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-For example: cold, dusky, or pale feet may indicate impaired circulation or tissue perfusion secondary to peripheral vascular disease
-Subjective data:
-What is your normal foot care routine?
- What type of footwear do you usually wear? Observe what the patient is wearing
-Have you had any foot problems; what treatments have you had for them?
- Do you examine your feet on a regular basis?
-Do you have diabetes mellitus or peripheral vascular disease?
-Objective data: (compare findings for both feet)
-Observe for cleanliness and skin integrity. Note open areas, drainage, or redness
- Inspect welling, inflammation, or infection
-palpate for edema
-Check the skin between the toes for cracks or signs of a fungal infection
-Notice color and temperature  (provide data about circulation and oxygenation)
-Check capillary refill
-Note foot odors

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-conditions of teeth, cavities, gingivitis
-conditions affecting the mouth: stomatitis, glossitis, oral lesions/ malignancies
-Oral pain/discomfort
-Bleeding
-Halitosis

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SUBJECTIVE: Ask about...
-skin history
-prescriptions/medications
-allergies
-History of other factors that can cause skin problems.
OBJECTIVE: Inspect/Observe
-color
-texture
-rash/bumps
-skin integrity
-burns

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Delayed surgical recovery  related to injury as manifested by observed unhealed wounds.

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-Prevent any cracks/ abrasions in the skin
-Be bale to properly perform effective skin care practices ie; moisturize, wash etc.

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Expected Outcomes:
-display healing of wound site.
- be free of infection
- Client can resume RDL activities without assistance.
Interventions:
-evaluate circulation and sensation in wound area.
- review client's medication record
- Note any preexisting conditions that may affect wound healing.

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-Inform patient of the importance of proper skincare & hydration.
-Teach patient how to properly clean their skin.
-Inform patient on abnormal signs/symptoms to be aware of
-Be mindful of existing allergies

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Subjective Data

history of health problems/current conditions

diseases/therapy affecting hair

factors influencing patient's ability to care for hair/scalp

use of special products

personal/cultural preferences

Objective Data

condition/cleanliness/texture/oiliness of hair

inspect scalp for dandruff/alopecia/etc

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There are no NANDA-I labels specific for hair
> Dressing Self-Care Deficit
> Bathing Self-Care Deficit
Examples:
> Risk for Impaired Skin Integrity related to secretions on the scalp
> Situational Low Self-Esteem related to alopecia secondary to chemotherapy

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-determining patients mental status/ inability to care for self
-Impaired oral Mucous Membrane Integrity r/t decrease in salvation
-Risk for infection r/e inefficient oral care

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> Discuss potential hair loss and regrowth with the patient and family
>Explore the potential impact on hair loss, interpersonal relationships, and self-image
>Prevent trauma to the scalp
-have patient use sunscreen
-lubricate the scalp with vitamin D and vitamin A ointment in order to decrease itchiness
>Use mild conditioner and shampoo
-avoid excessive heat/combing of the hair

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Subjective Data:
- history of health
- current conditions/current nail care
- *ask about diet
Objective data:
- appearance of nails (color, texture, thickness)
- Lab values for electrolytes and vitamin levels  (iron, Magnesium, Vitamin B)
-clubbing
-portal of entry for infection

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-Patient displays ability to care for own teeth and mouth freely and individually as evidenced by daily routine of brushing and flossing, and using mouthwash and fluoridation properly.
-Patient exhibits clean teeth, healthy gums, and mouth with a pleasant odor upon examination.
-Patient performs daily denture cleaning and care.

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Healthy Teeth, Healthy You. Preventing Hospital Acquired Pneumonia

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-preventing infection
-preventing oral discomfort
-maintain oral mucosa
-maintenance of lips
-keep teeth free from plaque and debris
-create goals/ plans to maintain dental hygiene

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-teaching good oral self-care
-denture care
-encouraging adequate nutrition intake
-acknowledgment of abnormal oral symptoms

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- Risk for infection r/t impaired skin integrity AMB observes sores/ abrasions
- Risk for injury r/t lack of sensation in feet AMB numbness and tingling.
-Risk for infection r/t poor foot hygiene AMB observed cuts and inflammation
- Deficient knowledge r/t foot care and foot hygiene AMB observed poor foot hygiene

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- Clean feet!
- Wear shoes that fit properly
- Inspects feet regularly

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-Discuss importance of Foot care/hygiene
-Daily Foot inspections
-Wash, rinse, and dry the feet well.
-Wear cotton or wool socks, which absorb perspiration
-IF diabetic, Avoid soaking the feet or if there is decreased circulation to the feet.
-Smoking constricts arterioles and decreases circulation to the feet.
- Protect the feet with proper foot wear, shoes that fit, and shoes that don't impair circulation.
Seek medical attention when...
- you experience pain in the foot
-wounds or ulcers on feet
-Numbness or tingling, decrease in sensation, cold skin temperature, corns, ingrown toenails, and for trimming very thick nails—especially if you have diabetes
-Cuts and cracks on feet

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- Stress the importance of foot care to the client
- Inform them about the types of risks they could face if they do not perform proper foot care
-  Daily foot inspections
- Hygiene for feet and nails
-Protecting feet

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- there is no nursing diagnosis for specific nail care

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- keep nails and hands dry and clean
-  do not bite nails
- limit use of nail polish
-nurse cannot cut or clip nails*
-refer to podiatrist

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- Inform patient that maintaining proper nail care is important in avoidance of possible infection
- Inform patient that diet plays a role in nail health
- Inform patient of risks associated with nail biting (transfer of bacteria from hands to mouth)

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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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- Maintain proper hand hygiene
- limit risk of infection
- patient displays an understanding of nail health and nail care

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Short term: Supervise the patient, while in care, to make sure they are using correct technique, and integrating hair care at least once a day.
Long term: The patient will be able to exhibit proper hair care with no supervision.

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How to properly brush hair

remove tangles, massage scalp, promote circulation, distribute oil

Importance of shampoo in cleaning scalp and hair

How to recognize common hair/scalp problems

If applicable: proper beard and mustache care

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EYES:
-Cleanliness
-Proper eyesight maintained
EARS:
-Promote Hygiene
-Prevent Hearing loss
-Prevent infection
-Maintain ability to communicate with others
NOSE:
-Clear nasal airways
-No obstructions blocking airways
-Free from Infection  and Complications

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EYES:
-Clean In → Out
-provide glasses
EARS:
-Clean with saline
-Remove excess wax in ears
-Wear protective equipment in noisy environments
NOSE:
-Have tissues by beside to release secretions + whenever they will be needed
-Promote hydration to loosen secretions
-Promote blowing nose to alleviate nose secretions