Need help: Start a diagnosis

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Hi,

Pls help am loss???:cry:

If ur patient have asthma with URTI and according to NANDA is gas exchange are ventilation imbalance and alveolar capillary membrane changes, do u have to pick only one of them? what sign and symptom i have to look at to do my goal care, intervation etc. Plus there is 2 result of physical ,diagnosis and chest examination result given... what i need to look at first? is that means the first result is the diagnosis and the second result is to match my related the goal care , intervation and outcome ? plse help?

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Specializes in med/surg, telemetry, IV therapy, mgmt.

if your patient has asthma with urti and according to nanda is gas exchange are ventilation imbalance and alveolar capillary membrane changes, do you have to pick only one of them?

yes. there is a difference between the two.

alveolar-capillary membrane changes

  • it quite simply means that the membrane, or tissue, that separates the wall of the air sac (alveoli) and the capillary (vessel) walls has changed from it's normal anatomical structure and has become abnormal, or pathological, because there is disease present. this occurs in lung conditions such as one of the copds, fibrosis, tb, invasive cancer and others where permanent damage to the alveoli take place that is not reversible resulting in loss of valuable surface area that is used for oxygen/carbon dioxide gas exchange

ventilation perfusion imba
lance

  • what this means is that an imbalance between oxygen and carbon dioxide exchange exists and there is either more oxygen or more carbon dioxide being exchanged than is normally supposed to occur. the usual reason for this is some sort of temporary blockage at the level of the alveoli. do not make the mistake of diagnosing a blockage in the bronchioles as being responsible for i
    mpaired gas exchange
    because oxygen and carbon dioxide are not exchanged in the blood vessels of the bronchi. ventilation perfusion imbalances occur when the alveoli are clogged with debris, exudates or built up sputum as in pneumonia, congestive heart failure or atelectasis following surgery.

what sign and symptom do i have to look at to do my goal, care intervention etc. plus there is 2 result of physical ,diagnosis and chest examination result given... what do i need to look at first?

impaired gas exchange
seems to be the diagnosis of the weekend. someone was working on a case study about asthma yesterday. all the signs and symptoms are listed on that thread along with priorities of care. does your patient have any of them?

https://allnurses.com/forums/f205/help-my-nursing-care-plan-assignment-related-asthma-gas-exchange-303903.html

if your two signs/symptoms of asthma are defining characteristics (symptoms) of the nursing diagnosis of impaired gas exchange then you have your nursing diagnosis. your goals and nursing interventions for that diagnosis will be based upon and aimed at those two signs and symptoms. as for the priority of care (what you need to look at first), see my post on the thread i just listed above.

also see the thread: https://allnurses.com/forums/f50/asthma-impaired-gas-exchange-302401.html.

does that answer your questions for you?

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