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Discussion

Asthma case study

hi im a first year Nursing student and i have an assignment on a case study of a lady with asthma. i am asked to concentrate on her respiratory problems relating to ineffective breathing pattern (IBP).

i am having difficulty working out

  • The goals of nursing care (relevant to IBP)..i can work out the obvious ones like improve RR and O2 saturation and dysponea etc... but i cant really work out anything else
  • Expected outcomes- i am also struggling with making time frames for the completion of goals because i have no idea how long anything will take. For example how long should i give for the patients RR to decrease through the combination of medication and O2?
  • The nursing actions (including what the RN does independently and in collaboration with other health professionals). i have been trying to research it but books are only getting me so far.

Thank you so much

thanks

Featured Replies

For the expected outcomes: It's not exactly how long medication takes. Remember that outcomes have to be realistic and measurable. Ex: Patient will have O2 sat within normal parameters by discharge or end of shift. Outcomes need to based on your nursing interventions.

Collaborative measure: Medication because physician has to write order for the medication to be given. ( I have seen this as an answer in many test practice books). RN Role: monitoring RR and O2 sat. That is something that you would do individually. I hope this helps.

  • Experts

goals and outcomes are pretty much the same thing--the result of our nursing interventions. it depends on what you define each. look in your lecture notes to be clear as to what your nursing program is calling a "goal" and what they are calling an "outcome". some define an outcome as whatever affects the etiology of the nursing problem and goals as everything else. others define an outcome as the predicted results of our independent nursing actions and goals as everything else. our nursing actions are what you will perform for the signs and symptoms of the ibp. coincidentally, they will also happen to further your goals and outcomes. everything is one big related group. most important is that you look at the diagnosis of ibp itself. the nanda taxonomy information will tell you its definition, related factors (what causes it), and defining characteristics (its signs and symptoms). this information is in many current care plan books, the appendix of current editions of taber's cyclopedic medical dictionary, and on these two websites:

you ask, how long should i give for the patients rr to decrease through the combination of medication and o2?

look in medication resources and on websites such as

make sure you are not confusing this diagnosis with
impaired gas exchange
or perhaps
ineffective airway clearance
. o2 saturation is the primary problem of
impaired gas exchange
. ibp first and foremost has to do with the difficulty of inspiration and expiration--the physical act of breathing in and out. in the case of asthma the problem is one of getting air through narrowed and constricted airways. goals require knowing what the patient is able to accomplish and this requires a knowledge of the person, and in this case, the disease process. also read medical case studies and see what doctors prescribe and say about the actions of specific medications on asthma on websites like emedicine (
http://www.emedicine.com/
). there should be several articles about asthma on emedicine.

outcome/goal statements have four components. look carefully at #4 (time frame). this information was taken from nursing care planning made incredibly easy:

  1. a behavior
    • this is the desired patient response/action you expect to see/hear as a direct result of your nursing interventions.
    • you must be able to observe the behavior

[*]it is measurable

  • criteria that identifies exactly what you are measuring in terms of
    • how much
    • how long
    • how far
    • on what scale you are using

[*]sets the conditions under which the behavior should occur

  • such conditions as
    • when
    • how frequently

    [*]take into account the patient's overall state of health (this requires knowing the pathophysiology of their disease process)

    [*]take into account the patient's ability to meet the goals you are recommending

    [*]it is a good idea to get the patient's agreement to meet the intended goal so both the nurse and the patient are working toward the same goal

[*]have a realistic time frame for completing the goal

  • long-term goals usually take weeks or months
  • short-term goals can take as little time as a day
  • it all depends on knowing what your nursing interventions are designed to do and what you believe your patient is capable of doing.

no doubled u r my schoolmate, am struggling with the same questions now :wink2:

welcome to connect with me and discuss.

cheers

rose

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