Nursing diagnosis

  1. I am taking care of a patient with a scald which covers 15% TBSA. I want to make a diagnosis of impaired skin integrity. I would like to know if the related factor should be what caused the burns or the damaged skin. i.e I want to know which of these diagnosis will be right or appropriate.
    1. Impaired skin integrity related to trauma to skin.
    2. Impaired skin integrity related to scald. or could it be

    Impaired skin integrity related to trauma to skin secondary to scalding.

    Please will it also be right to make a diagnosis of acute pain related to destruction of skin tissue?s
    Please, any suggestion is welcomed. Thank you.
  2. Visit galileogalilei profile page

    About galileogalilei

    Joined: Mar '13; Posts: 1


  3. by   VickyRN
    My suggestions:

    Impaired Skin/ Tissue Integrity related to damage to the epidermis and adjacent tissues secondary to the action of hot liquid or steam on the skin AEB burn to 15% TBSA, (any other evidence, such as reddened or dark brown skin, blisters, weeping of the skin, etc?)

    Acute Pain related to skin or tissue damage secondary to scalding burn AEB patient report of pain rating of "10" on numeric scale, grimacing, guarding and withdrawing damaged body parts

    Hope this helps
  4. by   Esme12
    Welcome to AN! The largest online nursing community!

    Vicki has given great suggestions.