NurseTogether.com does not provide medical advice, diagnosis, or treatment. Read theprivacy policyandterms and conditions. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), The Methodology of the Social Sciences (Max Weber), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Psychology (David G. Myers; C. Nathan DeWall), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Give Me Liberty! Collect client history, including risk factors and symptoms (objective and subjective data), Client is recovering from a bypass surgery 3 days ago and is currently admitted in the ICU. Impaired gas exchange can manifest with a variety of signs and symptoms. It deals with retained secretions and also takes into account the risks and problems associated with pulmonary inflammation. Continue with Recommended Cookies. Encourage frequent #2 Sample Pulmonary Embolism Nursing Care Plan - Impaired gas exchange Nursing Assessment Subjective Data: The patient complains of fatigue, shortness of breath, and chest pain Objective Data: The patient's SPO2 is 89% on 4L nasal cannula His fingers and lips are cyanotic Right heart strain shown on EKG Nursing Diagnosis High concentrations of oxygen should typically be avoided for patients with COPD. Pursed lip breathing and deep breathing exercises also prevents atelectasis or lung collapse. Respiratory System Crackles in all lung fields Diminished Impaired gas exchange related to smoking as evidenced by dyspnea, crackles all lung fields, and oxygen . causing the problem, PROBLEM-NURSING (relevant medical orders, comfort This air travels through airways that gradually get smaller until it reaches the alveoli. While we currently use primarily office automation tools to record service activity and generate related reports for our industrial services business, we are exploring the use of an electronic . Oxygen therapy will increase the supply of oxygen presently demanded by the body, Assist patient with ADLs as needed; Provide physical therapy exercises; Implement cardiac rehabilitation program and activity plan, These interventions will assist the patient with completing activities and will help to build the patients strength and endurance back to baseline, Using 3 pillows to sleep at night (increase from usual 1 pillow), Decreased activity level due to shortness of breath, Tachypneic, respiratory rate of 30 breaths/minute. Achievable, Realistic, Timeable, Prioritized INTERVENTIONS: He has a known history of hypertension and heart failure. Lung expansion is also achieved in doing these nursing interventions. How do you develop a nursing care plan? numerous . All rights reserved. an appropriate diagnostic statement from the information you gave would be impaired gas exchange r/t ventilation perfusion imbalance secondary to cf aeb hypoxia, hypercapnia, restlessness, and irritability. Assess the patients vital signs, especially the respiratory rate and depth. The patient has a history of obstruction sleep apnea and states (when awake) she does not wear her CPAP machine at night because it is too loud. When you breathe in, your lungs expand and air enters through your nose and mouth. Care Plans are often developed in different formats. such as monitor, assess, observe or To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. Treatment for hypercapnia involves noninvasive ventilation therapy, often called BiPAP, which is the name of a brand of ventilation therapy machine. Patient reports feeling weak and fatigued. When you breathe out, the lungs deflate, pushing carbon dioxide up through your airways where it exits your body through your nose and mouth. Overall, treatment for COPD with impaired gas exchange focuses on reducing symptoms and slowing disease progression. Methods:This is a prospective observational study in very preterm infants. Enter your email address below and hit "Submit" to receive free email updates and nursing tips. ancillary services) INTERVENTIONS Smoking cigarettes is the most important risk factor for COPD. Impaired gas exchange in COPD can cause symptoms like shortness of breath, coughing, and fatigue. -Pt will verbalize 4 benefits of wearing a CPAP machine at home when she sleeps. What nursing care plan book do you recommend helping you develop a nursing care plan? This book continues to stand out in the field for its strategic approach, solid research base, comprehensive range of topics, even-handed examination of oral and written channels, and focus on managerial, not entry-level, competencies. The following diagnoses are usually made when caring for patients with pneumonia: Impaired gas exchange Ineffective airway clearance Ineffective breathing pattern Knowledge deficit/Deficient knowledge Activity intolerance Risk for infection Risk