I spent my clinical day on Monday at a long-term care facility for kids. My patient was a 23 month old female on a ventilator. She was born at 26 weeks. I'm looking over the nursing diagnoses and I'm so confused! I thought this would be one of the easiest ones to come up with, but I'm having a hard time. It seems as if the diagnoses pertain to someone prior to being placed on a vent, not someone who is already on one. I think that impaired spontaneous ventilation would still be good because this is still true even though she's on the vent. But what about impaired gas exchange, or ineffective breathing patterns? What would be the priority? ABGs are used to determine the effectiveness of gas exchange, but there were none in her chart. I know the vent forces ventilation but cannot force respiration. As you can see, I keep going in circles. Thanks for your help!