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Impaired Tissue Integrity & Wound Care Nursing Care Plan

You can use this superintend to acceleration you clear your nursing trouble drawing and nursing interferences for adulterated work rectitude. What constitutes our whole’s shelter across palpable threats? Yes, it’s the integumentary classification, specifically, our husk, cornea, subcutaneous works, and mucous membranes are our foremost row of apology across threats from the palpable environment. In a natural contrast, these apologys are large to surrender the whole from any threats, besides, there are factors that may reason decrepitude or a curb in this row of apology causing decrepitude of work rectitude. The most low reason embraces material trauma (e.g., car garb, sports languor, cuts, rigorousen trauma, etc.,). Other reasons can be cognate to thermal factors (e.g., burns, frostbites), or chemical languor (e.g., thwartive reactions to drugs), infection, feedingal imbalances, clear imbalances, and altered publicity (e.g., hurry abscesss). A curb in work rectitude is naturally restoreed by the whole very courteous-mannered, though there are plight that it doesn’t restore it at all and replaces the lossd work relapse connective work. When work rectitude is left untreated, it could reason persomal or classificationic contagion and besides bring to necrosis.

See Also: Risk for Adulterated Husk Rectitude Trouble Drawing » 

Other factors to-boot embrace age, moment forfeiture, bald feeding and hydration, overmuch humidity and thirst, smoking, and other qualifications solemn blood thwartioner.

Signs and Symptoms

Impaired husk rectitude is characterized by the forthhence memorials and symptoms:
  • Damaged or destroyed work (e.g., cornea, mucous membranes, integumentary, subcutaneous)
  • Local pain
  • Protectiveness internal footing
  • Skin and work distortion changes (red, purplish, ebon)
  • Swelling environing the moderate languor

Goals and Outcomes

The forthhence are the low goals and expected outcomes for adulterated work rectitude. Use them in agreement your inplentiful engagement or covet engagement goals for your adulterated work rectitude trouble drawing:
  • Patient reports any altered perception or denial at footing of work decrepitude.
  • Patient demonstrates intelligence of drawing to remedy work and thwart languor.
  • Patient describes measures to shelter and remedy the work, including harm trouble.
  • Patient’s harm decreases in quantity and has growthd budding work.

Nursing Rate for Adulterated Work Integrity

Assessment is required in arrange to own potential problems that may own bring to Impaired Work Integrity as courteous-mannered-mannered as authenticate any issue that may exude during nursing trouble.
Assessment Rationales
Determine etiology (e.g., quick or continuous harm, blaze, dermatological lesion, hurry abscess, leg abscess). Prior rate of harm etiology is exact for personal identification of nursing interferences.
Assess footing of adulterated work rectitude and its qualification. Redness, turgescence, denial, blazeing, and longing are note of inflammation and the whole’s immune classification vindication to persomalized work trauma or adulterated work rectitude.
Assess characteristics of harm, including distortion, quantity (length, width, deepseatedness), drainage, and smell. These findings achieve exhibit notification on quantity of the adulterated work rectitude or languor. Pale work distortion is a memorial of decreased oxygenation. Smell may be a outcome of closeness of contagion on the footing; it may to-boot be hence from a necrotic work. Serous exudate from a harm is a natural portio of inflammation and must be differentiated from pus or feculent liberate, which is exhibit in contagion.
Assess changes in whole latitude, specifically growthd in whole latitude. Fever is a classificationic correction of inflammation and may betoken the closeness of contagion.
Assess the enduring’s roll of trouble. Pain is portio of the natural exasperating system. The quantity and deepseatedness of languor may assume denial perceptions.
Know memorials of longing and scratching. The enduring who scratches the husk in attempts to lessen terminal longing may notorious husk lesion and growth raise for contagion.
Assess enduring’s feedingal foothold; assign for a feedingal table and/or originate fareary supplements. Inlarge feedingal intake places the enduring at raise for husk curbdown and compromises remedying advance causing adulterated work rectitude.
Classify hurry abscesss by assessing the quantity of work privation. Wound rate is past certain when classified in such sort according to the National Hurry Abscess Advisory Panel. The forthhence are the stages of hurry abscesss: Stage I. Nonblanchable erythema memorialaling potential abscessation. Stage II. Partial-thickness husk forfeiture (abrasion, blister, or a superficial crater) involving the epidermis and may apply through the dermis. Stage III. full-thickness husk forfeiture involving privation to or necrosis of subcutaneous work that may apply down to but not through underlying fascia; abscess appears as a learned crater relapse or relapseout undermining of adjacent work. Stage IV. Full-thickness husk forfeiture relapse catholic destruction; work necrosis; or privation to muscle, blight, or supported structures (e.g., tendons, junction capsules)
Pay peculiar regard to all violent-raise areas such as huskny prominences, husk folds, sacrum, and heels. Systematic mistake can authenticate hovering problems forthcoming and arrange forthcoming matter.
Identify a drawing for debridement when necrotic work (eschar or despond) is exhibit and if congruous relapse overall enduring administration goals. Healing does not exude in the look of necrotic work.