for nutritional imbalance: less than body requirements Impaired gas exchange can result from any condition that compromises a patients airway, blood flow, or respiratory effectiveness. Encourage the patient to cough to expectorate any sputum. All Rights Reserved. Encourage pursed lip breathing and deep breathing exercises. C. Patient will have The free nursing care plan example below includes the following conditions: Ineffective Gas Exchange, Ineffective Airway Clearance, Pneumonia, COPD, Emphysema, & Common Cold. He states he is now only able to ambulate 1 block before needing to stop and rest whereas in the past he could walk half a mile. In addition to her hospital and trauma center experience, Shelly has also worked in post-acute, long-term, and outpatient settings. As a nurse, you will either follow doctors' orders for nursing interventions or develop them yourself using evidence-based practice guidelines. Vital Signs: BP 120/80, HR 80, O2 Sat 87% on room air, Temp. Physiological impairment in mild COPD. The nurse notes dyspnea upon minimal excretion with position changes. A non-cardiogenic process brought on by injury to the lung or a cardiogenic process brought on by an inability to remove enough blood from the lungs must be identified for appropriate treatment. Reports of sudden extreme dyspnea/air hunger, Head and bed elevation 20-30 degrees, semi-Fowlers position to reduce oxygen consumption and to promote maximal lung inflation, Engaging client in therapy regimen as it may enhance sense of control and cooperation with restrictions, Gradual increase in activity as allowed and tolerated. Administer appropriate reversal agents as ordered. SATISFY THE OUTCOME The patient is a current smoker and has been since she was 19 years old. Lab and Diagnostic work shows: WBC 30,000 and chest x-ray preliminary results show possible bilateral lower lobe pneumonia. As an Amazon Associate I earn from qualifying purchases. 2. Assessment B. s erm In 2 days, the patient will Patient verbalizes understanding of oxygen and other therapeutic interventions. Others can include: Tests can help to detect and diagnose impaired gas exchange in COPD. During BiPAP, you wear a mask that provides a continuous flow of air into the lungs, creating positive pressure and helping the lungs expand and stay expanded longer. Learn more. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Close monitoring of types of food and drinks is also important. This will also help to determine if additional medications are warranted or dosage adjustments need to be made. Diastolic heart failure means the heart is unable to relax fully between heartbeats and allows the appropriate amount of blood into the ventricle. Breath sounds can help determine or confirm the cause of impaired gas exchange. Bipap ordered with the following settings Ipap 20, Epap 8, Oxygen Percentage 30%, Rate 12. Diseases that affect the ability for blood to carry oxygen can also result in impaired gas exchange. This can prevent airway collapse, Pillows to support elevated position and support for arms, Supportive therapy to decrease chest and abdominal discomfort and pain if present, Assistance with positive airway pressure techniques-CPAP, BiPAP, PEP device, Assure breathing deeply will not dislodge tubes or cause wound opening, Diuretics, bronchodilators, antibiotics, steroids, pain medications, anticoagulants. Monitor the patients level of consciousness and changes in mentation. This website provides entertainment value only, not medical advice or nursing protocols. This limits 1. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Otherwise, scroll down to view this completed care plan. Learn causes for heavy breathing, including heavy breathing in sleep, plus treatments for these conditions. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. Some mechanisms behind impaired gas exchange in COPD can include one or a combination of the following: When gas exchange is impaired, you cannot effectively get enough oxygen or rid your body of carbon dioxide. Client mentions that he is starting to experience shortness of breath and has a hard time taking a deep breath Client states he feels lightheaded while in bed and has a constant headache. EKG Rhythms | ECG Heart Rhythms Explained - Comprehensive NCLEX Review, Simple Anatomy Quiz Most Nurses Get WRONG! RECOGNIZE/ANALYZE CUES Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. Impaired gas exchange related to inadequate surfactant levels and immaturity of pulmonary system Planning and Expected Outcomes : - The infant will suffer minimal respiratory distress syndrome, with reduced work of breathing and no morbidity. Lets examine how it works. Assess the patients vital signs, especially the respiratory