Help with Care plan Please......

[jgonzales1430]

I have a patient who as a Peg tube feeding & a central line in the right side of his neck. I have so many nursing diagnosis I can use, but my instructor would perfer for me to use RISK FOR IMPAIRED SKIN INTEGRITY. My patient is not totally immobile he can move himself, but he needs assistant. He can not sit up on his own and he is losing weight. Can you please help me. I have to turn this care plan in tomorrow.....

Jeanine:banghead:

[pinkiepie_RN]

do you not want to use "risk for impaired skin integrity" as a nursing dx or are you looking for help with more diagnoses?

if he's losing weight, nutrition: altered, less than body requirements would probably fit him as a non-risk diagnosis. risk for infection related to central line placement, maybe activity intolerance of some sort.

[jgonzales1430]

Thank you! I would rather use the other nursing diagnosis, but my instructor wants me to do a care plan on Risk for impaired skin integrity. I have never had problems with doing care plans before and this one has me stompped.

I was thinking I could write a care plan on nursing diagnosis RISK FOR IMPAIRED SKIN INTEGRITY R/T "some type of mobility problem".... But I am lost at this moment because my patient can move, but he requires assistance. He can turn over enough and lift his legs, but he gets very tired and week. Also, when getting out the bed he has to have assitance to be placed in a chair bid. He can not walk on his own. I am just at a lose because he doesn't have any signs of skin breakdown and I know I am trying to prevent them from happening. I am totally lost. Please try to help me.... Thank you

[MoopleRN]

What's his Braden Scale? That may be evidence to justify the diagnosis. Think about WHY he's a risk (you mentioned that he needs assistance) and describe an activity where he's more impaired.

[NurseBrittney]

Well the patient already has impaired skin integrity because of the peg tube and the central line do they not?

[NurseBrittney]

risk for impaired skin integrity related to impaired mobility as evidenced by weakness and fatigue?

[Daytonite, BSN, RN]

the risk for impaired skin integrity would have to do with potential skin breakdown around the peg tube. you need to look up the care of peg tubes, particularly the skin around the exit site.

[valkyria, BSN, RN]

* alteration in nutrition, less than body requirements

* self care deficit

* activity intolerance

* risk for infection( many extra entries to the body)**

* impaired mobility

*** some type of mobility problem, is she serious? you know better than that.

now, risk for impaired skin intergrity is a possibility because patients that have a peg and a central line, both require dressing changes of sorts, sometimes have problems with skin breakdown at or around the site. but, prioritize and that is not the most important problem, is it?

[MB37]

Do you have a careplan book? What does it say about that dx? What characteristics about the definition of the dx does your pt fit?