Nursing Diagnosis : Impaired Gas Exchange - Nursing Care Plan for Bronchitis
Impaired Gas Exchange related to ventilation-perfusion inequality.
Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. Bronchitis can be divided into two categories, acute and chronic, each of which has two distinct etiologies, pathologies, and therapies.
Acute bronchitis is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated (coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis, whereas bacteria account for fewer than 10%.
Chronic bronchitis, a type of chronic obstructive pulmonary disease, is characterized by the presence of a productive cough that lasts for three months or more per year for at least two years. Chronic bronchitis most often develops due to recurrent injury to the airways caused by inhaled irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants.
Nursing Diagnosis : Impaired Gas Exchange - Nursing Care Plan for Bronchitis
Goal: Demonstrate improved ventilation and adequate oxygenation of tissues with blood gas analysis in the normal range and free of symptoms of respiratory distress.
Nursing Interventions - Impaired Gas Exchange related to Bronchitis:
1. Assess the frequency, depth of breathing. Note the use of accessory muscles, mouth breathing, inability to speak / talk.
R / useful in the evaluation of the degree of respiratory distress and / or chronic disease process.
2) Elevate head of bed, help patients to choose a position that is easy to breathe. Encourage deep breath or breathing lips slowly as needed / individual tolerance.
R / oxygen delivery can be improved by a high seating position and breathing exercises to reduce airway collapse, dyspnea, and breath work.
3) Provide appropriate bronchodilator required. Can be administered orally, IV, rectal, or inhaled. Give oral bronchodilators or IV at the time interspersed with the action nebulizer, metered dose inhalers to extend the effectiveness of the drug. Observation of side effects: tachycardia, dysrhythmias, CNS excitation, nausea and vomiting.
R / Bronchodilators dilate the airway and helps fight the bronchial mucosal edema and muscular spasm. Because side effects can occur in this action, carefully adjusted doses for each patient, according to tolerance and clinical response.
4) Evaluate the effectiveness of the actions nebulizer, metered dose inhalers. Assess decrease shortness of breath, wheezing or crackles drop, looseness secretion, decreased anxiety. Make sure that the action is given before meals to prevent nausea and to reduce the fatigue that accompanies feeding activity.
R / Combining medication with a nebulizer aerosolized bronchodilator commonly used to control bronchoconstriction. Providing appropriate actions will reduce its effectiveness. Aerolisation ease bronchial clearance, help control the inflammatory process, and improve the function of ventilation.
5) Instruct and encourage the patient on diaphragmatic breathing and effective coughing.
R / techniques improve ventilation by opening the airway and clearing the airway of sputum. Improvement of gas exchange.
6) Provide supplemental oxygen in accordance with the indications of blood gas analysis results and patient tolerance.
R / can fix / prevent worsening hypoxia.
