Nursing Diagnosis/Care Plan Help

[HLee2015]

Hello!

We have an assignment in my Med-surg class to make a concept map based on a patient scenario. We have a very long patient scenario and we have to come up with five nursing diagnoses. From the scenario we have diagnoses for pain, skin, nutrition, and mobility. We are now trying to find a diagnosis that fits the respiratory information. We have the following information concerning/involving the respiratory system:

Pt is a 62 y/o African American male admitted to ICU for complications after open heart surgery.

Patient is a former coal miner

History of:

Type 2 diabetes

oral antihyperglycemic medication

hypertension

high cholesterol

highly active before surgery, able to ambulate long distances

smokes one pack of cigarettes per day

Currently, the patient has

vital signs of bp 168/84, hr 72, respiration 18/minute, O2 97% on room air

patient is on O2 through nasal cannula

reports he is tired with movement and is refusing to get out of bed

We are having a hard time finding a nursing diagnosis that fits the information we have about the respiratory system. Right now we have two potential options: activity intolerance and/or impaired comfort. Can anyone think of anything else or have any advice? I'm thinking our best bet might be to abandon the respiratory idea all together and use some of our other information from the patient scenario and making a box about infection. Help, please! Thank you!

[RN_EMT]

Due to the lack of mobility, hx of prolonged lung damage(smoking/asbestos from work), and recent surgery maybe use a diagnosis in alley of "at risk for" pnuemonia or blood clot . Also maybe impaired gas exchange =\

[Une Infirmiere, BSN, RN]

Hello HLee,

I'm not sure If I should tell you exactly what is a Nrsg Dx r/t the Respiratory system but there is a reason why the information that says he is a former coal miner is important. Coal mining exposed the patient to debris that causes scar tissues in the lungs (Pulmonary fibrosis). With too much scar tissues the lungs cannot expand as much as they should and the surface available for gas exchange is diminished. Looks like a potential problem to me!!

Good Luck on your assignment..