phil_heff

hi all, thanks again for responding. i reall appreciate it. i think what my tutors mean when they ask for nursing priorities, is the actual or potential problem the patient may have, and then to prioritise the problems accordingly and discuss the nursing care involved. in light of this i was wondering if i should consider the following; 1.the potential problem of developing respiratory failure, due to airway obstruction ( due to inflammation and bronchoconstriction) and ventilation/perfusion mismatch (due to air trapping in the alvoli, due to airway obstrction) therefore causing hypoxeamia and hypercarbina, resulting in acidosis, and possibley death; therefore the nurse must have bedside ready for intubation if needed, administer O2 to keep stats > 92%, administer meds including B2 aganosist and steriods to reduce inflammation and bronchocostriction, listen for reduced breathing sounds, which may suggest that the patients condition is worstening, if possible get patient to sit in the up-right position, teach pursed-lip expiration (allows for blowing of more CO2), reduce patients anxiety by remaining calm and at the patients bed...ect. 2, the potential problem of patient not responding to treatment and therefore the patients condition worsening, therefore the nurse must assess and monitor effectiveness of treatment through subjective observation i.e is the patients resuming a more effective breathing pattern, does the patient have retractions or using accessory muscles and objective measures ie. O2 stats, peak flow monitoring after meds, ABG's, ect; patient has actual poblem of knowledge deficit regarding condition and medication, therefore the nurse must educate re. inhaler technique, difference between meds., ie.preventitive meds (Inhaled Corticosteriods) and reliver meds (B2 agonists), importance of taking preventive meds daily (to reduce inflammation in the bonchial tree), and thus controlling asthma more effictively... im wondering if im along the right track here, would really appreciate some feedback

hi all, firstly i want to thank you for taking the time to reply. i have found all of your replies very helpful. so would i be correct to focus on 1.restoring an effective breathing pattern, 2.assessing and monitoring effectiveness of treatment, and 3.patient education prior to discharge for my three nursing priorities??? would these headings be appropiate and worded correctly?? phil:):)

hi all, i have to do an assignment on asthma, I have to provide an accurate discription of the pathophysiologhy, how its diagnosed, medications ect. outline key nursing interventions an indepth analysis of 3 nursing priorities the area im having difficulty with is identifying the nursing priorities? im basing my assignment on a patient experiencing an acute exacerbation of asthma in the emergency department would be really grateful for some help regards phil:lol2: