Assessment

Nursing Diagnosis

Analysis

Goals and Objectives Goal: y

Nursing Intervention y Assess patient general condition.

Rationale y To have baseline data and note any abnormal findings. To conserve energy/lo wer tissue oxygen demands.

Evaluation After 5 days patient was able to demonstrate increased perfusion as individually appropriate.

Subjective: anemic ako as verbalized by the client Objective: -dyspnea -pale conjunctiva -hemoptysis

Vital signs: RR-35cpm BP-90/60mmhg Lab result: Hemoglobin count- 105 Hematocrit level- 0.33

Ineffective Tissue Perfusion reated to decreased hemoglobin concentration in blood as evidenced by dyspnea, chest pain and pale conjunctiva

After 5 days of nursing intervention the client will be able to demonstrate increased perfusion as individually appropriate.

Encourage quiet and restful atmosphere.

Objectives: y After 10 minutes of nursing intervention the patient will be able to verbalized understandin g of the causative factors. After 30 minutes of nursing intervention the patient will be able to verbalized

Encourage early ambulation once tolerated Discourage wearing constrictive clothing, crossing legs.

To enhance venous return. To improve and facilitates good circulatio n.

Elevate head of bed especially at

To increase gravitiona

understandin g of condition and therapy regimen. After 15 minutes patient will be able to demonstrate behaviors/life style changes to improve circulation

night.

l blood flow. y To conserve energy.

Instruct to avoid strenuous activity. Instruct patient s SO about food rich in iron. Promote adequate bed rest.

To increase Hgb count. To promote wellness.

Attend needs.

To promote health. To promote recovery.

Administer meds as ordered.