Question

Scenario

Robert, 52, newly diagnosed COPD patient. Currently works at a shipping company. Lives in a private home with his 96-year-old mother. He is her primary caregiver. He has insurance supplemented by his employer up to 40%. He resides in zip code 11225

Identify primary, secondary, and tertiary interventions for each nursing diagnosis ( 3 nursing diagnoses). Complete template

3 nursing intervention, from each intervention 1 primary prevention, 1 secondary prevention and one tertiary intervention

3 interventions, 3 primary prevention, 3 secondary prevention and 3 tertiary prevention

Priority Nursing Diagnoses	Primary Prevention needs	Secondary Prevention needs	Tertiary Prevention needs	S.M.A.R.T Objectives for each Diagnosis	Based on the diagnoses, list the resources needed to care for this client in their Community (Zip Code Area)
Nursing Diagnosis 1
Nursing Diagnosis 2
Nursing Diagnosis 3

As the Community Health Nurse for this client, use the Functional Health Status Approach method for Community Assessment list the agencies available in the zip-code area to facilitate partnering for care of the individual in their community: - ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________

Answer 1

Chronic obstructive pulmonary disease is charecterized by airflow limitation that is not fully reversible,usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases resulting in narrowing of airways,hypersecretion of mucus and change in pulmonary vasculature.

nursing interventions iclude,

Obtain information about current symptoms

1)Ineffective airway clearance related to bronchoconstrictio

a)Bronchospasm can sometimes detected on auscultation,wheezing or diminished breath sounds can be heard.

b)Monitor the patient for dyspnea and hypoxemia.

c)Administer medications as per order,chest physiotherapy and Huff coughing is effective.

2)Ineffective breathing pattern related to shortness of breath.

a)Train the patient for diaphragmatic breathing.

b)Pursed lip-breathing.

c)Inspiratory muscle training.

3)Activity intolerance due to fatigue.

a)Educate about rehabilitative therapies.

b)Promote indipendence in excecuting activities of daily living.

c)Exercise training to stregthen the muscles.

1)Diaphragmatic breathing and coughing techniques improves ventilation by opening airways to facilitate gas exchange by clearing sputum.

2)assist in administering nebulizer and teach use of nebulizer.

3)Instruct to avoid bronchial irritants because that may cause bronchoconstriction.

4)Adequately hydrate the patient,this keeps the secretion moist and easier to expectorate.

5)Teach patient to coordinate diaphragmatic breathing with activity this will allow him to be more active and avoid excessive fatigue.

GOALS ARE,

1.)Achievement of airway clearance. 2)Improve breathing pattern. 3)Improve activity tolerance.

PREVENTION,

Promote home and community based care,provide instructions about self management,teach patient and family members early signs and symptoms of infection.Instruct to avoid extreme cold and heat and stay away from pollutants.

Direct the patient to community resourses,remind the patient and family about the importance of participating in general health promotion activities,pulmonary rehabilitation programs,smoking cessation programs.