care plan help for right knee abscess

[Mom25Girls]

I am doing my NCP and my instructor told me to use impaired skin intergrity due to the patient having right knee abscess. She has a history of osteomyelitis of the right knee with MRSA. I know I can't use a medical dx in the related to and I am having a problem coming up with the data (not used to working backwards here). She needs total assistance with transfers and can only put a little bit of weight on her legs. I have already written one for impared physical mobility and the teacher told me to use impaired skin integrity as the second one due to the abscess. I can't figure out data without using medical diagnosis. Thank you so much for any help yall have!

[Daytonite, BSN, RN]

you should have data for the abscess: length, width, depth, description of drainage, etc. those are your aeb items, or symptoms, of the nursing problem which is the impaired skin integrity (are we sure it's not impaired tissue integrity?)

• impaired skin integrity is altered epidermis or dermis. (page 320, nanda international nursing diagnoses: definitions and classifications 2009-2011)
  
• impaired tissue integrity is damage to mucous membrane, corneal, integumentary, or subcutaneous tissues. (page 323, nanda international nursing diagnoses: definitions and classifications 2009-2011)
  

if this abscess is due to osteomyelitis, i would image that his infection is deep in the tissues making this damage to subcutaneous tissue as well and, therefore, impaired tissue integrity would be a more correct diagnosis. the related factor, or cause, of this damage is the inflammation going on. all infection involves the inflammatory process (https://allnurses.com/general-nursing-student/histamine-effect-244836.html). infection occurs when a foreign microbe, such as mrsa, is introduced into the whole mess. there is a way to use medical diagnoses in nursing diagnostic statements. the proper way to write this diagnosis is:

• impaired tissue integrity r/t inflammation of the knee secondary to mrsa infection aeb [description of the wound: length, width, depth, type of drainage]