Saturday, December 6, 2014

Activity Intolerance and Altered Tissue Perfusion r/t Leukemia

Nursing Care Plan for Leukemia


Nursing Diagnosis for Leukemia : Activity Intolerance related to general weakness, increased metabolic rate.

Goal:
The client is able to tolerate the activity.

Expected outcomes:
  • Increased tolerance activity can be measured.
  • Participate in activities that can be measured.
  • Shows signs of physiological decline intolerant.
Nursing Intervention:
  • Evaluation reports weakness, note the inability to participate in activities.
  • Implementation of energy saving techniques.
  • Schedule eat about chemotherapy.

Collaboration:
  • Give supplemental O2.

Nursing Diagnosis for Leukemia : Altered Tissue Perfusion related to cessation of blood flow, secondary; destruction of human existence.

Goal:
Adequate perfusion.

Expected outcomes:
  • Balanced inputs and outputs.
  • Urine output of 30 mL / h.
  • Capillary refill less than 2 seconds.
  • Stable vital signs.
  • Strong peripheral pulses palpable.

Nursing Intervention:
  • Monitor vital signs.
  • Assess the skin to the cold, pale, humidity, capillary refill.
  • Note the change in the level of consciousness.
  • Maintain adequate fluid intake.
  • Evaluation of edema.
Collaboration:
  • Supervise laboratory tests: blood gas analysis, AST / ALT, CPK, BUN.
  • Serum electrolytes, provide a replacement as indicated.
  • Give hypo osmolar fluid.

1 comment:

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