Reference no: EM133859153
Part 1
Boyd is an active 12-year-old boy who is being seen at the school health clinic. He is healthy other than a new "pimple" on his right knee, which his mother reports "is beside a knee scrape that happened a week ago during PE class." Boyd is also complaining of a new "bite" on his upper right leg. He does not have a history of allergies or any chronic health conditions. He reports that he bathes daily and has not used any new personal care items. He is accompanied by his mother who reports that he is often outside riding his dirt bike or on his skateboard. He also plays baseball with indoor and outdoor practice at least two times a week year-round. Boyd lives with his mother, father, and older sister. There are two small dogs in the home.
Boyd reports slight pain at times at around a level 1 on a 0-10 scale and itching at times. He describes that the itching is worse at night. Upon inspection, the nurse notes a healing abrasion to the right knee with a small pustule beside it. The nurse also notes a vesicle on the right anterior thigh that is about the size a quarter. Erythema is noted around the vesicle, and the area is slightly warm to the touch. It is noted that the center of the area is darker in color that the outer edge. A hematoma is noted on the right knee. It is purplish brown in color. His vitals are 97.8 (oral, °F), 88 BPM, 18 respirations, 90/60 BP, and 98% on room air.
Other than the alteration in skin integrity, all other assessment findings are within normal limits. Boyd is sent home with instructions for keeping the abrasion and vesicles clean, and the areas are marked to assess if they increase in size. Mupirocin 2% ointment and triamcinolone acetonide 0.1% ointment are prescribed to be applied twice a day to all lesions.
Questions
1. What developmental, environmental, and social factors influence Boyd's alteration in tissue integrity?
2. Highlight or describe what information is most important.
3. What other information should be included?
4. What would indicate that Boyd's tissue integrity is improving?
5. What would indicate that Boyd's tissue integrity is getting worse?