Need Help with Care Plan

[1nurse4you]

Hi

I was wondering if I could get some help with this assignment

We can discuss your post here. It is a care plan with 4 questions.

Any help with this is greatly appreciated

[h=2]Instructions[/h]Instructions

If you are a Licensed Practical Nurse (or were educated at the practical nurse level), please submit the following assignment in the dropbox.

Patient Information: Raymond Pelasco is a 64-year-old male who has been admitted to a rehabilitation facility two days ago, following a short hospital stay for pneumonia, secondary to newly-diagnosed chronic obstructive pulmonary disease (COPD). Mr. Pelasco has smoked since the age of 16, and prior to his admission, smoked a pack of cigarettes per day. He owns a bar, and acts as the bartender most evenings. Most of the bar patrons are also smokers, and Mr. Pelasco is proud of the fact that he provides a place where smokers can feel comfortable. Mr. Pelasco says that he doesn't know how he can quit smoking, when he is around smokers so much of the time. Mr. Pelasco becomes short of breath and has a pulse rate >100 when he is up and around. He coughs frequently, producing small amounts thick white mucus. Mr. Pelasco is 5'10' and weighs 240. He states that his usual diet consists of bacon and eggs at breakfast, fast food for lunch, and usually snacks from the bar menu for dinner. He is divorced, with two adult children who live in other states.

On admission, Mr. Pelasco was assessed by the registered nurse, who developed the following plan of care:

Nursing diagnosis #1: Activity intolerance R/T insufficient knowledge of adaptive techniques needed secondary to COPD AEB shortness of breath and increased pulse rate on exertion

Goal: Within two weeks, the patient will be able to independently carry out activities of daily living using adaptive techniques AEB caring for self in apartment setting with minimal shortness of breath and pulse within normal range.

Interventions: Increase activity gradually, increasing the level of independence daily.

Educate the patient on importance of carrying out activities with frequent rest periods.

Nursing diagnosis #2: Potential for ineffective self health management R/T insufficient support and knowledge AEB new diagnosis, no family in area, and lifestyle centered around smoking and poor nutrition

Goal: Within one week, patient will develop a plan to manage own health effectively AEB describing at least three realistic lifestyle changes and identifying two methods of obtaining ongoing support.

Interventions: Encourage participation in support group for COPD patients.

Provide education on effects of nutrition and secondhand smoke on COPD.

Assignment: You are assigned to care for Mr. Pelasco for a 12-hour shift, and have reviewed the plan of care. Describe how you will implement the plan of care doing your time with him, using the following guidelines:

1. List the defining characteristics for each of the nursing diagnoses, using Carpenito's Nursing Diagnosis: Application to Clinical Practice (available online through the OUHSC Bird Library), or another appropriate reference. Please cite your reference. (20 points)
   
2. Mr. Pelasco has been in the rehab facility for two days, so it is likely the plan of care has been started. Describe how you will determine which interventions have been implemented and how, as well as how you will evaluate Mr. Pelasco's progress towards meeting the goals. (20 points)
   
3. If you were to learn that the interventions have not been fully implemented and that Mr. Pelasco has made minimal progress towards meeting the goals, describe how you will implement the plan of care during your 12 hours with Mr. Pelasco. (30 points)
   
4. Provide an example of appropriate documentation that reflects implementation of the nursing interventions and evaluation of the results. (30 points)
   

[1nurse4you]

I have to make a 75% or higher on this assignment or I will not be able to proceed in getting my nursing license.

This is why I would like to ask for help so I can review the information and submit the best possible answers.

Thanks for helping I look forward to the discussions

[Sour Lemon]

I have to make a 75% or higher on this assignment or I will not be able to proceed in getting my nursing license.

This is why I would like to ask for help so I can review the information and submit the best possible answers.

Thanks for helping I look forward to the discussions

That sounds more like "do it for me" than "help me".

[1nurse4you]

I need help with it and would like to go over it with someone else....

[1nurse4you]

I am not for sure about the question of defining characteristics of what it is asking. Does that mean post the symptoms in the text above or should I list the signs and symptoms of the diagnosis itself.

[CelticGoddess, BSN, RN]

You need to share what you have first, then people are more likely to help you out. What are your thought?

[HermioneG, BSN, RN]

What questions do you have, exactly? Or what would you like feedback on?

can you please post all the work that you've completed so far?

[1nurse4you]

happily... I just started this assignment so I will post about question one since its late.

I am unsure about how to answer the question and will have to ask my instructor if it wants the defining characterists from the article or all the ones that are listed for the nursing diagnosis from the book.

I beginning to think its from the book since it says to use the book but I am still unsure or maybe over thinking the problem.

answer to number 1

Mr. Pelasco has smoked since the age of 16, and prior to his admission, smoked a pack of cigarettes per day ( would this be a defining characteristic) also I would include COPD AEB shortness of breath and increased pulse rate on exertion

I am also not for sure on what self help management is. I have not had a chance to look some of this up since I just got the assignment. I would assume this is related to activities of daily living such as brushing teeth and hygiene such as bathing.

This is where I am starting and thank you for your reply. I will look more of this up tomorrow and look forward to working this out. Thanks

[1nurse4you]

thanks for your reply. happily... I just started this assignment so I will post about question one since its late.

I am unsure about how to answer the question and will have to ask my instructor if it wants the defining characterists from the article or all the ones that are listed for the nursing diagnosis from the book.

I beginning to think its from the book since it says to use the book but I am still unsure or maybe over thinking the problem.

answer to number 1

Mr. Pelasco has smoked since the age of 16, and prior to his admission, smoked a pack of cigarettes per day ( would this be a defining characteristic) also I would include COPD AEB shortness of breath and increased pulse rate on exertion

I am also not for sure on what self help management is. I have not had a chance to look some of this up since I just got the assignment. I would assume this is related to activities of daily living such as brushing teeth and hygiene such as bathing.

This is where I am starting and thank you for your reply. I will look more of this up tomorrow and look forward to working this out. Thanks

[1nurse4you]

I am unsure how I would determine which interventions have been implemented if I just started the shift.

I would assume I could ask him his activities since the care plan was initiated. I would evaluate his progress as seeing what he is eating for his meals and asking him if I could ask his doctor about starting a nicotine patch. that is one way I could see about helping him in his attempt to quit smoking.

[shibaowner, MSN, RN, NP]

I am unsure how I would determine which interventions have been implemented if I just started the shift.

I would assume I could ask him his activities since the care plan was initiated. I would evaluate his progress as seeing what he is eating for his meals and asking him if I could ask his doctor about starting a nicotine patch. that is one way I could see about helping him in his attempt to quit smoking.

If you just started the shift, you should have received hand off from previous nurse. You can also check the patient's chart to see what has been done. And you are correct - ask the patient.