Need Help with nursing care plan

[vaughald]

Here is what I have. I had a 5 m/o in end stage liver failure. Her platelet's were 27, PT 33 and aPTT was 120.6. In trying to come up with a care plan for her, i had a nursing diagnosis as risk for injury related to abnormal clotting factors AEB her test results(mentioned above). Is a suffiecient goal to show no signs of bleeding? Also, for the nursing interventions, should it be general info like strategies to prevent the problem from happening in the first place, monitoring for the specific signs of this problem reporting any symptoms that do occur to the doctor or other concerned professional? Thank you in advance for your help!

[rdsxfnrn]

5 m/o with end stage liver failure............???? she has bigger problems than bleeding............ an "at risk" dx should never be used first............... how bout altered comfort? pain? teaching family regarding impending death, impaired coping............ it does not always have to be about just the pt......... in this case too young and sick to absorb anything think oustside the box

[Daytonite, BSN, RN]

risk for injury related to abnormal clotting factors aeb her test results

a "risk for" diagnosis is an

anticipated

problem, meaning that a problem does not yet exist. therefore, there cannot be any aeb items in the diagnostic statement. if you have abnormal test results (platelet's of 27) then there is an

actual

problem to be addressed. a more appropriate nursing diagnosis to use for this would be

ineffective protection r/t thrombocytopenia aeb platelet count of 27.

did the patient have any evidence of bruising, petechiae, bleeding from the gums, epistaxis or low back pain? these are other symptoms of thrombocytopenia.