Answered: Make a Nursing Care Plan for "Impaired… | bartleby

Basic Clinical Lab Competencies for Respiratory Care: An Integrated Approach

Basic Clinical Lab Competencies for Respiratory Care: An Integrated Approach

5th Edition

ISBN:9781285244662

Author:White

Publisher:White

Chapter18: Bronchoscopy Assisting

Section: Chapter Questions

Problem 2SEPT

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Question

Make a Nursing Care Plan for "Impaired Gas exchange related to permanent damage of the bronchial walls"

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Client: Jon Stark
Care Plan by: W. Smith, RN
Date initiated: 12-29-2018
ASSESSMENT
(+) Dyspnea
(+) Abnormal breath
sounds
Heart rate - 128bpm
Restlessness
(+) Productive cough
Student Nursing Care Plans
DIAGNOSIS
Impaired gas
exchange RT
collection of mucus
in airways
OUTCOMES
Patient will maintain
optimal gas
exchange.
INTERVENTIONS
1. Assess respirations:
note quality, rate,
rhythm, depth, use of
accessory muscles.
ease, and position
assumed for easy
breathing.
2. Elevate head and
encourage frequent
position changes,
deep breathing, and
effective coughing.
RATIONALE
1. Manifestations of
respiratory distress
are dependent
on/and indicative of
the degree of lung
involvement and
underlying general
health status as
patients will adapt
their breathing
patterns to facilitate
effective gas
exchange.
2. These measures
promote maximum
chest expansion,
mobilize secretions
and improve
ventilation.
EVALUATION
Patient maintained
optimal gas
exchange AEB
normal respiratory
rate, (-) dyspnea,
effective coughing
techniques.
Nurseslabs

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