- The nurse would know to include questions about respiratory status, appetite and weight gain, activity tolerance, need for pulmonary or pancreatic medications, fever, and bone state.
- The nurse would observe the child’s appearance and color, check the nasal passages for polyps, check for crackling and wheezing in breathing, and analyze the sputum for quality and quantity.
- The nurse would expect a sweat chloride test, pulse oximetry, a chest radiograph, and pulmonary function tests to be ordered.
Medical Diagnosis: Cystic fibrosis
- Definition of medical diagnosis: an inherited disorder that impedes lung function. Etiology/pathophysiology: changes in epithelial ion transport on mucosal surfaces leading to thickened secretions.
- Common sign/symptoms Airway obstructions, clubbing, nasal polyps.
- Potential complications Bronchiectasis, hemoptysis, pneumothorax.
- Expected assessment findings: Head to toe assessment Barrel chest, wheezing, tachycardia, hyper-resonance during percussion.
- Diagnostic studies/labs sweat chloride test, chest radiograph. Normal values <29 mmol/l, no abnormalities Expected abnormalities >50 mmol/l, hyperinflation, atelectasis.
- All NANDA Nursing Diagnoses Ineffective child eating dynamics, Impaired gas exchange, Ineffective breathing pattern.
- Develop 3 NANDA Priority Nursing diagnosis Nursing Diagnoses Ineffective child eating dynamics, Impaired gas exchange, Ineffective breathing pattern.
- State patient goals/plan improve pulmonary function, prevent infection, facilitate growth nursing diagnosis Cystic Fibrosis.
- Write interventions for your plan medication, chest physiotherapy, family education.
- Scientific rationale for interventions The condition is incurable, so it is necessary to focus on healthy growth.
- Write how you would evaluate your plan Frequency of respiratory episodes in the patient what potentially may need revision medications, therapies.
- List of medications typical for cystic fibrosis medical diagnosis Pulmozyme, pancreatic enzymes, antibiotics usual dosage one 2.5 mg ampule a day, depends, depends side effect chest pain, coughing, runny nose; various; various educational considerations teach parents to provide interventions, teach child breathing exercises.
- The nurse would teach the family about the importance of maintenance during non-severe periods, the use of nebulizers and similar tools, and asthma management action plans.
- Asthma can damage a child’s self-esteem because they feel different from peers and fear an exacerbation.
Medical Diagnosis: Asthma
- Definition of medical diagnosis: a long-term lung condition. Etiology/pathophysiology: airways are inflamed, leading to higher activity and a variety of adverse responses following a trigger.
- Common sign/symptoms Shortness of breath, chest pain, wheezing when exhaling.
- Potential complications Sleep interference, bronchial tube narrowing.
- Expected assessment findings: Head to toe assessment Cyanosis, variable breathing, wheezing.
- Diagnostic studies/labs pulse oximetry, chest radiograph, blood gases test. Normal values >89%, no abnormalities, normal readings. Expected abnormalities <89%, hyperinflation, carbon dioxide retention, hypoxemia.
- All NANDA Nursing Diagnoses Impaired gas exchange, Ineffective breathing pattern, Disturbed sleep pattern, Risk for activity intolerance, Risk for situational low self-esteem
- Develop 3 NANDA Priority Nursing diagnosis Nursing Diagnoses Impaired gas exchange, Ineffective breathing pattern, Risk for activity intolerance.
- State patient goals/plan Restoring clear airway and normal breathing, promoting adequate oxygenation and ventilation nursing diagnosis Asthma.
- Write interventions for your plan medication, family education.
- Scientific rationale for interventions The patient will need to maintain their condition, resorting to medicine when it worsens.
- Write how you would evaluate your plan Frequency of acute periods in the patient what potentially may need revision Education topics.
- List of medications typical for asthma medical diagnosis Albuterol, flunisolide usual dosage 1 or 2 inhalations every 4-6 hours, 1inhalation twice a day side effect shakiness in the legs; pain, cough, throat soreness educational considerations Teach parents to provide preventative care, help maintain child’s self-esteem