Nursing Interventions for Adulterated Work Integrity

The forthhence are the curative nursing interferences for Impaired Work Integrity nursing personality:
Nursing Interventions Rationales
Monitor footing of adulterated work rectitude at last uniformly daily for distortion changes, redness, turgescence, irascibility, denial, or other memorials of contagion. Systematic mistake can authenticate hovering problems forthcoming.
Monitor foothold of husk environing harm. Mentor enduring’s husk trouble practices, noting the stamp of soap or other lustration agents used, latitude of infiltrate, and quantity of husk lustration. Individualize drawing is requioffice according to enduring’s husk qualification, deficiencys, and preferences.
Provide work trouble as deficiencyed. Each stamp of harm is best treated grounded on its etiology. Husk harms may be habituated relapse wet or dry surroundingss, persomal creams or lubricants, hydrocolloid surroundingss (e.g., DuoDerm) or vapor-permeable membrane surroundingss such as Tegaderm. An eye bungle or rigorous, yielding shelter for corneal languor. The surroundings replaces the shelterive capacity of the lossd work during the remedying system.
Keep a barren surroundings technique during harm trouble. This technique brings the raise of contagion in adulterated work rectitude.
Premedicate for surroundings changes as requisite. Manipulation of deepseated or catholic cuts or injuries may be denialful.
Wet fully the surroundingss relapse barren natural sarow disintegration antecedently non-location. Saturating surroundingss achieve satisfaction the non-location by crowd adherents and decreasing denial, distinctly relapse blazes.
Monitor enduring’s selfcontrol foothold and minimize charybdis of husk decrepitude footing and other areas to humidity from intemperance, sweating, or harm drainage. This is to thwart charybdis to chemicals in urine and sutensil that can despoil or erode the husk causing advance adulterated work rectitude.
If enduring is incontinent, utensil an inselfcontrol administration drawing. This is to thwart charybdis to chemicals in urine and sutensil that can despoil or erode the husk.
Administer antibiotics as arrangeed. Wound contagions may be directd courteous-mannered-mannered and past efficiently relapse persomal agents, although intravenous antibiotics may be betokend.
Tell enduring to forsake grating and scratching. Arrange gloves or prune the nails if requisite. Rubbing and scratching can reason advance languor and relapse remedying.
Encourage a fare that meets feedingal deficiencys. A violent-protein, violent-calorie fare may be deficiencyed to raise remedying.
Discuss homogeneity among large feeding consisting of clears, protein, vitamins B and C, sinewy, and calories. Nutrition plays an dignified role in conducting an pure husk and in promoting harm remedying.
Monitor for personal reconsignment of tubes, catheters, and other devices. Assess husk and work assumeed by the tape that secures these devices. Mechanical privation to husk and works as a outcome of hurry, contact, or scrape is frequently associated relapse palpable devices.
Check integral two (2) hours for personal reconsignment of footboards, restraints, traction, casts, or other devices, and assess husk and work rectitude. Mechanical privation to husk and works (pressure, contact, or scrape) is frequently associated relapse palpable devices.
For endurings relapse scant disturbance, use a raise rate utensil to classificationatically assess immobility-cognate raise factors. This is to authenticate endurings at raise for immobility-cognate husk curbdown.
Do not standing the enduring on footing of adulterated work rectitude. If arrangeed, hinge and standing enduring at last integral 2 hours, and troublefully convey enduring. This is to forsake the thwartive suitedty of palpable habitual forces (pressure, contact, and scrape).
Maintain the division of the bed at the last mark of eminence potential. To bring scrape and contact.
Educate enduring environing personal feeding, hydration, and methods to conduct work rectitude. The enduring deficiencys personal instruction of his or her qualification to thwart adulterated work rectitude.
Teach husk and harm rate and ways to mentor for memorials and symptoms of contagion, complications, and remedying. Early rate and interference acceleration thwart the clearment of grave problems.
Instruct enduring, memorialificant others, and lineage in the personal trouble of the harm including agency washing, harm lustration, surroundings changes, and impression of persomal medications). Accurate notification growths the enduring’s ability to direct therapy unconnectedly and bring the raise for contagion.
Encourage the use of pillows, bluster wedges, and hurry-reducing devices. To thwart hurry languor.
Educate the enduring the deficiency to communicate the physician or promote. This is to thwart advance adulterated work rectitude complications.

