HELP! What's a good care plan example for "ineffective tissue perfusion"?

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I'm getting so confused writing care plans over and over, especially with my instructor being so specific.

I'm thinking of 1 short term and 1 long term goal for a patient with "ineffective tissue perfusion: peripheral"

So far:

STG: Have decreased pain with a rating of 3/10 every hour

LTG: Maintain oxygen greater than 95% on 2L O2 every shift.

Interventions:

Nurse will:

- monitor vitals every hour

- keep left leg stabilized and elevated

- rate patient's pain level every hour

Are my interventions too general? I need to be more specific...

Thanks in advanced! I appreciate ALL of your input at this difficult and draining time of my crazy instructor.

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I'm not sure what your instructor is looking for, but neither of your goals match your ND. If the problem is ineffective tissue perfusion, your goals should be reflective of adequate tissue perfusion. Your STG is a good one if your diagnosis is acute pain. Your long term goal is good if you are using one of the respiratory diagnoses.

Good goals for peripheral tissue perfusion would be capillary refill

Your interventions should be geared more towards correcting the problem. Why doesn't the patient have good perfusion? Do they need to ambulate to get their blood circulating? Or maybe some range of motion exercises? Is there something blocking blood flow? What is going on that is causing the problem and what can you do as the nurse to fix it? You can use assessment in your interventions, like assessing cap refill.

When you look at interventions, you have to ask if they will help to fix the problem. How will keeping the leg stabilized improve peripheral blood circulation and tissue perfusion? I don't know the patient's problem, but I'm having a hard time connecting that.

Hope that helps, it's all about what your instructor wants though so you might want to make an appointment with him/her and get real feedback.

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Specializes in Medical and general practice now LTC.

Moved to the General Nursing Student Discussions forum

we have several threads in this forum discussing care plans :)

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I'm not sure what your instructor is looking for, but neither of your goals match your ND. If the problem is ineffective tissue perfusion, your goals should be reflective of adequate tissue perfusion. Your STG is a good one if your diagnosis is acute pain. Your long term goal is good if you are using one of the respiratory diagnoses.

Good goals for peripheral tissue perfusion would be capillary refill

Your interventions should be geared more towards correcting the problem. Why doesn't the patient have good perfusion? Do they need to ambulate to get their blood circulating? Or maybe some range of motion exercises? Is there something blocking blood flow? What is going on that is causing the problem and what can you do as the nurse to fix it? You can use assessment in your interventions, like assessing cap refill.

When you look at interventions, you have to ask if they will help to fix the problem. How will keeping the leg stabilized improve peripheral blood circulation and tissue perfusion? I don't know the patient's problem, but I'm having a hard time connecting that.

Hope that helps, it's all about what your instructor wants though so you might want to make an appointment with him/her and get real feedback.

This is an excellent response. I have nothing to add! :D Good luck! You'll get this care plan thing down in no time.

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one small addition: if a person has poor blood flow to a foot, that foot is at higher risk for pressure ulcer and nonhealing wounds. how would you assess for that, and what would you do to prevent it?:rolleyes:

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one small addition: if a person has poor blood flow to a foot, that foot is at higher risk for pressure ulcer and nonhealing wounds. how would you assess for that, and what would you do to prevent it?:rolleyes:

this is a good point and could be on the same care plan for this patient, but under its own diagnosis "risk for impaired skin integrity". you should keep them separate because although they are related, they have separate interventions and goals.

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"interventions:

nurse will:

- monitor vitals every hour

- keep left leg stabilized and elevated

- rate patient's pain level every hour:"

and another thing: an assessment (like taking vs and rating pain) is not an intervention. it's part of your assessment. you have to keep doing that, because part of nursing is always checking back to see how thing are going. (that's called "reassessment" or "evaluation.")

just measuring these things changes nothing for the patient, though. what will you do to help this patient whose problem is bad blood flow?

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