RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
Behavioral Objectives
1. Define the following terms.
I.
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
2. Compare and contrast normal
anatomy and physiology to the
pathology of the disease processes
in the
Integumentary System across the
lifespan.
II.
Content Outline
Definition of terms
Anaphylaxis
Antibody
Attenuation
Autoimmune
Exudate
Macule
Papule
Pustule
Purulent
Toxin
Urticaria
Vesicle
Tinea
Pin worms
Reyes Syndrome
Anatomy and Physiology of the
Integumentary System
A. Developmental considerations
1. Infant
2. Child
3. Adolescent
4. Adult
5. Older adult
B. Pathophysiology of Integumentary System
1. Inflammatory process
2. Allergic reaction
a. Adverse drug reaction
(1) Stephen Johnson Syndrome
Clinical Objectives
Use clinical evaluation tools to
measure standard criteria.
Use critical thinking as a basis for
decision making in nursing practice.
Learning Opportunities
Readings:
McKinney
Estes
Lewis
Adams
Read and discuss relevant, current
nursing practice journal articles and
apply to practice.
TVCC Library – Nursing Education on
Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
Communicate with patients, their
families, and other health care
professionals to make provisions for
health care.
Anti-Infective Medication Therapy:
Antifungal and Antiviral Agents
Identify and communicate reasons and
rationales for deviation from daily
plan of care to multi-disciplinary
health care team members.
Modify plan of care and/or expected
outcomes.
Use clinical evaluation tools to
measure standard criteria
RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
3.
Behavioral Objectives
Discuss factors included in the
assessment of the patient
experiencing problems of the
Integumentary System.
III.
Content Outline
Assessment of Integumentary System
A. Interview
1. Chief complaint
2. Precipitating factors
3. Medical hx
4. Family/social/occupational hx
5. Medication hx (prescription and OTC)
6. Knowledge of health maintenance
7. Risk factors for diseases of Integumentary
System
B. Physical
1. General
a. Vital signs
2. Skin
a. Color
b. Temperature and moisture
c. Vascularity
d. Sensations
e. Lesions (cuts, scars, rash)
(1) Characteristics
(a) Size
(b) Shape
(c) Color
(d) Texture
(e) Elevation or depression
(f) Pedunculation
(2) Exudates
(a) Color
(b) Odor
(c) Amount
(d) Consistency
(3) Pattern of arrangement
(4) Location and distribution
Clinical Objectives
Learning Opportunities
RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
Behavioral Objectives
C.
D.
E.
F.
G.
Content Outline
3. Turgor
4. Pigmentation
Nails
1. Shape
2. Texture
3. Color
Hair
1. Distribution
2. Color
3. Texture
Psychosocial
1. Family support
2. Social contact
3. Changes in self concept
4. Coping abilities
5. Financial support
6. Health beliefs/practices
7. Responses to health care provider
Cultural
1. Health belief practices
2. Spiritual/religious practices
3. Heredity
4. Environmental
5. Language
Developmental considerations
Clinical Objectives
Learning Opportunities
RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
Behavioral Objectives
4. Differentiate between etiology,
pathophysiology, and clinical
manifestations of the selected disease
process in the content column.
5. Discuss analysis, planning, and
implementation for management of
and the expected outcomes for the
selected commonly occurring disease
process.
IV.
V.
Content Outline
Commonly Occurring Problems of
Integumentary System
A. Bacterial
1. Acne
2. Cellulitis
3. Impetigo
4. Methicillin-Resistant Staphylococcus
Aureus (MRSA)
B. Viral
1. Chicken Pox (Varicella)
2. Herpes Zoster (Shingles)
3. Rubella (German Measles)
4. Rubeola (Measles)
C. Fungal
1. Candida
D. Infestations
E. Non-infectious
1. Contact dermatitis
F. Genetic
1. Atopic dermatitis (eczema)
2. Psoriasis
7. Community Health Issues
Selected nursing diagnoses/ implementations
A. Alteration in immune system
1. Inflammatory response
a. Natural immunity
b. Acquired immunity
c. Allergic reactions
d. Anaphylaxis response/ shock
Clinical Objectives
Learning Opportunities
RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
Behavioral Objectives
Content Outline
Collaborative interventions/ therapies
a. Immunizations
b. Corticosteriods
c. Epinephrine
d. Antihistamines
3. Evaluation of Outcomes
a. The patient will have reduced risk or
no complications from immune
responses AEB
(1) No respiratory deficits, redness or
swelling of mucous membranes
or epidermal tissues, no itching,
no s/s of disease process.
Impaired skin integrity
1. Independent Interventions
a. Protection of skin
(1) Excessive hydration
(2) Dehydration
b. Avoid friction, tears, burns
2. Collaborative interventions/ therapies
a. Administer medications and monitor
for desired effects/ side effects/
adverse effects.
(1) Systemic agents
(a) Antibiotics
(b) Antivirals
(c) Hormones
(d) Antihistamines
(e) Antifungals
2.
B.
Clinical Objectives
Learning Opportunities
RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
Behavioral Objectives
Content Outline
(2) Topical agents
(a) Antibiotics
(b) Coal tar products
(c) Steroids
(d) Antivirals
(e) Hormones
(f) Ectoparasitecides
b. Phototherapy
3. Evaluation of Outcomes
a. The patient will have reduced risk or no
complications from impaired skin
integrity AEB
(1) No signs/symptoms of infections,
scaring, postherpetic neuralgia
and eye complications
C. Discomfort – pain and itching
1. Independent Interventions
a. Assess area of involvement
b. Keep skin hydrated and lubricated
c. Control cool, humidity environment
d. Limit exposure to soaps, cleansers, and
hot H20
e. Prevent sleep deficit
Clinical Objectives
Learning Opportunities
RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
Behavioral Objectives
Content Outline
2. Collaborative Interventions
1.
Restrict scratching
(1) Developmental – age specific
(a) Mitts
(b) Nail care
(c ) Administer systemic
medications and monitor for
side effects and responses
 Narcotics
 NSAID’s
 Nonopiate analgesics
 Anti-pruitic
2. Administer topical medications
Anesthetics
Lotions, creams, and baths
3. Evaluations of Outcomes
The patient will have relief
of
D. Ineffective Individual Coping
1. Independent Interventions
a. Assess
(1) Body image disturbance
(2) Social isolation
(3) Emotional stress
(4) Anxiety
(5) Fear
(6) Powerlessness
(7) Dependence
4. Collaborative Interventions
1. Administer medications and
monitor for desired
effects/side effects/ adverse
effects
a. Anti-anxiety agents
Clinical Objectives
Learning Opportunities
RNSG 2504 – Care of the Patient with Common Health Care Needs
Unit V – Care of Patient Experiencing Common Health Problems of the Integumentary System
Behavioral Objectives
N/ADN Syllabus/Spring 10/RNSG 2504 Unit V
Content Outline
2. Evaluation of Outcomes
a. The patient will
have effective
coping
E. Knowledge Deficit of health maintenance
1. Independent Interventions
a. Skin care
b. Treatments
c. Community resources
d. Home health
e. Community clinics
f. Support groups
g. Transmission
(1) Isolation
2. Evaluation of Outcomes
a. The patient will have knowledge of skin
care, treatments, community resources
and mode of transmission of contagious
disease processes.
Clinical Objectives
Learning Opportunities
Reviewed 11/12