Question about a care plan for post-op T& A

[smghanayem]

Hello, I don't generally post on here but I have run across a question as I am composing my care plan for a post-op tonsillectomy and adenoidectomy of a four year old child.

My question is, I understand that after any surgery the client will be at risk for bleeding and infection. I was thinking about my nursing diagnosis being Ineffective Protection r/t post-surgical bleeding and infection risk. Can I address both of these issues with one diagnosis? If so, do I just come up with two goals? Or should I address them individually such as Risk for Infection and Risk for post-surgical bleeding? AND, I know that risk for post-surgical bleeding is NOT a NANDA diagnosis so I just need some of you advice on how to address this issue.

I am open to constructive criticism and advice. Thanks!

[nurseprnRN, BSN, RN]

in general, it is possible to have more than one goal for the care of a diagnosis, and separate interventions, which may overlap, for each.

however, i'd take a longer look at domain 11 in your nanda, safety/protection. "ineffective protection (00043)" refers to "decrease in ability to guard one's self from from internal or external threats such as illness or injury."

i'm not seeing a real clear connection in the defining characteristics to an otherwise normal 4-year-old in there. i'm seeing a bunch of better choices elsewhere on the list, though . what do you think?

[smghanayem]

That's what I originally thought too but when I was looking up risk for injury, it said in the NANDA dx book that bleeding risks should be addressed with ineffective protection. I am in my last semester of nursing school and never used that dx before but when I started brainstorming the idea, I thought that infection, bleeding and injury would all fit under that dx. I am thinking I may just save myself some time and go with my gut to use risk for injury and the infection separate. Thanks for your advice! :)

[tarheelsu]

When I think about inneffective protection, I think about someone who is unable to protect themselves, as in unconscious in surgery or a coma, etc.

Also, I thought risk for bleeding was a NANDA. I don't have my book handy but I think it is one.

[bols27]

wouldn't the fact that the patient is 4 put them at risk for ineffective protection in and of itself? deficient knowledge seems like another one you would be able to use a lot with children.