rate and depth. -The nurse will verbalize 5 benefits of the pneumococcal vaccine to the patient within 24 hours. limits. A 74-year old Hispanic male presents to the Emergency Department with complaints of increased dyspnea, reduced activity tolerance, ankle swelling, and weight gain in recent days. Compared to those with normal blood oxygen levels, those with hypoxemia had greater declines in 5-year quality of life. Impaired gas exchange r/t alveolar-capillary membrane changes AEB chest x-ray suggesting possible area of consolidation in the right lower lobe Acute Confusion r/t situational crisis AEB restlessness, irritability, and agitation. Three nursing diagnosesineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (ICE)were among the most frequently used, yet no reported clinical studies validated the defining characteristics of these diagnoses. However, his breathing is compromised due to excessive fluid. Appropriate breathing and coughing techniques mobilize secretions and increase air exchange and oxygenation. (2011). required for EACH Patient exhibited dyspnea on ambulation from stretcher to bed. However, in COPD, these structures have become damaged. The consent submitted will only be used for data processing originating from this website. F.A. Providing proper patient education is key for these patients to support them in understanding their condition and diagnosis. This will be a closely watched data point as it provides insight into the health of the US labor market. Provide reassurance and assess for increased. The patient is a current smoker and has been since she was 19 years old. Buy on Amazon, Gulanick, M., & Myers, J. L. (2017). NURSING DIAGNOSIS Chronic obstructive pulmonary disease. The data is expected to improve slightly to 51.9. (Signs) Adventitious breath sounds (i.e., crackles, rhonchi, wheezes) restful environment. -The nurse will teach the patient 3 signs and symptoms that indicate PCO2 level may be high and when to contact her md. Do not treat a patient based on this care plan. Administer 2 liters per minute of oxygen through a nasal cannula as ordered. Scope and Categories: Scope: Gas exchange is the process by which oxygenated air enters the respiratory tract, flows into the lungs, and is transported to the cells. Anna Curran. What are nursing care plans? All vital signs Encourage the patient to cough to expectorate thick sputum. Systolic heart failure means the heart is not able to contract completely and affects its ability to pump blood out of the heart. When collecting primary subjective data, which is an appropriate source for the nurse to use? These are the tiny air sacs in your lungs where gas exchange occurs. Impaired Gas Exchange is a NANDA nursing diagnosis that is used for conditions where there is an alteration in the balance between the exchange of gases in the lungs. Assessments, Administering, Short-term goal To increase oxygen saturation 92% prior to transfer from ED and admission to hospital floor unit Nursing Interventions with Rationales The formatting isnt always important, and care plan formatting may vary among different nursing schools or medical jobs. Early intervention is recommended to prevent total decompensation. Administer supplemental oxygen, as prescribed. Never position him/her on the operative side. All Rights Reserved. Impaired gas exchange Increased work of breathing Increased airway resistance Alveolar hyperplasia . Youll breathe in supplemental oxygen through a nasal cannula or a mask. Pt is oriented times 4 though. Impaired gas exchange in COPD can cause symptoms like shortness of breath, coughing, and fatigue. (2016). Objective Data Physical Assessment General condition: awake, weak looking, on mild-cardiorespiratory distress. Nursing Diagnosis: Impaired Gas Exchange related to transient tachypnea of the newborn (TTN) as evidenced by shortness of breath, fast and labored breathing and oxygen saturation of 88% The main assessment findings the nurse should be aware of for this patient begin with his vital signs, all of which are listed are abnormal. Chronic obstructive pulmonary disease compensatory measures. These conditions impact the lungs in different ways. Manage Settings The patient is excessively sleepy and falls asleep easily even with stimuli. Hypercapnia: What Is It and How Is It Treated? What are the risk factors for developing impaired gas exchange and COPD? To reduce the risk of drying out the lungs. The patient is to be admitted to the hospital for Acute Exacerbation of Congestive Heart Failure (CHF). Impaired gas exchange occurs due to alveolar-capillary membrane changes, such as fluid shifts and fluid collection into interstitial space and alveoli. Therefore, that becomes the priority for the