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Alteration in Comfort and Impaired Skin Integrity


The rash on the face, as well as such attendant factors as fever and excessive fatigue, are an excuse to determine which nursing intervention can be helpful in treatment. As a patient, thirty-five-year-old Mary is presented, and her main problem is itching and redness on her face. Also, the woman complaints of fever and weakness in her body. Possible nursing diagnoses include the alteration in comfort related to joint pain and impaired skin integrity related to chemical irritation. Both of these diagnoses can be applied to the patient, and appropriate training and care plans should be designed to help doctors and stop the patient’s health problem.

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Alteration in Comfort: Teaching and Nursing Care Plans

One of the possible diagnoses can be the alteration in comfort, which, in its turn, leads to joint pain and other symptoms described by the patient – weakness, increased fatigue, weight loss. According to Gordon (2014), this problem is often expressed in the form of the rash that the patient has on her face. A possible reason for this diagnosis is the recent Mary’s hiking and camping in the Appalachian Mountains where her living conditions did not match the usual ones, and the rash and accompanying symptoms began to occur.

The patient should be told about all possible manifestations of her problem and be provided with full information about the method of treatment that will be prescribed by her attending physician. Also, in order to avoid worrying about possible health consequences, it is required to inform Mary that her illness will not have any significant consequences for her body if she follows the prescriptions of the doctor and temporarily refrains from serious strains.

In order to care for the patient, it is required to provide her with peace. As Gordon (2014) remarks, no special measures and efforts are required. Nevertheless, it is essential to control that the patient does not experience physical exertion, timely takes medications, and is aware of the features of the treatment plan.

Impaired Skin Integrity: Care Plans

Impaired skin integrity is one of the possible diagnoses that is quite likely in the case of Mary. The woman spent much in the open air, and the air in the mountains, as it is known, is different from the urban one. The damage caused by climate change can cause rash and itching. According to Iori, Foracchia, and Gradellini (2015), as a nursing intervention for a breach of the integrity of the skin, it can be ensured that there are no changes in temperature, and the patient stays at the same environment. Also, as a care plan, it is required to monitor drug intake and to timely provide therapeutic procedures.

For teaching purposes, it is possible to use information about the conditions of being in the locality with other climatic features. Memos and videos can be useful for visualizing ways to protect against external factors. In addition, the patient can be offered electronic resources to study relevant and useful information.


Thus, both the described diagnoses can be applied to the patient, and for faster recovering, it is significant for Mary to follow nurses’ recommendations and advice. Alteration in comfort and impaired skin integrity can be treated with the help of timely procedures and appropriate control. Both teaching and nursing plans imply care only at home since the patient experiences painful sensations in the open air.

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Gordon, M. (2014). Manual of nursing diagnosis (13th ed.). Burlington, MA: Jones & Bartlett Publishers.

Iori, A., Foracchia, M., & Gradellini, C. (2015). Planning with NANDA, NOC, NIC taxonomies in neurologic rehabilitation. A clinical study. Professioni Infermieristiche, 68(3), 163-168.

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