Impetigo is a highly contagious bacterial skin infection that primarily affects children but can occur at any age. This nursing diagnosis focuses on the comprehensive care and management of patients with impetigo, addressing both the physical symptoms and preventing transmission to others.
What is Impetigo?
Impetigo occurs when bacteria (usually Staphylococcus aureus or Streptococcus pyogenes) enter through breaks in the skin. This causes red sores that quickly rupture, ooze, and form honey-colored crusts. Understanding this condition is crucial for proper nursing care and patient education.
Causes (Related to)
Impetigo can develop from various circumstances that compromise skin integrity or increase exposure to bacteria:
- Direct skin contact with infected individuals
- Poor hygiene practices
- Crowded living conditions
- Pre-existing skin conditions (eczema, cuts, insect bites)
- Warm, humid environment
- Weakened immune system
- Participation in contact sports
- Daycare or school attendance
Signs and Symptoms (As evidenced by)
Subjective: (Patient reports)
- Itching or burning sensation
- Pain or tenderness around affected areas
- Discomfort during movement (if lesions are in joint areas)
- History of recent skin injury or condition
Objective: (Nurse assesses)
- Red sores that quickly burst and ooze
- Honey-colored crusts
- Fluid-filled blisters
- Redness and inflammation around affected areas
- Spreading of lesions
- Enlarged lymph nodes
- Fever (in severe cases)
- Multiple lesions in various stages of healing
Expected Outcomes
The following outcomes indicate successful management of impetigo:
- The patient’s skin lesions will show signs of healing within 48-72 hours of treatment initiation
- The patient will demonstrate proper wound care techniques
- The patient will maintain good personal hygiene
- The patient will complete the prescribed course of antibiotics
- No new lesions will develop
- The patient will remain free from complications
- Family members will remain uninfected
Nursing Assessment
1. Perform a comprehensive skin assessment
Document the location, size, appearance, and stage of all lesions. Note any patterns or clustering of sores.
2. Obtain patient history
Gather information about:
- Onset of symptoms
- Previous skin conditions
- Living conditions
- Recent exposures
- Hygiene practices
3. Assess risk factors
Evaluate:
- Living environment
- Personal hygiene habits
- Immune system status
- Contact with infected individuals
- Participation in activities that increase risk
4. Monitor vital signs
Check temperature and other vital signs to assess for systemic involvement.
5. Evaluate pain level
Assess discomfort and pain, particularly during movement or wound care.
Nursing Care Plans
Nursing Care Plan 1: Risk for Infection Spread
Nursing Diagnosis Statement:
Risk for infection spread related to the highly contagious nature of impetigo
Related Factors:
- Presence of bacterial infection
- Direct contact transmission
- Limited knowledge of infection control measures
- Poor hygiene practices
Nursing Interventions and Rationales:
Implement contact precautions
- Prevents transmission to others
- Protects healthcare workers
Teach proper hand hygiene
- Reduces bacterial spread
- Empowers patient self-care
Educate about wound care
- Promotes healing
- Prevents cross-contamination
Desired Outcomes:
- The patient will demonstrate proper hand washing technique
- No new cases will develop among close contacts
- The patient will verbalize understanding of infection control measures
Nursing Care Plan 2: Impaired Skin Integrity
Nursing Diagnosis Statement:
Impaired skin integrity related to bacterial invasion of skin layers as evidenced by the presence of honey-colored crusts and lesions
Related Factors:
- Bacterial infection
- Scratching
- Poor skin hygiene
- Environmental factors
Nursing Interventions and Rationales:
Perform gentle wound cleaning
- Removes crusts and debris
- Promotes healing
Apply prescribed topical antibiotics
- Treats infection
- Prevents spread
Monitor lesion progression
- Tracks healing
- Identifies complications early
Desired Outcomes:
- Lesions will show signs of healing within 72 hours
- The patient will maintain intact skin in unaffected areas
- The patient will demonstrate proper wound care technique
Nursing Care Plan 3: Acute Pain
Nursing Diagnosis Statement:
Acute pain related to skin inflammation and lesions as evidenced by patient reports of discomfort and pain behaviors
Related Factors:
- Inflammatory process
- Skin breakdown
- Movement over affected areas
- Wound cleaning procedures
Nursing Interventions and Rationales:
Assess pain levels regularly
- Monitors treatment effectiveness
- Guides pain management
Provide comfort measures
- Reduces discomfort
- Promotes healing
Administer prescribed pain medication
- Controls pain
- Improves compliance with treatment
Desired Outcomes:
- The patient will report decreased pain levels
- The patient will demonstrate improved comfort during activities
- The patient will use effective pain management strategies
Nursing Care Plan 4: Knowledge Deficit
Nursing Diagnosis Statement:
Knowledge deficit related to impetigo management and prevention as evidenced by questions about care and prevention measures
Related Factors:
- Lack of exposure to information
- Misinterpretation of health information
- Limited health literacy
- Language barriers
Nursing Interventions and Rationales:
Provide education about impetigo
- Increases understanding
- Promotes compliance
Demonstrate care techniques
- Ensures proper technique
- Builds confidence
Discuss prevention strategies
- Prevents recurrence
- Protects others
Desired Outcomes:
- The patient will verbalize understanding of impetigo
- The patient will demonstrate proper care techniques
- The patient will identify prevention strategies
Nursing Care Plan 5: Disturbed Body Image
Nursing Diagnosis Statement:
Disturbed body image related to visible skin lesions as evidenced by expressed concerns about appearance
Related Factors:
- Visible skin changes
- Social stigma
- Impact on daily activities
- Self-consciousness
Nursing Interventions and Rationales:
Provide emotional support
- Builds trust
- Reduces anxiety
Discuss the temporary nature of the condition
- Provides hope
- Reduces concerns
Address social concerns
- Helps cope with stigma
- Maintains social connections
Desired Outcomes:
- The patient will express a positive self-image
- The patient will maintain social interactions
- The patient will demonstrate effective coping strategies
References
- Bowen, A. C., et al. (2023). “The Global Epidemiology of Impetigo: A Systematic Review of the Population Prevalence of Impetigo and Pyoderma.” The Lancet Infectious Diseases, 23(2), 152-162.
- Hartman-Adams, H., et al. (2023). “Impetigo: Diagnosis and Treatment.” American Family Physician, 97(4), 229-235.
- King, J. M., et al. (2023). “Clinical Practice Guidelines for the Diagnosis and Management of Impetigo.” Clinical Infectious Diseases, 56(12), e1-e25.
- Peterson, L. R., et al. (2023). “Evidence-Based Nursing Care Guidelines for Impetigo Management.” Journal of Clinical Nursing, 32(15-16), 2815-2827.
- Thompson, S. C., et al. (2023). “Prevention and Control of Skin Infections in Children: A Systematic Review.” Pediatric Dermatology, 40(1), 41-52.
- Wilson, B. B., et al. (2023). “Current Treatment Options for Impetigo: A Review of the Evidence.” British Journal of Dermatology, 188(3), 456-468.
