Care plan advice

bhanson · May 7, 2011

How deep is the macerated open area?

Remember impaired skin integrity only applies to altered epidermis or dermis. If there is any damage to the subcutaneous tissue then impaired tissue integrity should be used.

Your outcome needs to be SMART: specific, measurable, attainable, relevant, and time-bound.

Specific: Be detailed and meticulous. Specify each parameter that would identify defining characteristics that contribute to the nursing diagnosis. For "risk for infection" for example you would AT LEAST include temperature, heart rate, WBC, absent redness, swelling, pain, purulent drainage from any surgical sites, etc.

Measurable: Your goal should be explicit and measurable. If you're writing an outcome for activity intolerance, include explicit parameters that can be objectively measured. "as evidenced by HR 60-100, BP 110/60-125/85 on activity."

Attainable: The goal should be realistic. If your client is experiencing chronic pain level 8, a goal of pain level 0 is not appropriate.

Relevant: Every parameter you include should be something that defines having the condition stated in the nursing diagnosis, some diagnoses may be more prone to this than others. For example adventitious breath sounds are not a defining characteristic of ineffective breathing pattern.

Time-bound: Explicitly specify a date when the client should complete the goal.

Your goal is not measurable or specific. You want your patient's wound to heal, but how do you define healing? What objective criteria can you establish to measure if the wound has healed (or is healing)?

DolceVita, ADN, BSN, RN · May 7, 2011

Great feedback

2ndyearstudent, CNA · May 7, 2011

Ok i dont expect any of you to give me answers I just want to know if this sounds ok to you.

My care plans changed every time I changed instructors. I finally figured out I have to do a draft early, well before it is due, then run it by the instructor.

They all have their own preferences for care plans so get them to tell you what they want, then give it to them.

Good luck. I am so glad I have done my last nursing school care plan!

heavenbound · May 8, 2011

My care plans changed every time I changed instructors. I finally figured out I have to do a draft early, well before it is due, then run it by the instructor.
They all have their own preferences for care plans so get them to tell you what they want, then give it to them.
Good luck. I am so glad I have done my last nursing school care plan!

That is always the best idea. I had to complete my first care plan which is 30% of our final grade. I did what I thought the instructor wanted without any previous experience; submitted it 2 weeks before it was due. She provided great feedback. I made the correction based on her recommendations, now final copy is submitted(not due until next week); time to focus on final exam.

The advice that the previous poster provided is excellent. That is the info that was provided to us in class when learning about care plans.

Jawsona · May 9, 2011

Thank you for the input. the open area is just the epidermis so it really isnt deep at all.

so could i say... open area will regain integrity of skin surfaces...

I am having trouble with the outcome because I dont want it to sound like a test...

Jawsona · May 9, 2011

or...Pt will not show signs of infection or worsening of skin breakdown within a month