Published Dec 1, 2008
chickacherrycola
8 Posts
okay so i know that risk for hemorrhage is not a NANDA approved care plan but my :heartbeatLOVELY:heartbeat OB professor wants us to pretend like it is :banghead:for our postpartum patients and i am having trouble finding interventions and rationales for it... here's what i have for it so far...
Objective Data:
1) G 2 P 1
2) Length labor 37 weeks completed.
3) Anesthesia/analgesia- Spinal epidural.
4) Moderate Lochia, rubra, 1 clot.
5) Fundus U/2, soft
6) HGB 10.5
7) HCT 29.5
8) WBC 21.9
9) Platelets 253
10) VS=
T 98.0, P 52, R 18, BP 109/64, O2 98
11) Voided 3 hours after delivery.
12) No BM, bowel sounds present Qx4
13) Patient's membranes were artificially ruptured.
14) Foley catheter was placed with use of spinal epidural- per protocol.
Subjective data
1) "My bleeding has slowed down a lot today"
2) "Is this clot normal?"
3) "I change my pads about every 3-4 hours"
Nursing Diagnosis:
Risk for hemorrhage r/t childbirth.
Expected outcomes/Goal statements:
...help!!! need interventions!!
Daytonite, BSN, RN
1 Article; 14,604 Posts
it doesn't matter what your "lovely ob professor" wants you to word the diagnosis. the diagnosis is merely a label. years ago in my bsn program we weren't allowed to use the new nanda labels at all. we had to make up our own which meant wearing out copies of roget's thesaurus.
first of all, keep your focus in mind. with "risk for" diagnoses your focus is to prevent something specific from happening. the specific thing you want to prevent in this case is postpartum hemorrhage.
secondly, what are the risk factors, i.e. risk for postpartum hemorrhage r/t ??? what causes postpartum hemorrhage? lets get that established. is there any possible failed mechanism that might go on that could result in a hemorrhage? if this patient had a multiple gestation (twins), hydramnios, macrosomnia, abruptio placentae, placenta previa or an inverted uterus, then you need to replace the word "childbirth" with one of those in your diagnostic statement since they are a more likely reason for hemorrhage to occur.
thirdly, interventions for these diagnoses are really rather easy. the goals are to prevent the occurrence of the problem (postpartum hemorrhage). your interventions are to create an environment so postpartum hemorrhage won't occur:
[*]reporting any symptoms that do occur to the doctor or other concerned professional
[*]if symptoms occur, you have an actual problem on your hands and you need to re-evaluate the care plan and change the nursing diagnosis
expected outcomes/goal statements:
if you need answers to some questions that you may not find in your textbook, use the ob weblinks here. sometimes you will find more information posted for the public: