Quick Outcome Question

[misstvlgirl]

I am working on a care plan for a client in a persistent vegetative state and my dx is: Risk for impaired skin integrity R/T inability to reposition self.

No problem with that part.

Outcome # 1: Pt will remain free of skin breakdown through 11/28/08.

Outcome # 2:

I can't think of another ... my Mosby Dx Book suggests :

Pt will report altered sensation of pain .......

Pt will demonstrate ....

Pt will verbalize ....

HELP. My patient cannot report, demonstrate, or verbalize. I tried Pt will consume 1300 ml fluid per 24 hr shift but my instructor quashed that one said it didn't match dx. If I did Pt will maintain optimal skin integrity ... would that work?

I'm not asking anyone to do my ass't for me but I'm really stuck on this one (usually find these kind of straightforward but this one got me)

[misstvlgirl]

Okay .... how about this ... could I use:

Patient will maintain well nourished and hydrated skin

and use fluid balance requirements and protien and vitamin Gtube supps as interventions? Basically, does that outcome match the diagnosis?

[Daytonite, BSN, RN]

take the signs and symptoms of a stage i ulcer and use one of them to report "no evidence of [it]" as an outcome.

i just posted some of these weblinks on another post. you might want to look at the tutorial as it has really nice info about the symptoms and descriptions of the various stages of pressure ulcers.

• http://www.nursingquality.org/ndnqipressureulcertraining/module1/default.aspx - pressure ulcer training tutorial (includes photos)
  
• http://www.hill-rom.com/usa/pdf/ctg285.pdf - guidelines for staging of pressure ulcers
  
• http://www.medicaledu.com/staging.htm - staging of ulcers
  
• http://ame-medical.com/staging_ulcers_guidelines.pdf - staging pressure ulcers

remember, when your interventions are written, ask yourself, "how is this intervention going to give me this outcome?" if it doesn't, then you might have a nice intervention, but it isn't focused on achieving the goal, won't help your patient and your instructor is going to ding you for it.

[misstvlgirl]

Thank you. That makes a lot of sense.