Nursing Care Plan – Impaired skin integrity r/t traction application

Definition

Altered epidermis and/or dermis (The integumentary system is the largest multifunctional organ of the body)

Related Factors:

External

  • Hyperthermia or hypothermia
  • Chemical Substance; Radiation; Medications
  • Physical Immobilization
  • Humidity; Moisture; (excretions/secretions)
  • Altered Fluid Status
  • Mechanical Factors (e.g., shearing forces, forces, pressure, restraint), [trauma:injury/surgery]
  • Extremes in Age

Internal

  • Altered Nutritional State ( e.g., obesity, emaciation); metabolic state; fluid status
  • Skeletal Prominence; alterations in turgor ( change in elasticity); [Presence of Edema]
  • Altered Circulation; sensation; pigmentation
  • Developmental Factors
  • Immunological Deficit
  • [Psychogenic]

NCP – Impaired skin integrity r/t traction application

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