Help with DX

  1. 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.
  2. Visit cnbowling profile page

    About cnbowling

    Joined: Apr '09; Posts: 14


  3. by   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.
  4. by   cnbowling
    She didn't actually have an episiotomy, maybe a small laceration but nothing much. But there was still swelling.
  5. by   Daytonite
    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 vaginal 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.