Need advice on picking a nursing DX

lifeisbeautiful · Nov 17, 2004

That is a good one! You could also write a Nursing Care Plan for someone with Thrombocytopenia (they have a high risk for bleeding). Risk for altered_________(fill in the blank) tissue perfusion r/t acute/chronic blood loss as manifested by prolonged bleeding from_______________(fill in what may cause this person prolonged bleeding).

(brief examples)

Then you will list what you will do for this (rationales):

Do not administer aspirin or aspirin products because of the affect they have on clotting. Teach pt. this and other ways to control active bleeding.

Administer platelets/blood to treat bleeding or replace what was lost.

Evaluate pt. for signs of bleeding each shift.

Another good Care Plan would be a risk for impaired tissue integrity or risk for altered oral mucous membranes.

You could also write NCP for Neutropenia, which you had mentioned is loss of protection (Risk for infection r/t decreased neutrophils) or Anemia.

crb613, BSN, RN · Nov 17, 2004

also pain, fatigue, anemia & altered nutrition: less than body requirements then your r/t & AEB. I think you have a good one but we have to do three & prioritize & then do our care paln on # 1. Good luck

chris_at_lucas_RN, RN · Nov 18, 2004

Hi everyone, Ihave a question. I'm writng my first nursing care plan for a pt w/leukemia. I'm having a problem finding the best nursing dx to work up. I originally choose ineffective protection. Becuause the pt was on bleeding precautions, and had a very low platelet and RBC count. I was wondering if this is good enough or if I should change it? Any suggestions would help. Thankyou.

Thank you for starting this thread! I was inspired to google "ineffective protection," which seemed to be related more to renal stuff than blood stuff. Ditto when I looked it up in my care plan book.

Here's a way to approach this. Don't think about the medical diagnosis. That may trip you up. Think instead of how the patient will be feeling, and/or what you will be doing for them. That will give you the clearest indication of the nursing diagnosis.

After all, nursing has to to with prevention of disease or minimizing the effects of the disease, generally. Interestingly, nursing diagnoses relate to those kinds of goals, not to medical diagnoses.

Once you make the transition from the medical dx idea to the nursing one, it will make soooooo much sense.

For your lady with leukemia, have you thought of risk for injury (they can get fatigued and lightheaded, making falling more likely, injury is a big deal for them because they don't have the blood components to take care of injuries), pain r/t bruising (speaks for itself) for starters.....

Gotta go feed the family. But wanted to post this first.

Again, thanks for the thread. It's excellent (althogh it would be better placed in the student forums.....)

KRVRN, BSN, RN · Nov 18, 2004

Is it a woman that has lost her hair due to treatments? Maybe Altered Body Image?

kim93079 · Nov 18, 2004

Anxiety r/t current disease process might fit too

snwflknurse · Nov 18, 2004

i did the same type of condition last week...leukemia on neutropenic precautions. my plan had to be related to activity and exercise and i chose

fatigue r/t effects of acute leukemia AEB "I'm really tired" (subjective) and inability to restore energy even after sleep, increase in rest requirements, inability to maintain usual level of physical activity (objective)

hope that helps.

Hi everyone, Ihave a question. I'm writng my first nursing care plan for a pt w/leukemia. I'm having a problem finding the best nursing dx to work up. I originally choose ineffective protection. Becuause the pt was on bleeding precautions, and had a very low platelet and RBC count. I was wondering if this is good enough or if I should change it? Any suggestions would help. Thankyou.

Michelle St · Nov 18, 2004

Thanks to everyone who replied. Your suggestions were great!! I really feel as if I can write a good care plan now. Once again thnak to everyone for all the wonderful input!!!:wink2:

kathy_79 · Nov 18, 2004

"Becuause the pt was on bleeding precautions, and had a very low platelet and RBC count"

what about risk for injury. describe her current situation, meds, labs, head -to-toe assess.

godd luck, i am on my second care plan workshop now. it is time consuming but very helpfull for me to focus on pt and develop knowledge.

:)

Michelle St · Nov 18, 2004

"Becuause the pt was on bleeding precautions, and had a very low platelet and RBC count"
what about risk for injury. describe her current situation, meds, labs, head -to-toe assess.
godd luck, i am on my second care plan workshop now. it is time consuming but very helpfull for me to focus on pt and develop knowledge.
:)[/quote
Thanks Kathy we had our workshop today too.]