John Walker Nursing Care Plan Pneumonia COPD 2021 | RN 101 Nursing Care Plan Pneumonia COPD - COMPLETE

John Walker Nursing Care Plan Pneumonia COPD 2021 | Nursing Care Plan Pneumonia- COPD Patient: Joan Walker, 84 years old History of Present Problem: Joan Walker is an 84-year-old female who has had a productive cough of green phlegm that started four days ago that persists. She was started three days ago on prednisone 40 mg PO daily and azithromycin (Zithromax) 250 mg PO x5 days by her clinic physician. Though she has had intermittent chills, she had a fever last night of 102.0 F/38.9 C. She has had more difficulty breathing during the night and has been using her albuterol inhaler every 1-2 hours with no improvement so she called 9-1-1 and was brought to the emergency department (ED) where you are the nurse who will be responsible for her care. Personal/Social History: Joan was widowed six months ago after 64 years of marriage and resides in assisted living. She is a retired elementary school teacher. She called her pastor before coming to the ED and he has now arrived and came back with the patient. The nurse walked in the room when the pastor asked Joan if she would like to pray. The patient said to her pastor, “Yes please, I feel that this may the beginning of the end for me!” T: 103.2 F/39.6 C (oral) P: 110 (regular) R: 30 (labored) BP: 178/96 O2 sat: 86% 6 liters n/c NANDA-I Dx Goal Expected Outcome Nsg Intervention Rationale Evaluation P: Impaired gas exchange E: decreased functional lung tissue Patient will maintain optimal gas exchange, as evidenced by ABGs within the patient’s usual range, oxygen saturation of 90% or greater, alert 1.The nurse will assess patient for altered breathing patterns in the beginning of the shift and every 1-2 hrs. 1.Assess for altered breathing patterns: -Auscultate breath sounds every 1 to 4 hour -Increased work of breathing -Monitor respiratory pattern - abnormal rate, rhythm, and depth of 1.The patient with COPD has hyperinflation of sthe alveoli. This change leads to an increased anteroposterior chest diameter (barrel chest) and 1.Patient has improved breathing patterns in response to therapy in 3 days.