Prioritizing Nursing Diagnoses for a Full-Thickness Burn Patient’s Home Discharge

Discharging a patient with a full-thickness burn injury, such as in the case of a 22-year-old female client, requires meticulous planning and assessment. In this article, we will explore the critical process of prioritizing nursing diagnoses for a patient with full-thickness burns who is transitioning to home care after an extended hospital stay. We will determine the nursing diagnosis with the highest priority to ensure a successful and safe transition to home-based care.

The Complexity of Full-Thickness Burn Injuries

Full-thickness burn injuries are among the most severe types of burns, involving damage to all layers of the skin and potentially extending to underlying tissues, muscles, or bones. These injuries pose unique challenges and require comprehensive care plans to promote healing, manage pain, prevent complications, and support the patient’s overall well-being.

The Scenario

Imagine a 22-year-old female client who has spent a month in the hospital receiving treatment for full-thickness burn injuries. As her wounds have minimally opened and she is stable enough for discharge, she will continue her recovery at home with the assistance of home care services. In this transitional phase, determining the highest-priority nursing diagnosis is vital for providing effective care and ensuring her safety and recovery.

Priority Nursing Diagnosis

The nursing diagnosis with the highest priority in this scenario is:

Impaired Skin Integrity

While the client’s full-thickness burn injuries have begun to heal, the integrity of her skin remains compromised. This diagnosis takes precedence for several reasons:

  1. Wound Care: Full-thickness burn wounds require meticulous care, including wound cleaning, dressing changes, and monitoring for infection. Proper wound care is essential for preventing complications and promoting healing.
  2. Preventing Infection: Full-thickness burns are at high risk of infection due to the loss of skin’s protective barrier. Preventing infection is paramount, as it can significantly impede the healing process and lead to systemic complications.
  3. Pain Management: Impaired skin integrity is often accompanied by significant pain and discomfort. Effective pain management is crucial for the client’s comfort and well-being.
  4. Scar Management: Full-thickness burn injuries are prone to extensive scarring. Early intervention and scar management are essential to minimize scarring and improve the cosmetic and functional outcomes for the client.
  5. Nutritional Support: Proper nutrition plays a vital role in skin healing. Assessing the client’s nutritional status and providing guidance on a balanced diet are essential components of addressing impaired skin integrity.
  6. Education and Self-Care: The client and her caregivers need education on wound care techniques, signs of infection, and the importance of adherence to the care plan. Ensuring they have the knowledge and skills for ongoing care is crucial for successful home-based recovery.

Collaborative Care

The management of impaired skin integrity in a full-thickness burn patient involves collaboration among various healthcare professionals, including wound care specialists, dietitians, physical therapists, and home care providers. Coordination of care and regular follow-up assessments are essential to track progress and address any emerging issues promptly.


Prioritizing nursing diagnoses for a patient with full-thickness burns transitioning to home care is a critical step in ensuring a successful and safe recovery. In this scenario, impaired skin integrity takes precedence due to the ongoing need for wound care, infection prevention, pain management, scar management, and patient education. By addressing this nursing diagnosis with the highest priority, healthcare providers can contribute significantly to the client’s healing process and overall well-being during the transition to home-based care


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