontinence
e) The nurse will assess for edema in the extremities. a) “ Nutritional deficiencies, anemias and metabolic disorders also contribute to the development of pressure ulcers” (Brunner et al, 2010)
b) “The development of pressure ulcers is directly related to the duration of immobility” (Brunner et al, 2010)
c) “Weight-bearing bony prominences are most susceptible to pressure ulcer development because they are covered only by skin and small amounts of subcutaneous tissue” (Brunner et al, 2010)
d) “Prolonged contact with moisture from perspiration, urine, feces and drainage produces maceration (softening) of the skin. (Brunner et al, 2010)
e) “Any condition that reduces the circulation and nourishments of the skin and subcutaneous tissue increases the risk of ulcer development. Patients with edema have impaired circulation and poor nutrition of skin tissue.” (Brunner et al, 2010) The patient maintains skin integrity and will have a quick recovery.
Table 6 – Plan of Care for Nursing Diagnosis #4: Impaired respiratory pattern related to low lung volume as evidence by patient requiring supplemental oxygen to maint...
... middle of paper ...
...t with Mr. J.S. was beneficial for many reasons. I gained knowledge on kidney stones, and the many complication that are associated with it. It was also very interesting to see how chronic steroid use can drastically affect the skin. I was able to see how important family support can be and how the patient could have benefited from it. He seemed sad and depressed throughout the day and continuously asked for the phone to be near him in case someone called. I feel as though having a family member with him would have made a huge difference. Because of this, I tried to spend most of my time with him, giving him the attention he very obviously needed. When the shift came to an end and I was saying goodbye to Mr.J.S. became emotional and thank me for everything I did for him. It was very rewarding to see how something so simple can make such a an impact on someone’s day.
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