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Nursing Care Plan for Anemia

The nursing care plan is for a 40-year-old female patient diagnosed with postpartum hemorrhage due to retained placental fragments and anemia. Her hemoglobin level is low at 61 g/L. The nursing diagnosis is ineffective tissue perfusion related to her decreased hemoglobin. The plan is to monitor her vital signs and assess perfusion indicators over 4 days with goals of understanding her condition and demonstrating increased perfusion as shown by normalizing lab values and capillary refill. Interventions include IV fluids/blood products, monitoring labs, and maintaining circulating volume.

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1K views2 pages

Nursing Care Plan for Anemia

The nursing care plan is for a 40-year-old female patient diagnosed with postpartum hemorrhage due to retained placental fragments and anemia. Her hemoglobin level is low at 61 g/L. The nursing diagnosis is ineffective tissue perfusion related to her decreased hemoglobin. The plan is to monitor her vital signs and assess perfusion indicators over 4 days with goals of understanding her condition and demonstrating increased perfusion as shown by normalizing lab values and capillary refill. Interventions include IV fluids/blood products, monitoring labs, and maintaining circulating volume.

Uploaded by

katrina_velasco_1
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Name of Patient: H.F.

Diagnosis: PPOID with Retained Placental Fragments, Anemia 2

Name of Student: Anna Katrina B. Velasco Year & Section: BSN2C

Nursing Care Plan


ASSESSMENT NURSING DIAGNOSIS Ineffective tissue perfusion r/t decreased haemoglobin concentration in blood AEB pallor, decrease haemoglobin and RBC level, pale conjunctiva, poor capillary refill Definition: Decrease in oxygen resulting in the failure to nourish the tissues at the capillary level. Source: NANDA 11th edition RATIONALE DESIRED OUTCOMES After 4 days of nursing intervention, client will be able to: 1. Verbalize understanding of condition, therapy regimen side effects of medications, and when to contact healthcare provider. 2. Demonstrate increased perfusion as individually appropriate (e.g.hematocrit, hemoglobin, RBC,WBC, capillary refill within normal range) INTERVENTION JUSTIFICATION EVALUATION

Subjective: Nakapoy ko gusto ko magpahuway. As verbalized by the patient. Objective: Pallor Pale conjunctiva Pale lips Poor capillary refill= > 3 sec Low hgb level=61 g/L(Normal hgb count: 135-170 g/L) RBC of 1.94/L Hematocrit of 0.18(Normal: 0.40-o.54)

Predisposing: 40y/old Female Precipitating: Multiparity (G7P7) Manual Extraction of Retained placental fragments

Independent 1. Assessed and monitored vital signs, skin color and capillary refill. 2. Note customary baseline data (e.g., usual BP, weight, ABGs and other appropriate laboratory study values. 3. Ascertain impact of condition on functioning lifestyle. Dependent 1. Administer IV 1. Maintains 1. General indicators of circulatory status and adequacy of perfusion. 2. Provides comparison with current findings. 3. To note degree of impairment.

BP= 90/70 mmHg (Normal: 120/80 mmHg) Strength: Good family support Weakness: Low socioeconomic status

3. Maintain adequate tissue perfusion as evidence by good capillary refill and normal skin color.

fluids/blood products as indicated. Collaborative 1. Monitor laboratory studies such as hemoglobin, hematocrit and RBC. 1.

circulating volume to maximize tissue perfusion.

Normal values indicate adequate tissue perfusion.

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