Question

Case Study - outcome identification and planning

You are a nurse admitting a patient to the hospital from the emergency department (ED) with shortness of breath and recent weight loss. After receiving a report from the ED nurse, you ready the patient’s room according to unit specifications and collect the necessary equipment and forms. When the patient arrives, she is using oxygen via a nasal cannula and seems to be comfortable. As you begin your admission activities and paperwork, you note that her shortness of breath slightly increases as she answers your questions. Accompanying the patient is her daughter, who comments, “This is the fourth time she’s been admitted to this hospital in the past year.” The patient and her daughter demonstrate a close, loving relationship. The daughter not only encourages her mother but also sets boundaries regarding her mother’s anxiety.

1. 1. What general priorities would you expect to establish from this information?
2. 2. How would you determine their priority?
3. 3. How would you identify expected patient outcomes in this case?
   4. What might they be?
4. 5. How would you select evidence-based nursing interventions?
5. 6. Why is it important to develop well-written care plans?

Answer 1

a) The general prioritise of the client are =

- to maintain oxygenation to the patient.

- reduce shortness of breath and respiratory distress.

- laboratory examinations has to be done.

- improve nutrition of the patient.

The priorities has to be determined by the basic needs of the client. For this purpose proper history has to take and physical assessment has to be done.

Assessment =

- The details history of previous hospitalization, any known food or drug allergy, food habit of the client.

- the respiratory assessment, cardiac assessment has to be done.

- some laboratory examinations likes as arterial blood gas examinations, complete blood count has to be done.

- assess the oxygen refill time and central and periferal cyanosis of the client.

Interventions =

i) the vital signs has to be monitored in every 30 minutes interval.

ii) the moist Oxygen inhelation has to be maintained.

iii) Nebulization haa to be provided to the patient with prescribed bronchodilators by the physician.

iv) the patient has to provide semifowler or high fowler position.

v) blood samples has to be collected from the patient for laboratory examinations.

vi) small and frequent balanced diet has to be administered to the patient.

vi) intravenous fluids has to be administered as per prescription.

c) Expected Patient Outcomes =

- The patient breathing pattern will be improved.

- Patients feels comfortable.

- her symptoms are reduced.

d)The evidence based nursing interventions has to be selected as per Patients priority needs. The interventions has to be selected after discussion with the patient and her daughter and their preferences.