Help with DX

[cnbowling]

I have an OB patient and was going to go with Impaired Tissue Integrity but not sure if its tissue integrity or skin integrity. What do you think? I gave ice packs, tucks pads, epifoam, and instructed her on sitz baths to help with soreness and swelling. I was thinking skin integrity was more like preventing infections but not really sure.

[deftonez188]

I assume your talking about an episiotomy or laceration. It really depends on how deep the wound is - if it is a 1st degree to 4th degree - that's what you want to know.

You are giving care for it, so I know you have one, just how deep is the question. Skin integrity is just that, skin. Tissue refers to everything below it, fascia, adipose, muscle, etc.

[cnbowling]

She didn't actually have an episiotomy, maybe a small laceration but nothing much. But there was still swelling.

[Daytonite, BSN, RN]

your diagnosis is always based on assessment of the laceration never on the treatments for it. how did the doctor describe the laceration in their documentation?

• impaired skin integrity
  
  • first degree lacerations - involves superficial lady partsl mucosa or perineal skin
    

  [*]impaired tissue integrity

  • second degree lacerations - involves deeper tissues and perineal muscles
    
  • third degree lacerations - extend into the rectal sphincter
    
  • fourth degree lacerations - extend through the rectal sphincter and into the rectal mucosa
    

swelling is part of the inflammatory response of this mom's body to the tissue trauma. the 4 cardinal signs of inflammation are redness, heat, swelling and pain.