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Nursing Differential Diagnoses and Care

The rash with which the patient presented to the healthcare facility has not spread to any other part of the body apart from the face, thus, external exposure to some allergen or infection was likely the trigger for the condition’s appearance. Both teaching and nursing plans for each nursing diagnosis formulated for the patient are expected to include two dimensions of the problem: the internal and the external. The nursing diagnoses are the following:

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  • Nursing Diagnosis 1: A potential comfort alteration related to pain in the joints or the peripheral nerve inflammation or dysfunction related to systemic lupus erythematosus that is evidenced by erythematous plaques, fatigue, and muscle pain.
  • Nursing Diagnosis 2: The risk of internal infection as associated with the inadequate primary defences, which is broken skin, as evidenced by high body temperature (fever).
  • Nursing Diagnosis 3: Impaired tissue integrity associated with the rash that is related to the exposure to nature after spending a week hiking and camping in the Appalachians. The development of the rash is evidenced by the fact that going outdoors makes the rash worse (increased itchiness and painfulness) is indicative of the rash being triggered by the external environment.

For Nursing Diagnosis 1, the patient should ensure the following of positive choices in diet and exercising to manage pain in the joints. It is recommended to eat a diet rich in fruit, vegetables, as well as lean protein to prevent vitamin deficiency. Regular and mild exercising will manage the joint paint as well as release pressure from the nerves. The patient should be taught to recognize the early signs of nerve inflammation and make healthy choices to manage the condition under the supervision of a healthcare provider.

For Nursing Diagnosis 2, it is recommended to monitor the redness, swelling, increased pain as well as the appearance of discharge from the lesions (Vera, 2016). Monitoring the signs is necessary because of the patient exhibiting fever, which is one of the first signs of infection. In case if the temperature does not decrease and the mentioned signs of the infection keep appearing, the patient needs to present to the health care provider immediately for antibiotic care. The teaching plan of the patient should involve learning how to identify the primary signs of infection. The patient should learn to make connections between the external symptoms that present on the skin as well as inadequate responses, such as fever, in order to make relevant decisions for further diagnosis and intervention.

For Nursing Diagnosis 3, the nursing care plan should focus on avoiding external irritants and heal the impaired tissue integrity steadily and with minimum invasion. It is recommended that the patient stays indoors for at least a week and prevents the exposure to sunlight. The application of chemical creams, serums, and ointments should be avoided to ensure that the irritation does not get worse. The patient should present to the dermatologist for further testing and prescription of medicated creams that could soothe the skin. The teaching aspect of the plan should involve educating the patient on the risks of being exposed to nature in unknown areas (Midtbust, Dyregrov, & Djup, 2018). The patient may be allergic to the plants in the Appalachians, which is why it is important to be aware of the effects that the exposure to nature may have on one’s skin integrity.


Midtbust, L., Dyregrov, A., & Djup, H. W. (2018). Communicating with children and adolescents about the risk of natural disasters. European Journal of Psychotraumatology, 9(sup2), 1429771.

Vera, M. (2016). Risk for infection. Web.

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