NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
Diagnosis at a glance
| Code | 00374 |
|---|---|
| Label | Risk for excessive bleeding |
| Before (2021-2023) | Former code 00206 |
| Spanish label | Riesgo de sangrado excesivo |
| Domain | 11. Safety / protection |
| Class | 2. Physical injury |
| Type | Risk |
| Status | Current |
What changed in 2024-2026
The word "excessive" was added because every surgery involves some bleeding: the diagnosis targets bleeding beyond what is expected. The code changed from 00206 to 00374.
What it means
This diagnosis describes a patient who is not bleeding abnormally yet, but whose treatment, illness or habits could lead to more blood loss than expected after a wound, a procedure or a bump. The nurse monitors, prevents injury and teaches the patient to recognize warning signs.
Explanation written by our team. The official definition is in the NANDA-I 2024-2026 book.
When to use it
Clinical situations where it commonly shows up. The diagnosis is confirmed by your assessment, not by the medical diagnosis.
- Patients on anticoagulant or antiplatelet therapy.
- Postoperative patients, especially after vascular, cardiac or major orthopedic surgery.
- Low platelet counts from chemotherapy, leukemia or liver disease.
- Postpartum patients and complicated pregnancies.
- Peptic ulcer disease or esophageal varices.
- Older adults on anticoagulants who are at risk for falls.
What to assess
- Current medications: anticoagulants, antiplatelets, NSAIDs.
- Platelet count, INR and coagulation times, as ordered.
- Dressings, drains and puncture sites.
- Skin and mucous membranes: bruising, petechiae, bleeding gums.
- Signs of occult bleeding: black, tarry stools, dark or reddish urine, coffee-ground emesis.
- Blood pressure, heart rate and level of consciousness.
- Fall risk using a tool such as the Morse Fall Scale.
- What the patient knows about their therapy: dosing schedule, lab follow-up, and drugs and foods that interfere with it.
Risk factors
What makes the problem more likely, and what nursing can monitor or modify.
- Inadequate knowledge of anticoagulant therapy precautions.
- Irregular, missed or doubled anticoagulant doses.
- Self-medicating with NSAIDs, aspirin or herbal supplements.
- Missing ordered lab monitoring, such as INR checks.
- Sudden changes in leafy green vegetable intake in patients taking vitamin K antagonists.
- Excessive alcohol use.
- Cluttered surroundings or unsafe footwear that increase the chance of falls.
- Using a hard toothbrush or a straight razor.
At-risk populations
- Older adults taking anticoagulants.
- Postpartum women.
- Patients recovering from major surgery.
- People with excessive alcohol use.
- Patients with cancer receiving chemotherapy.
Associated conditions
- Anticoagulant or antiplatelet therapy.
- Thrombocytopenia.
- Cirrhosis and other chronic liver diseases.
- Hemophilia and other clotting disorders.
- Peptic ulcer disease and esophageal varices.
- Pregnancy complications, such as placenta previa or HELLP syndrome.
How to write it (PES)
Risk for Excessive Bleeding related to inadequate knowledge of anticoagulant therapy precautions, in a patient with atrial fibrillation on oral anticoagulants (associated condition).
Like every risk diagnosis, it has no "as evidenced by" clause. If active bleeding is already present, the focus of the care plan changes.
Example written by our team for a fictional patient. Adapt it to your own patient's data. Build your statement with the PES generator.
Goals / expected outcomes
Written in measurable terms: what, how much and by when.
- Patient shows no bleeding beyond what is expected during the hospital stay.
- Patient maintains blood pressure and heart rate within their usual baseline.
- Before discharge, patient names three signs of bleeding that require medical attention.
- Patient explains how to take the anticoagulant and which medications to avoid without checking with the provider first.
- Patient experiences no falls or injuries during the hospital stay.
Nursing interventions and rationales
| Intervention | Rationale |
|---|---|
| Monitor vital signs, dressings and drains as often as ordered. | Unexplained tachycardia can be the first sign of occult bleeding. |
| Apply pressure to puncture sites for at least 5 minutes, longer if the patient is on anticoagulants. | Prevents hematomas and delayed bleeding. |
| Avoid IM injections whenever possible and use smaller-gauge needles. | Lowers the risk of deep hematomas. |
| Recommend a soft toothbrush and an electric razor. | Prevents minor injuries that would bleed more than usual. |
| Implement fall precautions. | A fall in an anticoagulated patient can cause serious bleeding. |
| Review drug interactions: NSAIDs and some supplements increase bleeding. | Many patients take them on their own. |
| Review platelet and INR results and report out-of-range values to the provider. | Allows therapy to be adjusted before bleeding starts. |
| Teach warning signs and when to go to the emergency department. | Seeking care early changes the outcome. |
| Explain why the anticoagulant should be taken at the same time every day and why a missed dose should not be doubled without checking with the provider. | Irregular doses make the drug's effect rise and fall unpredictably. |
NOC outcomes and NIC interventions
Outcomes (NOC) and interventions (NIC) that published sources link to this diagnosis. Pick the ones that fit your patient.
