lala1016

As I am writing the case study I am still torn. I think the client has Impaired Gas Exchange r/t ventilation-perfusion inequality aebabnormal breathing, cyanosis, tachycardia, hypoxemia, and dyspnea, but I also think the patient has Ineffective Airway Clearance r/t COPD aeb crackling and wheezing lung sounds and cyanosis. But which one should I start intervening on first?

Thank you so much! That was really helpful!

Thank you so much. I think I am going to go with the Impaired Gas Exchange. As far as the "hyperplasia of the bronchial walls," I got that from my book. I am not absolutely sure it is correct for this patient myself. That is something I would have confirmed before using it.

hi all, i am a new nursing student and new to this site. i am working on my first case study, and i am having a hard time deciding on the diagnosis. i know i am close, but i am such a perfectionist that my uncetainty is driving me nuts. i can not make a decision unless i am absolutely sure. i have spent countless hours on this trying to decide, so needless to say my time-managment is not going well. i will take any help i can get. the case is as follows: case scenario "i can't breathe." morrie gasped for breath. "help me."morrie looked up at you, his nurse, with eyes filled with fear. he raised thehead of the bed farther with the control and continued to gasp for breath. youcould feel your own anxiety increasing; it felt like morrie's anxiety wascontagious. you pushed the overbed table so morrie could lean forward on it,sat on his bed, and worked with him to do pursed lip breathing and slow hisbreathing. you have given him all the medications that he could have. and youprayed he would get better. nursing assessment morrie has chronic obstructive pulmonary disease (copd).he has been suffering for 5 years and is frequently a client on the respiratorynursing unit. he stopped smoking once diagnosed, but unfortunately still has significantlung disease. his vital signs are: 180/92-100.2-116, 28. his lungsounds are wheezing, with loud crackles throughout. the oxygensaturation is 84. he has oxygen per venture mask. his toes and fingersare cyanotic, as well as his oral mucous membranes. based on this information i grouped the significant symtoms and with the help of my nursing diagnosis handbook, came up with the possible diagnosises of ineffective airway clearance, imparied gas exchange, and ineffective breathing patterns. after that i am asked to give a complete diagnosis with the "related to" and "aeb". i can not decide whether to use impaired gas exchange r/t ventilation-perfusioninequality aeb abnormal breathing, cyanosis, tachycardia, hypoxemia, anddyspnea, or ineffective airway clearance r/t hyperplasia of the bronchial walls and asthma aeb adventitous breath sounds, cyanosis, and dyspnea. i realize that both might apply to the patient, but i need to pick the one that is most accurate/ more serious. which diagnosis is it most likely to be with the senerio?

Congrats! I found out on Feb 14 that I will be starting this summer too! I am very excited and nervous at the same time! What state is your program in?

I say take A&PI and Chem together, and A&PII with Micro...I took A&PII with Micro and got A's in both classes, so very doable! Chem will also help a little with the A&P's. HTH :)

I have not started the Nursing Program yet. I start in May, and I am so excited! Anyways, I have been attending full-time classes obtaining my AA and getting my pre reqs finished with three small children. I have had one semester when I felt like this. I lost my motivation and even disliked one of my professor's who made the class so boring, but all of these feelings passed. As soon as the semester was over and I had that little break in between, I was ready to start the next semester and haven't felt that way again. I hope this helps. I say keep pulling through this semester. It will get better!

Lola, I too have children, ages 2,3, and soon to be 5. I start the ASN Program in May! I am nervous as to how it will work out, so I am very interested in responses you get on this post. If you would like, once I get my plans in place, I will let you know how my schedule will be. It is just me and my husband making it happen, and he has to work full-time. I suppose we will have a babysitter 1-2 days a week. :)