Nursing diagnosis: breathing

[xxiangel]

Hi guys... Just need your input really quick here:

I got two of these Dx for my patient:

1. Ineffective airway clearance RT increased production of bronchial secretions AEB presence of rhonchi and ineffective cough

2. Ineffective breathing pattern RT inability to breathe with head of bed flat, immobility, stasis of secretions, orthopnea, secondary to anemia.

I need to know if these are the same Dx, or if they are different? (If they are ok, did I word my Dx correctly?)

Thank you for the help !! :redbeathe

[Turd Ferguson]

Different... what is the chief complaint and pertinent information of the patient?

The first dx looks ok to me, the second one is missing the AEB

[xxiangel]

The pt. was in on SOB, and then diagnosed with pneumonia. The next day, the pt ended up getting 3 transfusions of blood because their hemoglobin was VERY low.

[Turd Ferguson]

I would consider Impaired Gas Exchange as my first dx, also look at Ineffective Tissue Perfusion (r/t anemia) to fit somewhere in there. Ineffective breathing pattern can probably be incorporated into Impaired Gas Exchange and Ineffective Airway Clearance, but the choice is yours as to what you use.

A lot of your interventions for Gas Exchange nursing dx's are going to be similar though, so you should be able to cover some good points with whatever you use

[ImThatGuy, BSN, RN]

I don't like ineffective breathing pattern since I couldn't really care less what their "pattern" is. I always try to relate it to impaired gas exchange because ultimately that's what you want to do (exchange gases), and it's so much easier to word. Ineffective breathing pattern, ineffective airway clearance, and a couple of others all relate to or point to the impaired gas exchange.

[CuriousMe]

Hi guys... Just need your input really quick here:

I got two of these Dx for my patient:

1. Ineffective airway clearance RT increased production of bronchial secretions AEB presence of rhonchi and ineffective cough

2. Ineffective breathing pattern RT inability to breathe with head of bed flat, immobility, stasis of secretions, orthopnea, secondary to anemia.

I need to know if these are the same Dx, or if they are different? (If they are ok, did I word my Dx correctly?)

Thank you for the help !! :redbeathe

In your second one, it looks like all your RT's are actually AEB. None of them explain why...they're your evidence that it's happening.

[dudette10, MSN, RN]

I don't know if this is right or not, but I distinguish between the three diagnoses as follows:

--ineffective airway clearance when secretions and a nonproductive cough are the problem,

--ineffective breathing pattern when positioning, anxiety, or chest wall muscles are the problem, and

--impaired gas exchange when perfusion is the problem, e.g. anemia

Hope that helps!

[Turd Ferguson]

I don't know if this is right or not, but I distinguish between the three diagnoses as follows:

--ineffective airway clearance when secretions and a nonproductive cough are the problem,

--ineffective breathing pattern when positioning, anxiety, or chest wall muscles are the problem, and

--impaired gas exchange when perfusion is the problem, e.g. anemia

Hope that helps!

I agree with the first two, but impaired gas exchange deals with ventilation, not perfusion. It indicates that something is blocking the transfer of gases from your lungs to your blood (secretions, pulmonary effusion, pulmonary embolism, emphysema, tumors)

[dudette10, MSN, RN]

I agree with the first two, but impaired gas exchange deals with ventilation, not perfusion. It indicates that something is blocking the transfer of gases from your lungs to your blood (secretions, pulmonary effusion, pulmonary embolism, emphysema, tumors)

Now that I think about it, it's both ventilation and perfusion. (I was thinking of a particular patient that I'm writing a care plan for right now in which impaired gas exchange is related to perfusion only, so I inadvertently limited my definition. :) )

As for your examples, secretions could go under both impaired gas exchange and ineffective airway clearance, depending on assessment data. Pulmonary effusion and pulmonary embolism are perfusion problems. Emphysema and tumors are ventilation problems. Do you agree with that categorization?

ETA: Now, I'm second-guessing emphysema as only a ventilation problem. Emphysema reduces the alveolar surface area for gas exchange with retention of air in the alveoli AND a decrease in the number of capillaries perfusing the area, so in other words, both?

Maybe tumors pathophysiologically affects the area of the tumor in the same way--both ventilation (decreased vital capacity d/t the space taken up by the tumor) and perfusion.