- using the nursing process, develop two plans of care ‐ 1 related to one priority physiological nursing diagnosis and 1 related to one priority psychosocial nursing diagnosis. Please include the following information in each plan of care:
- priority nursing diagnosis,
- short and 1 long‐term goal,
- 5 nursing interventions with rationale statements,
- 5 evaluative statements based on interventions, and
- a minimum of 3 potential patient education needs for
A reference list with each member’s nursing care plan formatted according to APA 7TH edition. A minimum of at least three (3) references are required for this assignment.
Using the Nursing Process: Developing Two Plans of Care
The nursing process is a systematic, patient-centered approach that guides nurses in providing effective care to their patients. It involves five key steps: assessment, diagnosis, planning, implementation, and evaluation. By using the nursing process, nurses can identify patient needs, establish goals and interventions, and evaluate the effectiveness of care. In this essay, we will explore how to use the nursing process to develop two plans of care, one related to a priority physiological nursing diagnosis and the other related to a priority psychosocial nursing diagnosis.
Plan of Care 1: Priority Physiological Nursing Diagnosis
Priority Nursing Diagnosis: Ineffective Airway Clearance
Assessment: The patient is a 55-year-old male with a history of chronic obstructive pulmonary disease (COPD) who was admitted to the hospital with shortness of breath and productive cough. Upon assessment, the patient was found to have increased work of breathing, wheezing, and a productive cough with yellow sputum.
Diagnosis: Ineffective airway clearance related to increased mucus production and airway obstruction as evidenced by wheezing and productive cough.
Planning: Short-term Goal: The patient will have improved airway clearance within 24 hours as evidenced by decreased wheezing and productive cough.
Long-term Goal: The patient will maintain effective airway clearance throughout hospitalization as evidenced by clear lung sounds and absence of productive cough.
Interventions:
- Administer bronchodilators and mucolytics as prescribed to open airways and promote mucus clearance. Rationale: Bronchodilators and mucolytics help to improve airway patency, reduce airway resistance, and promote mucus clearance, which can help to improve airway clearance.
- Encourage coughing and deep breathing exercises. Rationale: Coughing and deep breathing exercises can help to mobilize and expel mucus from the airways, which can improve airway clearance.
- Assist with positioning, such as sitting upright or leaning forward, to improve lung expansion and promote mucus clearance. Rationale: Proper positioning can help to improve lung expansion and facilitate the movement of mucus from the airways.
- Administer oxygen therapy as prescribed to maintain adequate oxygenation. Rationale: Adequate oxygenation is essential for effective airway clearance and can help to reduce respiratory distress.
- Monitor respiratory status, including lung sounds, oxygen saturation, and respiratory rate. Rationale: Regular monitoring of respiratory status can help to identify changes in airway clearance and the effectiveness of interventions.
Evaluative Statements:
- After receiving bronchodilators and mucolytics, the patient’s wheezing decreased and sputum production decreased.
- The patient was able to perform coughing and deep breathing exercises effectively and reported feeling less short of breath.
- The patient was able to maintain an upright position for longer periods of time without experiencing shortness of breath.
- The patient’s oxygen saturation remained within an acceptable range, and respiratory rate decreased.
- Lung sounds improved, with fewer crackles and wheezes present.
Patient Education Needs:
- Explain the importance of taking medications as prescribed, including bronchodilators and mucolytics.
- Demonstrate and teach the patient how to perform coughing and deep breathing exercises effectively.
- Instruct the patient on the proper positioning to promote airway clearance and lung expansion.
References:
Buckley, M. S., & McCoy, C. E. (2017). Management of acute exacerbations of COPD: a summary and appraisal of published evidence. Annals of pharmacotherapy, 51(9), 757-772.
McCrory, D. C., Brown, C.