What are subjective data of impaired skin integrity?
Impaired skin integrity is characterized by the following signs and symptoms: Affected area hot, tender to touch. Damaged or destroyed tissue (e.g., cornea, mucous membranes, integumentary, subcutaneous) Local pain. Protectiveness toward site.
How would you describe tissue integrity?
Concept Definition: The structural intactness of tissues and conditions that impair tissue integrity. Scope and Categories: Scope: Tissue integrity can range from an intact state, which protects the body, to various levels of impairment.
How do you document skin integrity?
Information gathered from the skin inspection and aspects of management should be clearly documented in the patient’s notes and care plan. Inspection should include assessment of the skin’s colour, temperature, texture, moisture, integrity and include the location of any skin breakdown or wounds.
What is subjective data?
As the word “subjective” suggests, this type of data refers to information that is spontaneously shared with you by the client or is in response to questions that you ask the client. Subjective data can include information about both symptoms and signs. You won’t know about a symptom unless the client tells you.
What does impaired tissue integrity mean?
Definition. Damage to the mucous membrane, cornea, integumentary system, muscular fascia, muscle, tendon, bone, cartilage, joint capsule, and/or ligament. [ from NANDA-I]
How does impaired circulation affect skin integrity?
Poor Circulation and Skin Integrity Poor circulation decreases the normal strength, elasticity, and flexibility of the skin. Once that happens, our skin is more prone to break in one way or another. Poor circulation can lead to skin wounds and lesions.
What components are necessary for tissue integrity?
The interrelated concepts for Tissue Integrity are Immunity, Perfusion, Thermoregulation, Mobility, Sensory, Nutrition, Elimination, and Fluids and Electrolytes.
How can you prevent impaired skin integrity?
Drink plenty of water. Eat a balanced diet. Keep their skin clean. Use a barrier cream over the buttocks and groin at every change of brief/diaper to prevent the skin from absorbing excess moisture.
How do elderly maintain skin integrity?
The following are strategies to promote and maintain skin integrity: Moisturize dry skin to maximize lipid barriers; moisturize at minimum twice daily. Avoid hot water during bathing; this will increase dry, cracked skin. Protect skin with a moisture lotion or barrier as indicated.
What is the purpose of subjective data?
This is information patients give concerning how they feel, what symptoms they are experiencing, their fears, and concerns. Subjective data give insight into how susceptible a patient is to a health problem and the psychological as well as the physiological condition of the patient. They also confirm objective data.