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    Nursing Care Plan Ineffective Breathing Pattern Hepatic Mass

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    Rheegell Ellar-Fuertes
    Patient PP is a 63-year-old male with a nursing diagnosis of an ineffective breathing pattern related to intra-abdominal fluid collection, as manifested by difficulty breathing when lying supine. The patient's assessment found short, shallow breathing and generalized edema. The plan is for the patient to understand effective breathing patterns and demonstrate behaviors to maintain them within 4 hours. The nurse will assist the patient with repositioning every 2 hours and deep breathing exercises every 2 hours to reduce abdominal pressure and facilitate lung expansion.

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    Nursing Care Plan Ineffective Breathing Pattern Hepatic Mass

    Uploaded by

    Rheegell Ellar-Fuertes
    2K views2 pages
    Patient PP is a 63-year-old male with a nursing diagnosis of an ineffective breathing pattern related to intra-abdominal fluid collection, as manifested by difficulty breathing when lying supine. The patient's assessment found short, shallow breathing and generalized edema. The plan is for the patient to understand effective breathing patterns and demonstrate behaviors to maintain them within 4 hours. The nurse will assist the patient with repositioning every 2 hours and deep breathing exercises every 2 hours to reduce abdominal pressure and facilitate lung expansion.

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    hepatic mass

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    Patient PP is a 63-year-old male with a nursing diagnosis of an ineffective breathing pattern related to intra-abdominal fluid collection, as manifested by difficulty breathing when lying supine. The patient's assessment found short, shallow breathing and generalized edema. The plan is for the patient to understand effective breathing patterns and demonstrate behaviors to maintain them within 4 hours. The nurse will assist the patient with repositioning every 2 hours and deep breathing exercises every 2 hours to reduce abdominal pressure and facilitate lung expansion.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    2K views2 pages

    Nursing Care Plan Ineffective Breathing Pattern Hepatic Mass

    Uploaded by

    Rheegell Ellar-Fuertes
    Patient PP is a 63-year-old male with a nursing diagnosis of an ineffective breathing pattern related to intra-abdominal fluid collection, as manifested by difficulty breathing when lying supine. The patient's assessment found short, shallow breathing and generalized edema. The plan is for the patient to understand effective breathing patterns and demonstrate behaviors to maintain them within 4 hours. The nurse will assist the patient with repositioning every 2 hours and deep breathing exercises every 2 hours to reduce abdominal pressure and facilitate lung expansion.

    Copyright:

    © All Rights Reserved
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    Nursing Care Plan

    Name of patient : PP Sex: M Age: 63 Nursing Diagnosis: Ineffective breathing pattern related to intra abdominal fluid collection as manifested by difficulty of breathing in supine
    lying position .

    ASSESSMENT Su#$e%ti&e: Medyo hirap a o huminga lalo na apag na ahiga.!

    NURSING DIAGNOSIS Ineffective breathing pattern related to intra abdominal fluid collection as manifested by .

    ANAL SIS ;iver dysfunction Inability of the liver to metaboli8e fat< protein< and carbohydrates. $rotein(albumin deficiency.

    PLANNING S'ort Term: After & hour of nursing intervention the client 5ill: "erbali8e understanding of the importance of effective breathing pattern 3emonstrate behaviour that 5ill help maintain effective respiratory pattern.

    IMPLEMENTATION Independent: 3etermine clientAs readiness and barriers to learning.

    RATIONALE !OR NURSING INTER"ENTION Individual may not be physically< emotionally< or mentally capable at this time. >or the client to further understand his condition and the nurse and client to be on the same phase. +apid shallo5 respiratory may be present due to fluid accumulation in the abdomen. >acilitates breathing by reducing pressure on the diaphragm and minimi8es ris s of aspiration of secretions. 0o practice the right 5ay and aids in lung expansion. Aids in lung expansion and mobili8ing secretions.

    E"ALUATION

    O#$e%ti&e: "ital Signs #$ % &3'()' mm*g ++ % ,- cpm $+ % ./ bpm 0 % 31. ' degrees 2elsius 3yspnea S4# Shallo5 breathing 6asal flaring 4rthopnea Abdominal girth ), cm 7enerali8ed edema 9Induration : , left : 3 right 9presence of ascitis and pitting edema

    Movement of albumin from the serum to the peritoneal cavity. 3ecreased serum osmotic pressure. =scape of fluid in the extracellular space. >luid accumulation in the peritoneal spaces. S(Sx: Acites( generali8ed edema ?:,;< :3+@ o Increase Abdominal 7irth 3iaphragm is compressed o

    =ducate the client about current condition

    Monitor respiratory rate< depth< and effort.

    7oal met After & hours of nursing intervention the client 5as able to verbali8ed understanding of the importance of effective breathing pattern and demonstrated behaviours that 5ill help maintain effective respiratory pattern. At the end of the shift the client 5as able to maintain effective respiratory pattern.

    Long Term: At the end of the shift the client 5ill: Maintain effective respiratory pattern.

    Beep head of the bed elevated or position on sides.

    =ducate the client about proper deep breathing exercise.

    =ncourage freCuent repositioning and deep9breathing exercise as appropriate.

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