Week 8 Flashcards
Examples of role-relationships NANDA dx
Risk for impaired attachments
Caregiver role strain
Grieving
Interrupted family process
Social isolation
spiritual well being
Faith: cultural or institutional religion, belief in something, enables action
Religion: Specific system of practices assoc. w/ form of worship
Spiritual problems
Acute illness
Chronic illness
Terminal illness
Near-death experience
Spiritual interventions
Health promotion: establish presence, trust, support
Acute care: identify support system, diet therapy, supportive rituals
Restorative care and continuing care: prayer/meditation
Spiritual evaluation
Success=increased/restored sense of connectedness
Conditions that affect air movement
Eupnea Tachypnea Bradypnea Apnea Hypercarbnia/capnia
Conditions that affect diffusion
Hypoxemia
Hypoxia
Cyanosis
Biots respirations
4-5 irregular breaths then a period of apnea
Complete vs partial respiratory function
alteration
complete: No chest movement, unable to speak
Partial: low snoring, retractions, inspiratory stridor, restlessness, dyspnea
Throat culture collection
Collect culture before antibiotics
Depress tongue, swab posterior wall of throat
Avoid antiseptic mouthwash before
Avoid touching any other mouth area
Two swabs preferred
Nursing respiratory diagnoses
Ineffective airway clearance
Inffective breathing pattern
Impaired gas exchange
Activity intolerance
Respiratory planning
Maintain patent airway
Improve ease of breathing
Maintain ability to take part in activities
Prevent risks associated with O2 problems
Nursing positioning interventions respiratory
Positioning: semi or high fowlers
Orthopenic/tripod position
Turn every two hours, sit up/out of bed
Ambulation
Nursing hydration/medication interventions respiratory
Humidifiers
Bronchodilators
anti-inflammatory
Leukotriene modifiers
Expectorant
Cough suppressant
Pursed lip breathing used for
COPD
