This NCP nursing care plan for atopic dermatitis is for patients who are experiencing some type of allergic response of the skin. In this scenario, the patient is experiencing an allergic reaction to poison ivy and is having extreme pruritus. Therefore, our nursing diagnosis will be Impaired Comfort and our patient’s goals and nursing interventions will compliment this nursing diagnosis.
What is Poison Ivy and How to Treat it?
So what is poison ivy? Poison is a plant that grows in cool shady areas and tends to plague individuals during the spring and summer months. It is known for its three leaves and sometimes thorns. The leaves secrete a sap call Urushiol and this is the toxic chemical responsible for stimulating an allergic immune response.
Nursing Care Plan for Impaired Comfort due to Dermatitis
Scenario:
A 30 year old male patient is admitted with a hypersensitive case of poison ivy. His arms, legs, face, and torso are affected. He stated that he was clearing brush outside his garage and the next day woke up with extreme itching and “these red remarks” all over my body. He states he didn’t know he had poison ivy and thought he wasn’t allergic to it. However, when the doctor in the ER showed him a picture of a poison ivy plant, the patient says that was what he was “chopping down” outside his garage. He said he thought it was a vine. On assessment, the patient has impaired skin integrity extending throughout the body with some weeping lesions. He is obviously having pain from the itching and says he can’t stand it. He is grimacing and scratching the lesions. VS: HR 100, BP 150/86, Temperature 99.2, O2 sat 98% on RA. The patient is admitted on 24 hour observation is prescribed IV Bendrayl every 6 hours, corticosteroids, and warm oatmeal soaks.
Subjective data:
- Patient’s statements: “clearing brush outside the garage and the next day woke up with extreme itching and “these red remarks” all over my body.”
- “didn’t know I had poison ivy and thought I wasn’t allergic to it”
- “However, when the doctor in the ER showed him a picture of a poison ivy plant, that was what I was “chopping down” outside my garage. I thought it was a vine.”
Objective data:
- Your observations & concrete data:
On assessment, the patient has impaired skin integrity extending throughout the body with some weeping lesions. He is obviously having pain from the itching and says he can’t stand it. He is grimacing and scratching the lesions. VS: HR 100, BP 150/86, Temperature 99.2, O2 sat 98% on RA. The patient is admitted on 24 hour observation is prescribed IV Bendrayl every 6 hours, corticosteroids, and warm oatmeal soaks. His arms, legs, face, and torso are affected.
Nursing Diagnosis
Impaired comfort related to pruritus secondary to poison ivy as evidence patient itching poison ivy lesions, grimacing on face, and verbalizing discomfort.
Patient Goals
- Patient will rate itching and discomfort less than a 3 on a 1-10 discomfort rating scale within 4 hours of medical treatment.
- Patient will display decrease emotions of grimacing and action of itching skin lesions within 4 hours of medical treatment.
- Patient will verbalize how to properly take discharged home medications of by mouth Bendrayl and by mouth corticosteroids by discharge.
Nursing Interventions
- The nurse will assess the patient for a satisfactory comfort rating to help measure if medical treatments are proficient within 1 hours of admission.
- Every 4 hours the nurse will assess the patient discomfort rating by using a 1-10 scale.
- The nurse will administer per doctor’s ordered Bendrayl 50 mg IV every 6 hours as needed for itching.
- The nurse will educate the patient by verbalizing and providing printed material on how to properly take corticosteroids medications by discharge.
- The nurse will educate the patient by verbalizing and providing printer material on Bendrayl, common side effects, and how to take it properly by discharge.
- The nurse will provide the patient as needed the opportunity to take oatmeal warm bath soaks per doctor’s order.
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