The nursing care plan addresses three issues for a patient: risk of infection due to their medical conditions including a history of renal transplant rejection and diabetes; fatigue related to chronic illness and dialysis treatments; and impaired coping ability due to their chronic illness, frequent hospitalizations, and lifestyle changes. For each issue, the plan identifies goals, interventions, and methods of monitoring and evaluation. The overall goal is to prevent infection, manage fatigue, and enhance the patient's ability to cope with their health challenges.

1. Nursing Care Plan
Assessment Diagnosis Planning Implementation Evaluation
• Presence of
premicath, history
of renal transplant
rejection, diabetic
status.
1. Risk for Infection
related to compromised
immune function
secondary to end-stage
renal failure, diabetes,
and recent transplant
rejection, as evidenced
by: Premicath insertion,
compromised renal
function, diabetic
condition, and
immunosuppression.
• Short-term Goal: Prevent
infection by maintaining strict
aseptic techniques during
dialysis and catheter care.
• Long-term Goal: Promote
overall health to minimize
infection risks.
• Educate the patient on the
importance of hand hygiene.
• Ensure proper catheter care
and aseptic techniques
during dialysis.
• Administer prescribed
prophylactic antibiotics if
indicated.
• Monitor for signs of
infection regularly.
• Assess the patient's
understanding and
compliance with
infection prevention
measures.
• Patient expresses
feelings of fatigue
and reduced
ability to perform
daily activities.
2. Fatigue related to
chronic illness and
dialysis treatments, as
evidenced by: Patient
reports of feeling tired,
decreased activity
tolerance, and altered
sleep patterns.
• Short-term Goal: Manage
fatigue through adequate rest
and energy conservation.
• Long-term Goal: Enhance
overall energy levels and
improve quality of life.
• Encourage scheduled rest
periods between activities.
• Collaborate with the
healthcare team to adjust
dialysis schedule if needed.
• Provide education on energy
conservation techniques.
• Assess changes in the
patient's reported fatigue
levels.
• Monitor for
improvements in overall
energy levels and
activity tolerance

2. • Patient reports
feelings of
frustration,
anxiety, or
sadness.
3. Impaired Coping related
to chronic illness,
frequent
hospitalizations, and
lifestyle changes, as
evidenced by Patient’s
verbalization of stress
and anxiety
• Short-term Goal: Provide
emotional support and coping
strategies.
• Long-term Goal: Enhance the
patient's ability to cope with the
challenges of chronic illness.
• Offer therapeutic
communication and active
listening.
• Collaborate with the
healthcare team to provide
counseling or psychological
support.
• Encourage the patient to
engage in activities that
bring comfort and relaxation.
• Assess changes in the
patient's emotional well-
being over time.
• Monitor the patient's
participation in coping
mechanisms and adjust
interventions
accordingly.