Impaired Tissue Integrity

 

Instructions: Fill out this form, print it, and hand it in with your assessment to your instructor. When you click on Next at the bottom of the page, you see the data you submitted. Please follow the instructions on how to save the data on the next page.

AOL users: Read this instruction.

Definition: state in which an individual has damage to mucous membrane, subcutaneous tissue,integumentary,  corneal tissue. If the tissue involved is just the skin- use impaired skin integrity,  or if just the mouth- use altered oral mucous membranes. 

1. Your initials (required): 

2. Defining Characteristics- check those that apply to your client:

None- high risk diagnosis  damaged tissues
corneal mucous membrane integumentary  subcutaneous
3. Related Factors- check those that apply to your client:

immobility  chemical irritants including body secretions altered circulation  mechanical factors (shearing, restraints, cast, etc)
nutritional alterations  radiation  heat or cold medications   
altered fluid status  altered sensation 


4. Goal (ultimate, long term) 

5. Outcome Criteria (short term) 

6. Evaluation: Was the outcome criteria met? 

Yes- Give Evidence: 

No- Explain how you would change the plan: 

 

7A. Interventions 

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7B. Rationale for each intervention
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