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  • Assessment

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    Dyam Mitch
    22 vues2 pages
    The patient was experiencing difficulty breathing. On examination, the patient showed signs of dyspnea, productive cough, and use of accessory muscles. The diagnosis was ineffective airway clearance related to increased secretions production, likely due to chronic obstructive pulmonary disease (COPD). The plan was for the patient to demonstrate improved airway clearance through effective coughing and expectoration after 4 hours of nursing interventions like positioning, breathing exercises, and assisting the cough. Interventions included medication administration, supplemental humidification, maintaining a clear environment, and pursed lip breathing exercises to help clear secretions and improve breathing.

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    The patient was experiencing difficulty breathing. On examination, the patient showed signs of dyspnea, productive cough, and use of accessory muscles. The diagnosis was ineffective airway clearance related to increased secretions production, likely due to chronic obstructive pulmonary disease (COPD). The plan was for the patient to demonstrate improved airway clearance through effective coughing and expectoration after 4 hours of nursing interventions like positioning, breathing exercises, and assisting the cough. Interventions included medication administration, supplemental humidification, maintaining a clear environment, and pursed lip breathing exercises to help clear secretions and improve breathing.

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    22 vues2 pages

    Assessment

    Transféré par

    Dyam Mitch
    The patient was experiencing difficulty breathing. On examination, the patient showed signs of dyspnea, productive cough, and use of accessory muscles. The diagnosis was ineffective airway clearance related to increased secretions production, likely due to chronic obstructive pulmonary disease (COPD). The plan was for the patient to demonstrate improved airway clearance through effective coughing and expectoration after 4 hours of nursing interventions like positioning, breathing exercises, and assisting the cough. Interventions included medication administration, supplemental humidification, maintaining a clear environment, and pursed lip breathing exercises to help clear secretions and improve breathing.

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
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    Signaler comme contenu inapproprié
    sur 2

    ASSESSMENT Subjective: Nahihirapan ako huminga as verbalized by the patient. Objective: Use of accessory muscle.

    Dyspnea Productive cough V/S taken as follows: T: 36.7 P: 57R: 25 Bp: 100/80

    DIAGNOSIS Ineffective airway clearance related to increased production of secretions.

    INFERENCE Chronic obstructive pulmonary disease (COPD) is a disease characterized by air flow limitation that is not fully reversible. Airflow limitation is usually progressive and associated with an inflammatory response in the lungs stimulated by irritants. Common cause of COPD is cigarette smoking, air pollution, allergens and infections thatmay also act as irritants.

    PLANNING After 4 hrs. Of nursing interventions, the client will demonstrate behaviors to improve airway clearance .e.g. cough effectively and expectorate secretions.

    INTERVENTION Independent: Assist patient to assume position of comfort, e.g., elevate head of bed, encourage patient to lean on over bed table or sit on the edge of the bed. Keep environmental pollution to a minimum, e.g., dust, smoke and feather pillows, according to individual situation Encourage or assist with pursed lip breathing exercises. Observe characteristics of cough like persistent or hacking or moist. Assist with measures to improve Effectiveness so cough effort.

    RATIONALE Elevation of the head of the bed facilitates respiratory function by use of gravity. Precipitators of allergic type or respiratory reactions that can trigger or exacerbate on set of acute episode. Provides patient with some means to cope or control dyspnea and reduce air trapping. Coughing is most effective in an upright position or head down position after chest percussion. After 4 hrs. Of nursing interventions, the client was able to demonstrate behaviors to improve airway clearance. e.g. cough effectively and expectorate secretions.

    Dependent: Administer medication as

    A variety of medications maybe used to decrease mucus and to improve respiration.

    prescribed by the physician. Provide supplemental humidification like nebulizer

    Humidity helps reduce viscosity of secretions, facilitating expectoration, and may reduce or prevent formation of thick mucus plugs in bronchioles.

    NURSING CARE PLAN HERO KATE L. LIWANAG BSN 3-5

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