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Patient will develop a good nail care routine daily, so no bacteria grows. Follow up with podiatrist for nail care.

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Subjective data:
Ask patient about nail history.
Questions such as
- "Have you noticed any changes with your nails recently..."
-"Do you put any products in your  nails"
-"Do you preform any nail practices"

Objective data:
Observe color, contour, shape and hygiene of nails.

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Subjective Data: Last dental cleaning, history of any dental illness, how often client normally brushes teeth, flosses, etc. Ask the client if they have experienced any pain in their mouth, teeth or gums.

Objective Data: Examine inside of patients mouth and document any redness, excessive plaque build up, tooth decay, or bleeding of the gums.

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As a nurse knowing the function, factors, and cultural preferences that can affect the skin will aid in completing the database for assessment on the patient.
Subjective Data:
1. Ask the patient about their usual bathing/skin care practices and preferences. When their last dermatologist exam was.
2. Past and current skin problems and if it's had an effect on the patients life ie; psoriasis.
3. Prescriptions, OTC medications as some medications can affect the skin or healing time ie; corticosteroids.
4. Any history of allergic skin reactions to medications, food, plants, skin care products ie; fragrance sensitivity.
5. History of diseases known to cause skin problems ie; peripheral circulation issues, inadequate nutrition due to GI disease like Ulcerative Colitis (as nutritional status can affect healing time).
Objective Data:
Inspect each area in an orderly fashion ie; head to toe, noting objective data as you move through the assessment.
1. Observe for any rashes, lumps, lesions, dryness.
2. Look for wounds and drainage from wounds if there present ie; pressure ulcers, etc.
3. Note overall cleanliness, texture, hydration level, turgor, and temperature of skin.
4. Observe for any changes in skin color. Know the differences between light skin and dark skin concerning color changes (pg. 712):
- Pallor (light skin: pale skin w/o underlying pink tones; dark skin: ashen grey or yellow color).
- Erythema (difficult to see in dark-skinned people, so you would palpate the skin for increased warmth).
- Jaundice (best seen in sclerae of eyes).
- Cyanosis (light skin: blue tint to skin; dark skin: examine conjunctivae, tongue, buccal mucosa, and palms/soles for dull, dark color).

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subjective data:
1.ask the client about any problems or concerns they may have about their oral hygiene. Ask client questions related to their overall stress level.
2. Ask the client when their last dental exam was, do they take oral hygiene seriously such as brushing their teeth twice a day, using floss, mouthwash, etc.
2.Ask if they use tobacco or drugs as this could affect oral hygiene
4. Ask the client about risk factors they may have regarding oral problems
Objective Data:
1. inspect the lips, oral mucosa, gums, and tongue. Mucosa and gums should be pink and moist without lesions or bleeding.
2. Look for loose, missing, or decaying teeth; tartar and stomatitis
3. note any odors
4. Check if tongue is a normal color and there are no lesions.

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Impaired skin integrity R/T urinary incontinence AMB maceration of the skin.
Risk for impaired skin integrity R/T immobility.
Situational low self esteem R/T body image AMB wound on sacrum.

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There are no NANDA-I labels to describe nail problems. However, the following are examples of nursing diagnoses related to nail care:
- Risk for Impaired Tissue Integrity related to ingrown nails secondary to trimming too close to the cuticle

Risk for Infection related to loss of skin integrity secondary to hangnails, cracked cuticles, or trauma from using sharp scissors or nail clippers

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Objective: Look throughout the hair for any debris
Look at scalp for any irritation, discoloration, or balding
Palpate the scalp for tenderness
Look at the texture of the hair - take into consideration that race can affect hair texture
For patients with facial hair - asses the cleanliness of it, any food stuck in it

Subjective: Ask the patient about their hair care routine and products, frequent hair loss, scalp itchiness/irritation, any previous conditions to be noted

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- Impaired Oral Mucous Membranes
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- Teach importance of oral care and the proper way to perform it
- Emphasize the Importance of Flossing and Teeth Brushing in Regards to Oral Care

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Teach Proper Nail Care
File the Patients Nails
Clean Underneath the Patients Nails
Push back cuticles gently.
Avoid biting nails.
Consult podiatrist for ingrown toenails or other nail problems.

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Situational low self esteem R/T body image AMB noticeable balding spots in hair

Eczema in the scalp R/T cutaneous inflammation AMB scratching, discomfort, and cold weather

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Outcomes, Interventions, Goals, Client Teachings

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Outcomes, Interventions, Goals, Client Teachings

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Outcomes: Patient 1 will verbalize positive body affirmations to help increase self-esteem in 2 weeks time.
Patient 2 will take proper care of scalp to reduce inflammation and promote comfort in 2 weeks time.

Interventions: Patient 1 can find ways to style hair to cover bald spots, look into hair treatments to promote hair growth, look into wigs.
Patient 2 can use special shampoo to promote moisture in the scalp, find products to reduce itching and irritation, and focus on not scratching which will further irritate the scalp.

Teachings: Educate patient 1 on reasons for hair loss/balding
Educate patient 2 on why cold weather can worsen eczema and how to properly care for the irritation.