As a nursing student, you will come across these terms, the risk for bleeding nursing diagnosis. A bleeding condition can affect your life quality and, if not treated, can cause death. You may acquire this bleeding disorder from birth or after an illness like cancer. So, it's essential to understand the causes, risk factors, and prevention measures of risk for bleeding. Again, learn the risk of falls and how to prevent them in patients.
Learn how to make risk for bleeding nursing diagnosis and falls and understand more about these health conditions.
What is Bleeding?
Bleeding, also known as hemorrhage, is blood loss internally or externally. Blood loss can occur in almost any part or organ of the body. Internal bleeding can occur through a broken vessel or tissue, while external bleeding occurs through the skin cut. Bleeding can also occur when blood flows through a natural opening like the ears and mouth.
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It's a clinical judgment that a nurse makes about a patient's response to a health condition or vulnerability to that response by an individual or family. A diagnosis helps nurses communicate their professional judgments to patients and fellow or other health practitioners. After a diagnosis, a nurse can create a care plan for the patient to measure the outcomes.
A nursing diagnosis is based on the data that a nurse collects or after assessment. This information instructs the nursing care that a patient will receive.
The risk of bleeding is the threat of decreasing blood volume caused by various factors. These risk factors that cause bleeding include:
Genetic disorders - some conditions can be caused by genes that you inherit from your parents. For instance, a genetic disorder, like hemophilia, is a gene mutation leading to inaccurate clotting factor formation.
Liver disease - slows down the production of clotting factors, for example, hepatitis or cirrhosis.
Cancers that interfere with blood clotting, like Leukemia
Major invasive surgery
Ulcerative gastrointestinal disorders – like bowel and peptic ulcer
Trauma or severe injury to the brain or body
Immune disorders like rheumatoid arthritis
Medications like NSAIDs and cancer chemotherapy increase the risk of bleeding as a drug side-effect.
Using anticoagulants (drugs that inhibit clotting), like heparin, warfarin, and oral anticoagulants
Severe platelets deficiency
Which are the Care Treatments that Can Increase the Bleeding Risk?
Treatments that can make the bleeding condition worse include:
Blood thinner membranes – also called anticoagulants, prevent blood clot formation inside the blood vessels.
Devices that increase blood flow – for instance, ventricular assist devices
Interferon alpha – drugs that treat some types of cancer
A bleeding disorder is a health condition that hinders a patient blood clotting process. This clotting process is called coagulation, where it changes from liquid to solid state. The coagulation process becomes possible through the platelets of blood cells; they clump together at the injured area and form a fibrin clot. This process prevents the excess loss of blood from the body.
Patients with bleeding disorders, as we will discuss, lack enough clotting factors, or their platelets fail to work appropriately or may be less in number.
Bleeding disorders can occur due to vitamin K deficiency, a low red blood cell count, inheritance, or specific medication side effects.
Which are the Types of Bleeding Disorders?
Two types of bleeding disorders occur in a patient, and they include:
Acquired Bleeding Disorders
These disorders develop when something in your body, like disease or medicine, inhibits the functioning of blood clotting factors. Again some issues may also arise if your blood vessels develop complications. Examples of acquired disorders include the following:
Liver disease that causes bleeding
Vitamin k deficiency
Von Willebrand and hemophilia can develop from drug effects or be inherited.
These are the conditions that a patient acquires through gene inheritance, and they include:
Combined deficiency of vitamin K and clotting factors II, VII, IX, and X
Hemophilia A, B, and C occur when there is a lack of certain clotting factors.
Von Willebrand disease – results when the body lacks the Von Willebrand factor for blood clotting.
Hereditary hemorrhagic telangiectasia – it's a rare disease that causes entanglement of blood vessels in different parts of the body.
Which are the Symptoms of a Bleeding Disorder?
Bleeding conditions will present unique symptoms, but the common ones are:
Unexplained bruising or even after a minor injury
Heavy bleeding menstruation – one changes a tampon or pad after every hour, and it takes longer than seven days
Frequent nose bleeds
Excessive bleeding from small cuts that bleed longer than 10 minutes
Joint pains caused by internal bleeding
Post-surgery bleeding - heavy bleeding after surgery, even dental
Blood in poop – which is a nursing diagnosis for gi bleed
Blood in pee( hematuria)
Gastrointestinal (GI) Bleed
Any bleeding occurs in the gastrointestinal tract, including the esophagus, intestine (colon), rectum, and anus. This type of bleeding indicates an underlying condition in the patient; thus, it's not an illness but a sign of a health condition.
There are two sections of the tract, upper and lower, where bleeding can occur. The upper GI bleeding is more frequent than the lower GI. Men are more prevalent, especially with age, to have lower GI bleeding.
Which Underlying Conditions Can Cause GI Bleed?
If a patient is suffering from any of the following, it can lead to GI bleed:
Peptic ulcers diseases
Diverticulosis and diverticulitis
Signs and Symptoms of GI Bleed
The signs and symptoms of GI bleed can vary depending on the severity of the condition. The common signs and symptoms are:
Bright red or dark black spots on stools
Vomiting blood or particles that look like coffee grounds
Abdominal pain or cramping
Weakness or fatigue
Dizziness or lightheadedness
As a nurse, you should know the above signs and symptoms to make the correct nursing diagnosis for gi bleed.
How to Assess Risk for Bleeding?
As a nurse, ensure you check out the following in your patient:
Find out the patient's medical history for risk factors or current health conditions that may put them at risk of bleeding. For instance, some diseases cause a risk for bleeding, such as liver, inflammatory bowel disease, or peptic ulcer disease.
