Patient Case Study: Ineffective Breathing Pattern
1. Ineffective Breathing Pattern r/t decreased lung expansion a.e.b decreased respiratory rate and depth
Outcome: Have patient regain normal breathing pattern of 16 within 6 hours after surgery 11/20/15
Interventions Rationale
Auscultate breathing listening for wheezing or crackles, silence in breathing Wheezing could mean bronchospasms. If there is crackles then she could have liquid in her lungs. Silence in breathing could indicate atelectasis.
Watch respiratory rate and depth, skin color, listen for breath sounds every 15 mins. Able to encourage patient to take deep breathes when, her breathing seems shallow.
Monitor vital signs every 15 mins Change in vitals can be caught right away and could suggest hypoxia if the respiration …show more content…
Impaired Urinary Elimination r/t surgical manipulation a.e.b. sensation of bladder fullness Outcome: Have empty bladder completely without catheter by 11/23/15
Interventions Rationale
Monitor urinary output Will be able to know if she has urinary retention if she has less than 500 in 12 hour period
Provide privacy, run sink Relaxes the perineal muscles and helps with voiding
Encourage good perianal washing Patient will be clean and reduces risk of UTI
Bladder scan if unable to void within the first 4-6 hours after catheter removal Allows the caregiver to see how much urine the patient is retaining
3. Risk for Low Self-Esteem r/t changes in femininity Outcome: Patient will verbalize acceptance of the situation by 11/23/15
Interventions Rationale
Listen to patient concerns and fears Listening will show the patient that I care about her feelings and I will be able to help answer and questions or misunderstanding.
Provide correct information before, after the surgery This will help the patient to put away some fears but knowing the truth of the matter.
Listen for negative talk, or denial during our conversations after surgery I can identify the stages of grief. I will be able to intervene and make her see the positive of getting a
Outcome: Have patient regain normal breathing pattern of 16 within 6 hours after surgery 11/20/15
Interventions Rationale
Auscultate breathing listening for wheezing or crackles, silence in breathing Wheezing could mean bronchospasms. If there is crackles then she could have liquid in her lungs. Silence in breathing could indicate atelectasis.
Watch respiratory rate and depth, skin color, listen for breath sounds every 15 mins. Able to encourage patient to take deep breathes when, her breathing seems shallow.
Monitor vital signs every 15 mins Change in vitals can be caught right away and could suggest hypoxia if the respiration …show more content…
Impaired Urinary Elimination r/t surgical manipulation a.e.b. sensation of bladder fullness Outcome: Have empty bladder completely without catheter by 11/23/15
Interventions Rationale
Monitor urinary output Will be able to know if she has urinary retention if she has less than 500 in 12 hour period
Provide privacy, run sink Relaxes the perineal muscles and helps with voiding
Encourage good perianal washing Patient will be clean and reduces risk of UTI
Bladder scan if unable to void within the first 4-6 hours after catheter removal Allows the caregiver to see how much urine the patient is retaining
3. Risk for Low Self-Esteem r/t changes in femininity Outcome: Patient will verbalize acceptance of the situation by 11/23/15
Interventions Rationale
Listen to patient concerns and fears Listening will show the patient that I care about her feelings and I will be able to help answer and questions or misunderstanding.
Provide correct information before, after the surgery This will help the patient to put away some fears but knowing the truth of the matter.
Listen for negative talk, or denial during our conversations after surgery I can identify the stages of grief. I will be able to intervene and make her see the positive of getting a