Help with nursing diagnoses

the reason your diagnostic statement doesn't sound good is because a respiratory rate of 20 and pulse ox of 98% are normal assessment data and are not symptoms of an ineffective breathing pattern (you can see a list of the symptoms posted here: [color=#3366ff]ineffective breathing pattern). you have diagnosed the patient incorrectly. nursing diagnoses are based upon abnormal symptoms. i cannot stress the importance of using a nursing diagnosis reference when determining nursing problems so this misdiagnosing doesn't happen. if you need a respiratory diagnosis, you need to reassess the patient's respiratory system. if this is the only respiratory assessment information you have you then perhaps you need to do a more thorough respiratory assessment to find possible symptoms. you can find information on assessing the respiratory system on this sticky thread:

• https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms (in nursing student assistance forum)

you should re-read your nursing textbook on the patient undergoing general anesthesia. post op patients who have undergone general anesthesia are at risk for the following respiratory problems:

• atelectasis
  
• hypoxia
  
• pneumonia
  
• pulmonary embolism

pathophysiology: the reason we have patients cough and deep breath after surgery is because the lungs have been underinflated and irritated during general anesthetic by the gasses. secretions tend to build up and settle in the deep alveoli. deep breathing helps to open up and reinflate the alveoli. . .the deeper the breaths, the more air that reaches the distal alveoli. coughing efforts will help to move any secretions along and up the respiratory track. surgery in the abdominal area limits the respiratory and coughing efforts. many times the first couple of days of coughing and deep breathing following abdominal surgery will yield no sputum and the lungs will still be clear. that doesn't mean that secretions aren't still sitting around down in the alveoli or the patient's lung sounds won't be clear. you can't see this sputum or what dastardly things sputum sitting around in distal alveoli is up to. often postop productive coughing after a deep breathing and coughing session doesn't start to occur until later days 3, 4, etc, when postop breathing effort is much better. coughing and deep breathing for a postop patient gets the tick sputum sitting around in the distal alveoli loosened up so it can start to move out. by postop days 3 and 4, the patient is usually successful at coughing up an occasional very thick plug of sputum depending on how much coughing and deep breathing they did. if they don't have an underlying respiratory disease to begin with or are not smokers you may not be around when this happens, so post op patients, as part of an assessment, should always be asked if they have been able to successfully cough up any sputum. those patients who won't keep up with deep breathing and coughing except when the nurses prompt them are at a greater risk of developing the complications listed above.

• ineffective airway clearance ([color=#3366ff]ineffective airway clearance) [not having productive cough]
  
• risk for infection ([color=#3366ff]risk for infection) [pneumonia]
  
• risk for impaired gas exchange ([color=#3366ff]impaired gas exchange) [hypoxia]
  
• risk for ineffective tissue perfusion, cardiopulmonary ([color=#3366ff]ineffective tissue perfusion specify type: renal, cerebral, cardiopulmonary, gastrointestinal, peripheral) [atelectasis, pulmonary embolism]