References and Sources

Recommended media for the nursing personality adulterated work rectitude and trouble drawing:
  1. Baranoski, S., & Ayello, E. A. (2008). Wound trouble essentials: Practice principles. Lippincott Williams & Wilkins.
  2. Berman, A., Snyder, S. J., Kozier, B., Erb, G. L., Levett-Jones, T., Dwyer, T., … & Parker, B. (2014). Kozier & Erb’s Fundamentals of Nursing Australian Edition (Vol. 3). Pearson Higher Education AU.
  3. Carpenito-Moyet, L. J. (2006). Handbook of nursing diagnosis. Lippincott Williams & Wilkins.
  4. Corbett, L. Q. (2012). Wound trouble nursing: administrative issues and opportunitiesAdvances in harm trouble1(5), 189-193.
  5. Hardy, M. A. (1990). A guide examine of the personality and matter of adulterated husk rectitude: dry husk in older beings. International Register of Nursing Terminologies and Classifications1(2), 57-63.
  6. Iverson-Carpenter, M. S. (1988). Impaired husk rectitudeJournal of geron
  7. Malaquias, S. G., Bachion, M. M., Martins, M. A., Nunes, C. A. D. B., Torres, G. D. V., & Pereira, L. V. (2014). Impaired work rectitude, cognate factors and defining characteristics in beings relapse vascular abscesss. Texto & Contexto-Enfermagem23(2), 434-442.
  8. Menna Barreto, L. N., Swanson, E. A., & de Abreu Almeida, M. (2016). Nursing outcomes for the personality adulterated work rectitude (00044) in adults relapse hurry abscessInternational register of nursing instruction27(2), 104-110.
  9. Menna Barreto, L. N., Silva, M. B. D., Engelman, B., Figueiredo, M. S., Rodríguez‐Acelas, A. L., Cañon‐Montañez, W., & Almeida, M. D. A. (2019). Evaluation of surgical harm remedying in orthopedic endurings relapse adulterated work rectitude according to nursing outcomes classificationInternational register of nursing instruction30(4), 228-233.
  10. Mendham, J. E. (2004). Gabapentin for the matter of longing produced by blazes and harm remedying in children: a guide examine. Burns30(8), 851-853.
  11. Murphy, J. V., Banwell, P. E., Roberts, A. H., & McGrouther, D. A. (2000). Frostbite: pathogenesis and matterJournal of Trauma and Quick Trouble Surgery48(1), 171.
  12. Pezzi, M. V., Rabelo‐Silva, E. R., Paganin, A., & de Souza, E. N. (2016). Nursing Interventions and Outcomes for the Personality of Adulterated Work Rectitude in Patients After Cardiac Catheterization: Survey. International register of nursing instruction27(4), 215-219.
  13. Ratliff, C. (1990). Impaired husk rectitude cognate to radiation therapyJournal of enterostomal therapy17(5), 193.
  14. Piloian, B. B. (1992). Defining characteristics of the nursing personality” violent raise for adulterated husk rectitude”Decubitus5(5), 32-4.


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