let me ask you this, why are you choosing ineffective tissue perfusion as a diagnosis? to me, a low hemoglobin and hematocrit are not defining characteristics, or symptoms, of ineffective tissue perfusion of the kidneys. what other symptoms do you have for this patient? the reason i ask that is because your nursing diagnosis is always developed from the assessment data that you have accumulated from the patient's history, physical exam, laboratory results and other information in his/her chart and well as the actual assessment and observations that you made. i also recommend that you look up esrd and look at what the signs and symptoms of this medical disease are and see what you might have missed in your initial review of this patient's record. i think what you might have been alluding to was anemia with the low h&h. and, anemia is one of the problems that esrd patients have, but it doesn't support a nursing diagnosis of ineffective tissue perfusion (renal). a patient with esrd that is on dialysis has fluid overload problems. here's information from family practice notebook on chronic renal failure (esrd) http://www.fpnotebook.com/ren38.htm
look at the outline and item xiii (management: end stage renal disease) where it has reasons for dialysis listed under it: uremia, hypervolemia, hyperkalemia, severe metabolic acidosis, and low creatinine clearance. does your patient have any of these conditions? he/she must have one or wouldn't be on dialysis!
bring back some more data that you have on this patient so i can help you formulate some nursing diagnoses. or, is this a case study?
also, i recommend that you review the posts and information contained in these two threads:
- desperately need help with careplans (in nursing student assistance forum)
- careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)
welcome to allnurses!