NOC outcomes
- 0409Blood Coagulation
- 0413Blood Loss Severity
- 3101Self-Management: Anticoagulant Therapy
NIC interventions
- 4010Bleeding Precautions
- 6680Vital Signs Monitoring
- 4260Shock Prevention
- 6650Surveillance
Linkages drawn from care plans published by health services, universities and nursing journals. Labels may vary depending on the NIC and NOC edition your facility uses.
Case study: Older adult on anticoagulants with bruising
Patient. 74-year-old woman with atrial fibrillation taking acenocoumarol (a vitamin K antagonist). Admitted to the medical floor with pneumonia; she lives alone.
Assessment
- INR 3.6 (target range 2 to 3).
- Has been taking naproxen on her own for knee pain for 2 weeks.
- Bruises of 3 to 4 cm on both forearms; she does not remember bumping into anything.
- Hemoglobin 12.1 g/dL, BP 128/76 mmHg, HR 82 bpm.
- Morse Fall Scale score of 55.
- Does not know which bleeding signs to watch for or which medications to avoid.
Nursing diagnosis
Risk for Excessive Bleeding related to self-medication with NSAIDs and inadequate knowledge of anticoagulant therapy precautions, in a patient with atrial fibrillation on acenocoumarol (associated condition).
Goal
During the hospital stay, the patient has no new bleeding, and before discharge she names three warning signs and the medications she should not take without checking with her provider.
Interventions
- Report the INR and naproxen use to the provider.
- Monitor skin, urine, stools and vital signs every shift.
- Apply pressure to puncture sites for at least 5 minutes.
- Implement fall precautions: bed in low position, call light within reach, closed-toe footwear.
- Teach warning signs and which pain relievers she may use as directed by her provider.
Evaluation
On day 3 the INR is 2.6 after the provider's adjustment, with no new bruising, no bleeding and no falls. She names three warning signs and has stopped the naproxen. The diagnosis stays active until discharge because she remains on anticoagulation.
How it differs from similar diagnoses
- Risk for shock (00205): Risk for shock: use it when volume loss threatens to compromise organ perfusion.
- Risk for adult falls (00303): Risk for adult falls: often paired with this diagnosis in older adults on anticoagulants.
Common mistakes
- Still using code 00206 in 2024-2026 assignments.
- Listing only the medical condition as the factor ("related to anticoagulants") without a modifiable factor.
- Keeping a risk diagnosis when active bleeding is already present.
- Assigning it to every surgical patient even when nothing increases bleeding beyond what is expected.
Other diagnoses in the Physical injury class
Domain 11, Safety / protection. See every diagnosis in this domain.
Frequently asked questions
What is the NANDA code for risk for excessive bleeding?
00374, in Domain 11 (Safety/protection), Class 2 (Physical injury). It replaces the old 00206 in the 2024-2026 edition.
What happened to Risk for Bleeding 00206?
In 2024-2026 it is called Risk for Excessive Bleeding, and its code is 00374.
Is risk for bleeding the same as risk for hemorrhage?
"Risk for hemorrhage" is how many people search for it, but the official NANDA-I label is Risk for Excessive Bleeding.
Is an anticoagulant a risk factor for bleeding?
It is a treatment, and the taxonomy treats it as an associated condition. Risk factors are the things nursing can change: what the patient knows, self-medication, fall risk.
What if my patient is already bleeding?
Notify the provider and act on the bleeding. The risk diagnosis is resolved, and the care plan shifts to the actual problems, such as fluid volume loss.
Study material: the explanation, characteristics, factors, examples and case study on this page were written by our editorial team. The official text for Risk for excessive bleeding (00374) is in NANDA International Nursing Diagnoses: Definitions and Classification 2024-2026. This page does not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes · Spanish edition table of contents · NOC/NIC: source 1. Reviewed November 2, 2026.