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Emerson Fletcher

Peds Concept Map

Key Problem: Activity
intolerance:
Supporting data:
Key Problem: ineffective Key Problem: impaired gas
Inability to do strenuous exercise
airway clearance exchange:
Inability to move around without
Supporting data: Supporting data
being out of breath
Retractions O2 90%
Tired appearance
Labored breathing HOB elevated
Lethargy
Productive cough Sub clavicular retractions
Inability to eat
Expiratory wheezes present Albuterol q4
Prolonged dyspnea
Restlessness Isolation
Crying
Clammy skin Expiratory wheezes
irritability
Fatigue Heart rate 145
Reduced tolerance to Nasal suction PRN
activity Key Problem: Deficient
knowledge:
Supporting data:
Key Problem: Ineffective Meds
breathing pattern: Reason For Needing Health Care Times of treatments
Supporting data: Asthma: Use of equipment
Productive cough Key assessment: Pulse ox reading
Dyspnea Lung sounds When seek medical advice
Prolonged expiration Pulse Ox Assess past and present
Retractions Resp rate/ effort therapies including client
Respiratory depth changes O2 status response to them
Lung sounds Wheezing Ability to distinguish
Fatigue Trouble sleeping between rescue meds and
RR 40 controllers
s/s of resp distress

Key Problem: Interrupted

family process Key Problem: Fatigue Key Problem: Health
Supporting data: Supported data: seeking behaviors:
Parental stress Falling asleep in mom’s Prevention of asthma
Excessive parental worry arms attack
Parental overprotectiveness Hard to arouse Supported evidence:
Trouble bre
Little parental involvement Irritable when awake Teaching s/s of asthma
with nurse/ nursing student Crying attack
Parental anxiety Tired eyes patient stated triggers
Fatigue No appetite albuterol on hand
Little parental Restless took all medications as
communication ordered
Ineffective coping
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Problem # ____1___: Ineffective Breathing Pattern

General Goal: Patients respiratory rate and pulse Ox % will increase

Predicted Behavioral Outcome Objective (s): The patient will maintain maximum position for
effective breathing

Nursing Interventions Patient Responses

1. Encourage rest 1. Patient will rest and limit activity to help overall breathing
2. Expiratory activities 2. Patient will strengthen lungs
3. Maintain clear airway 3. Use suctioning to prevent aspiration
4. Encourage cough 4. Break up mucous secretions

Evaluation of outcomes objectives: Patient’s respiration and O2 & increases to maintain a clear airway and
effective breathing pattern.

Problem # ________2_________: Ineffective airway clearance

General Goal: patient will maintain clean and open airways

Predicted Behavioral Outcome Objective (s): The patient will have normal lung sounds and
depth of respirations.

Nursing Interventions Patient Responses

1. Patient position upright with elevated HOB 1. Elevated positioning promoted better / more efficient breathing
2. Take Albuterol when scheduled 2. Albuterol opens patients’ airways
3. Teach proper breathing 3. Take deep breaths and hold for up to 2-3 seconds
4. Use incentive spirometry when needed 4. Promotes better lung expansion

Evaluation of outcomes objectives: Patient will be able to maintain clear airway clearance by proper breathing
techniques and keeping an upright position.
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Problem # ____3___: Impaired gas exchange

General Goal: Patient remains free of signs of respiratory distress

Predicted Behavioral Outcome Objective (s): The patient will verbalize understanding
therapeutic and pharmacological interventions, or depending on the age, parents will.

Nursing Interventions Patient Responses

1. Elevate HOB 1. Makes it easier for patient to breathe

2. Encourage movement as long as Dr gives the okay 2. Patient will do activities with supervision
3. Maintain a sitting up position 3. Patient will maintain clear airway so its easier to breathe
4. Encourage deep breathing 4. Patient will breathe slowly and use devices as needed

Evaluation of outcomes objectives: Patient was able to improve breathing throughout shift when following
medication regimens, Doctor’s orders, and breathing techniques.
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Problem # ____4___: Interrupted family process

General Goal: Patient and family will feel more comfortable and stress relieved.

Predicted Behavioral Outcome Objective (s): Family will demonstrate acceptance, adjustment,
and coping behaviors related to the symptoms and effects of asthma.

Nursing Interventions Patient Responses

1. Provide support to the family 1. Allows patient and family to open up

2. Provide clear & accurate information 2. Relives patient and family stress
3. Implement a home care plan 3. Implementing at hospital will strengthen plan when going home
4. Assist family to explore feelings 4. Validates normalcy of their feelings

Evaluation of outcomes objectives: Patients family members felt more comfortable with patients’ medication
regimen and asking questions to further any misunderstandings.

Problem # ____5___: Activity Intolerance

General Goal: Patient is able to participate in daily activities without distress

Predicted Behavioral Outcome Objective (s): The patient will engage in normal activities with
absence of fatigue

Nursing Interventions Patient Responses

1. Encourage activities such as quiet play, reading, etc 1. Avoids changes in patients s resp status while allowing play
2. Disturb only when necessary 2. Patient will conserve more energy if resting
3. Schedule rest periods 3. Promotes adequate rest and decreases stimuli
4. Help with ADL’s 4. Conserve patients’ energy

Evaluation of outcomes objectives: Patient was more alert and awake when allowed periods of rest, which
overall improves functioning.
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Problem # ________6_________: Deficient Knowledge

General Goal: Improve understanding of disease

Predicted Behavioral Outcome Objective (s): Patient and family will verbalize understanding of
the disease and the resources available to them.

Nursing Interventions Patient Responses

1. Avoid asthma triggers 1. Avoiding triggers can lessen the frequency of asthma attacks
2. Review medication regimen 2. Patient will have a better understanding of the reasoning behind ordered medications
3. Discuss the use of medical alert bracelet 3. This allows patient to alert others if an emergency occurs
4. Keep emergency phone numbers on hand 4. This will help patient seek immediate medical attention

Evaluation of outcomes objectives: Patient and family were able to make future plans to make sure child is
safe at all times if an emergency were to happen.

Problem # ________7_________: Fatigue

General Goal: Preform daily activities without irritability

Predicted Behavioral Outcome Objective (s): Patient will demonstrate decreased fatigue as
evidenced by less irritability and restlessness.

Nursing Interventions Patient Responses

1. Allow family member support 1. This minimizes patients’ anxiety and fear which can decrease fatigue
2. Provide quiet environment 2. Encourages patient rest and lessens O2 consumption
3. Encourage simple activities 3. Encourages patient relaxation and emotional comfort
4. Schedule nursing care to allow rest periods 4. Lessens fatigue for patients when allowing them to rest
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Evaluation of outcomes objectives: Patient was less irritable when allowed to sleep without being disturbed.

Problem # ________8_________: Health seeking behaviors: prevention of asthma attack

General Goal: patient will verbalize understanding of asthma triggers

Predicted Behavioral Outcome Objective (s): Patient and family will verbalize understanding of
triggering agents and prevention measures for asthma attacks

Nursing Interventions Patient Responses

1. Teach proper handwashing techniques 1. Avoids transfer of bacteria from touching other supplies or humans to avoid
triggers
2. Encourage breathing exercises 2. Prevents attacks before it begins and increases
ventilation
3. Discuss s/s of an attack 3. Teaches the actions that can be used to prevent sever attacks
4. Teach patient and family about medication administration 4. Promotes compliance to maintain wellness

Evaluation of outcomes objectives: Patient and family were able to identify triggers and medications needed if
an attack occurred.