00201 Risk of ineffective brain perfusion

image_pdfDownload PDF

00201 Risk of ineffective brain perfusion

Definition of the NANDA label

Risk of decreased brain tissue circulation.

Related factors

• Abnormal partial thromboplastin time.
• Abnormal prothrombin time.
• Akinetic left ventricular segment.
• Aortic atherosclerosis.
• Arterial dissection.
• Joint fibrillation.
• Atrial myxoma.
• Brain tumor.
• Carotid stenosis.
• Brain aneurysm.
• Coagulopathy (eg, sickle cell anemia).
• Dilated cardiomyopathy.
• Disseminated intravascular coagulation (DIC).
• Embolism.
• Brain trauma.
• Hypercholesterolemia.
• Hypertension.
• Infectious endocarditis.
• Thrombosis of the left atrium.
• Mechanical valve prosthesis.
• Mitral stenosis.
• Brain neoplasia.
• Recent myocardial infarction.
• Sinus node syndrome.
• Substance abuse.
• Thromboembolic therapy.
• Treatment-related side effects (cardiopulmonary bypass, medications).

NOC

• Circulatory state.
• Status of vital signs.
• Neurological status.
• Tissue perfusion: cerebral.
• Electrolyte and acid-base balance.
• Water balance.
• Tissue integrity: skin and mucous membranes.
• Tissue perfusion: peripheral.
• Urinary elimination.

NIC

• Hemodynamic regulation.
• Circulatory precautions.
• Management of cerebral perfusion.
• Management of vital signs.
• Improved cerebral perfusion.
• Monitoring of intracranial pressure (ICP).
• Neurological monitoring.
• Electrolyte management.
• Management of urinary elimination.

image_pdfDownload PDF