IMPAIRED GAS EXCHANGE

TABLE OF CONTENT

BODY CONTENT PAGE

INTRODUCTION 2
DEFINE CONCEPT OF 3
IMPAIRED GAS EXCHANGE

PART A 1.DEFINE NURSING 4-7

PROCESS
2.FIVE COMPONENT OF
NURSING DIAGNOSIS
PART B RELATED FACTOR OF 8
IMPAIRED GAS
EXCHANGE
PART C NURSING CARE PLAN 9
REFERENCES 10
DEFINE THE CONCEPT OF IMPAIRED GAS
EXCHANGE

• Gas exchange is the process by which oxyen is transported to cell and carbon dioxide
is transported from cells.
• Excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-
capillary membrane.Gas is exchanged between the alveoli and the pulmonary
capillaries via diffusion.
• Diffusion of oxygen and carbon dioxide occurs passively, according to their
concentration differences across the alveolar-capillary barrier.
• These concentration differences must be maintained by ventilation (air flow) of the
alveoli and perfusion (blood flow) of the pulmonary capillaries
• .A balance between the two normally exists but certain conditions can alter this
balance, resulting in Impaired Gas Exchange.
• Dead space is the volume of a breath that does not participate in gas exchange.
• It is ventilation without perfusion.
PART A

Definition Of Nursing Process

• it is a systematic,rational method of planning and providing nursing care.its goal is to
identify a client’s health care status and actual or potential health problems to
establish plans to meet the identified needs and to deliver specific nursing
interventions to address those needs(American Nurses Association,2010)
• nursing process is a systemtic method of providing care to clients
• the nursing process is a systematic method of planning and providing individualized
nursing care
Five Components

1.Assessment

• data-gathering activities for the purpose of collecting a complete,relevant database

from which nursing diagnosis can be made
• the data collected establish a baseline and allow the physician and nurse to identify
problems and plan the care

Types of assessment

• Initial assessment
• Problem-focused assessment
• Time-lapsed assessment
• Emergency assessment

Steps In Carrying Out Assement

• Collection
• Verification
• Organization
• Interpretation

2.Nursing Diagnosis

A clinical judgment about an individual , family or community responses to actual and

potential health problems / life processes.

Type of Nursing Diagnosis;

• Actual nursing diagnosis

• Risk nursing diagnosis
• Wellness diagnosis
• Syndromesis
3.Planning

Formulation of the nursing actions in an organized, individualized and goal directed manner.

Importance of writing nursing care plan;

• Communicates nursing care priorities

• Identify and co-ordinates resources
• Organizes information exchanged in change of shift reports
• It enhances the continuity of care

Strategies for effective care planning;

• Clearly communicate the patients care plans to other health care personal
• Establish a realistic nursing care plan with outcomes that are measurable
• Establish outcomes that are future-oriented

4.Implementation

Nursing interventions/Nursing oders (actions) that are listed on the nursing care plan are
carried out

Process Of Implementation
• Ongoing assessment the patient
• Determining the nurse’s need for assistance
• Implementing the nursing interventions
• Supervising the delegated care
• Documenting nursing activities
Skills Required In Implementation
Cognitive skills ( Intellectual skills)
Include problem solving,decision making , critical thinking , creativity and innovative
 Psychomotor skills
• Hands-on skills such as manipulating equipment, giving injections, bandaging,
moving and lifting of patients and etc.

• These are known as procedures, or tasks to be carried out.

Interpersonals skills
• Verbal and nonverbal communication skills
• Interaction between people
• Ability ph the nurse to communicate effectively with others
• Caring, comforting,advocating, sensitive, supportive

5.Evaluation

The making of a judgement about the amount, number, or value of something assessment

Process In Evaluation
• Collecting data released to the desired outcomes
• Comparing the data with outcomes
• Relating nursing interventions to outcomes
• Drawing conclusions about problem status
• Continuing , modifying or terminating the nursing care plan
PART B
Related factor:

1.Related factor of impaired gas exchange:

✓ Altered oxygen supply

✓ Altered oxygen of carring capacity of blood
✓ Alveolur-cappilary membrane changes
✓ Ventilation perfusion imbalance

2.Related to excessive or thick secretions secondary to:

✓ Allergy
✓ Infection
✓ Inflammation smoking

3.Related to treatment;

✓ Anesthesia (general or spinal)

✓ Sedation drug

Defining characteristic :

➢ Abnormal arterial blood gasses

➢ Abnormal breathing (rate depth and rhythm)
➢ Confusion
➢ Restlessnes
PART C

Nursing diagnosis :

1.Impaired gas exchange due to___________.

Goal/Outcome:Patient will demonstrate a normal depth rate and pattern of breathing.

Nursing intervention:

1.Assess patient general condition eg.Alert rate of breathing or early sign difficulty of
breathing.
Rational : to get patient cooperation for next intervention.

2.Monitor patient vital sign and SPO2.

Rational : to detect early any abnormaly like spo2 drop.

3.Administer oxygen therapy like nasal prong 31.

Rational : to increase the oxygen supply to body.

4.Put patient in high fowlers position/prop up the beb.

Rational : to maintain the airway

5.Encourage frequent depth breathing

Rational : to promote optional chest expansion

6.Assist doctor to take Atrial Blood Gasses (ABG)

Rational : as intervention to detect any abnormality like respiratory acidosis

Evaluation : Patient breathing rate normal (12-20 bpm) and patient spo2 is 100%
REFERENCES
1.BOOKS

2.HTTPS;//NURSESLABS.COM/IMPAIRED-GAS-EXCHANGE/

HTTPS;//WWW.SCRIBD.COM/DOC/36105254/NURSING-CARE-PLAN-
IMPAIRED-GAS-EXCHANGE
HTTPS;//WWW.NCBI.NLM.NIH.GOV/PMC/ARTICLES/PMC4547073
3.FROM LECTURER