Thursday, August 13, 2015

Anemia - Assessment and 4 Nursing Diagnosis

Nursing Care Plan Anemia - Assessment and Diagnosis
Nursing Care Plan for Anemia

Assessment

1. Activity / Rest
  • Fatigue, weakness, general malaise.
  • Loss of productivity, reduction in the passion for work.
  • Low tolerance for exercise.
  • The need for rest and sleep more.
2. Circulation
  • A history of chronic blood loss.
  • A history of chronic infective endocarditis.
  • Palpitations.
3. Integrity ego
  • Religious or cultural beliefs influence the selection of treatment, for example: rejection of blood transfusions.
4. Elimination
  • A history of pyelonephritis, kidney failure.
  • Flatulence, malabsobsi syndrome.
  • Hematemesis, Melana.
  • Diarrhea or constipation
5. Food / liquids
  • Decreased appetite.
  • Nausea / vomit.
  • Body weight decreased.
6. Pain / comfort
  • The location of pain, especially in the abdomen and head.
7. Breathing
  • Shortness of breath at rest or activity
8. Seyuality
  • Menstrual changes, for example; menorrhagia, amenorrhea
  • Decreased sexual function.
  • Impotence.


Nursing Diagnosis

1. Impaired tissue perfusion related to a decrease in the supply of oxygen / nutrients to the cells.

Characterized by:
  • Palpitations,
  • Pale skin, mucous membranes dry, brittle nails and hair,
  • Cold extremities,
  • Changes in blood pressure, slow capillary refill,
  • Inability to concentrate, disorientation.


2. Activity intolerance related to imbalance of oxygen supply

Characterized by:
  • Weakness and fatigue,
  • Complained decrease in activity / exercise,
  • More need of rest / sleep,
  • Palpitations, tachycardia, increased blood pressure.


3. Imbalanced Nutrition: less than body requirements related to failure to digest, absorption of food

Characterized by:
  • Weight loss is normal,
  • Decrease skin turgor, oral mucosal changes,
  • Decreased appetite, nausea,
  • Loss of muscle tone.


4. Constipation or diarrhea related to a decrease in the amount of food, change the digestive process, adverse effects of drug use

Characterized by:
  • Any changes in the frequency, characteristics, and the amount of feces,
  • Nausea, vomiting, decreased appetite,
  • Abdominal pain,
  • Peristaltic disorders.
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