Scrutinize the patient's medications for drugs that affect hemostasis. Some of these medications are anticoagulants, NSAIDs, or chemotherapy; they affect the body's ability to clot blood. Cancer drugs usually suppress bone marrow function and affect the production of platelets.
Monitor the vital signs like blood pressure and heart rate
Assess the patients occasionally and watch for signs of orthostatic hypotension. Note if the patient has light-headedness or significant blood pressure when changing position.
Carry out the stool and urine for occult blood to distinguish bleeding from gastrointestinal or urinary tracts.
Check the skin and mucous membranes for signs of petechiae, bruising, hematoma formation, and oozing.
Assess the skin color for necrosis and color changes from blue or purple
Check the hematocrit and hemoglobin
These are early signs of bleeding where symptoms ate invisibly.
Self-Care for Patients at Risk for Bleeding
Nurses should instruct the patients on appropriate risk-reduction measures:
Use of soft brush and avoid dental picks
Avoid straining bowel movements
Avoid forceful coughing, sneezing, or blowing your nose
Avoid vaginal douches and tampons
Keep off the use of suppositories, enemas, and thermometers
Be cautious when using sharp objects or use an electric razor instead of razor blades
Avoid alcoholic drinks and smoking, especially for peptic ulcers and gastritis with GI bleeding
Be careful when taking medicines. Always consult your healthcare provider. Keep off drugs such as aspirin or other anti-inflammatory medicines like naproxen or ibuprofen due to bleeding risk.
Bleeding causes iron loss, so it's best to eat iron-rich food. These foods include red meat, shellfish, poultry, eggs, beans, whole grains bread, and leafy green vegetables.
These are some measures nurses should advise as a risk for bleeding care plan so that the patients can heal or live at ease with the condition.
Risk of Falls in Patients
Falls mainly occur in hospitalized patients and can lead to injuries. Safety measures should be enhanced for such patients to reduce the risk. As a nurse, you should assess the patient and apply fall prevention measures advised in the risk for fall nursing care plan for better results.
Which Factors are Related to Falls?
Some of the causes of falls in patients include:
Low visual acuity –inability to read at an average distance even with glasses
Hearing impairment – makes your brain struggle to interpret sound, and if there are no resources, it will affect your balance.
Impaired mobility and strength – weakness in the body and mobility challenges can cause falls.
Delirium – leads to cognitive issues and imbalance in the body.
Lower limb prosthesis – may affect your balance.
Use of medications like sedatives, narcotics, alcohol, and antihypertensive – makes you unsteady, feel dizzy, unsteadiness, blurred vision, and this increases your chance of falling.
Cluttered environments, restrained – impedes movement and leads to trips and falls.
Use of assistive devices – especially for older patients it leads to mobility issues
Measures to Reduce the Risk of Falls
Falls are prevalent in our healthcare environment and especially for elderly patients. Falls lead to severe injuries, mobility impairment, and even death. Therefore to reduce these impacts of falls, specific measures should be taken to prevent or even reduce the risk of falls.
Assess the risk for falls – healthcare professionals should assess a fall risk when a patient is admitted. This process includes the following reviews: medical history, mobility status, medication use, and other risk of falls factors. For instance, some medication use, like sedatives, can increase the risk of falls.
Create awareness – nurses should educate the patients and their caregivers on fall prevention measures. For instance, they should advise them on using proper footwear, safely moving in and out of bed, and more.
Promote environment safety – the medics should ensure that the patient environment is safe by removing clutter, offering support to the patient, and providing adequate lighting.
Supply patients with assistive devices - assistive devices are necessary if the patient is still weak or has a mobility impairment. Give them canes, walkers, grab bars in the bathroom, wheelchairs, and more.
Observe the fall prevention program – healthcare workers should have a fall prevention program in place and implement it. These prevention measures can be through staff training, regularly monitoring patients, and creating awareness.
Advice on physical activities – nurses should encourage patients on the same exercises that will make them strong and improve their balance. Healthcare providers should monitor the exercises to avoid causing more harm.
The term describes patients at increased risk of bleeding due to health conditions, medication use, genetic disorders, and pregnancy. Some of these factors are acquired, while others are inherited.
What are Some Risk Factors for Bleeding?
The risk factors and the causes of bleeding in a patient are almost the same, and they include:
Genetic disorders like hemophilia
Liver diseases that affect the production of coagulation factors
Cancer that interferes with the blood clotting process
Pregnancy and postpartum issues
Taking some medicines, such as NSAIDS
How to Make Risk for Bleeding Nursing Diagnosis?
The risk for bleeding nursing diagnosis is made through the following ways:
Evaluate the patient's medical history
Assessment of medication use
Examine the patient's vital signs like pressure and heart rate
What are Some Nursing Interventions for Patients at Risk for Bleeding?
Nurses intercede for patients at risk of bleeding in the following ways:
Educating patients on the best risk–reduction practices
Administering the prescribed medications
Creating awareness of preventative measures like avoiding the use of some medications which are risk factors
As a Patient, Which Bleeding Precautions Should You Follow?
To prevent bleeding, ensure you practice the following:
Use soft brushes
Use electric razor
Be careful with sharp objects
Avoid straining while coughing, sneezing, or blowing your nose
To Wind Up
The risk of bleeding threatens a patient's health; thus, nurses should learn to diagnose it accurately. Patients should also be empowered to handle and even prevent the situation. Healthcare providers should educate both the patients and caregivers on preventive measures.
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