patient and the nurse should begin by improving his oxygen saturation and breathing status. Pt family member tells you that the patient has been sleeping constantly for 2 weeks. Your FEV1 result can be used to determine how severe your COPD is. positioning Patient is experiencing difficulty of breathing related to impaired gas exchange as evidenced by breathing using accessory muscles, restlessness, diaphoretic, feeling lightheaded also abnormal temperature, SpO2, BP, HR, RR, 2. Acute exacerbations of this chronic condition can also be very common especially if an individual is not following or is unaware of the appropriate guidelines and recommendations. demonstrating, performing treatments, optimal chest Upon physical assessment his breathing is shallow and labored, respiratory rate is 30 breaths per minute, heart rate 115 beats per minute, oxygen saturation 83% on room air, blood pressure 179/98 mm Hg, he has +4 pitting edema in bilateral lower extremities, and crackles are heard in his lung fields throughout. airways or alveoli that have lost elasticity and cannot expand and deflate to their full capacity when you breathe in and out, alveoli walls that have been destroyed, leading to reduced surface area for gas exchange, long-term inflammation thats led to thickening of the airway walls, airways that have become clogged with thick mucus, pipe, cigar, or other kinds of tobacco smoke. Pt family member tells you that the patient has been sleeping constantly for 2 weeks. Ventilation is improved if the airway remains patent through frequent positioning. (2014). 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UNIVERSITY OF SOUTH ALABAMA At the same time as oxygen is moving into the blood, carbon dioxide moves from the blood into the alveoli. Adhering to your treatment plan can help improve outlook and boost quality of life. Enter the email address you signed up with and we'll email you a reset link. Impaired Gas Exchange Diagnoses: Chronic Bronchitis (COPD) Problem Identified: Impaired Gas exchange Nursing Diagnoses: Impaired Gas Exchange r/t altered oxygen supplyobstruction. thefabulousmrst 22 Posts Specializes in NICU. Impaired gas exchange - RECOGNIZE CUES ASSESSEMENT (Subjective/Objective Data pertinent only to the - StuDocu university of south alabama college of nursing usa con: nursing plan of care ahn448 recognize cues cues assessement data pertinent only to the nursing Introducing Ask an Expert DismissTry Ask an Expert Ask an Expert Sign inRegister Congestive heart failure is a chronic condition that can progress over time. Use a continuous pulse oximeter to monitor oxygen saturation. 2005-2023 Healthline Media a Red Ventures Company. Nursing Interventions: Teach patient how to use incentive spirometer, pain medication to support deep breathing, ambulate 3x/day, encourage patient to cough/deep breathe, assess O2 saturation, assess lung sounds. These include things like heart disease, pulmonary hypertension, and lung cancer. Impaired Gas Exchange r/t ventilation-perfusion imbalance (atelectasis & anemia) aeb Hemoglobin level was 9 g, SaO2was 90%, Outcomes: The outcome of the plan of care is that by discharge Mrs. Moore will be able to move at least 1500 mL on the spirometer, have clear breath sounds bilaterally, have a SaO2 greater than 95%, be afebrile, and be able INTERVENTIONS AND SATISFY : an American History (Eric Foner), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Nursing Diagnosis: Impaired Gas Exchange related to alveolar edema due to elevated ventricular pressures secondary to CHF as evidenced by shortness of breath, SpO2 level of 85%, abnormal ABG results and crackles upon auscultation. Thereby, backing up into the right side and then ultimately to the lungs and throughout the body causing congestion. The Project Gutenberg EBook of The Principles of Psychology, Volume 1 (of 2), by William James This eBook is for the use of anyone anywhere in the United States and most other par Nursing Diagnosis: Impaired gas exchange secondary to shallow respiratory depth as evidenced by O2 saturation 88% on RA. Individual parameters are scored. To improve the delivery of oxygen in the airways and to reduce shortness of breath and risk for airway collapse. COLLEGE OF NURSING ABGs were collected and the patients pCO2 74, pH 7.24, P02 55, HCO3 33.2. Desired Outcome: The patient will demonstrate adequate oxygenation as evidenced by improved arterial blood gases (ABG) results. Objective and subjective data collection Vitals: R-54, H-128, T-37.4 (axillary), BP-91/64, MAP-62, O 2-94% Other objective data: Wt 9.6 kg, Ht 76.5 cm, apical strong and regular, nail beds pink . associated with This is referred to as Impaired Gas Exchange. Monitor the color of skin and mucous membrane. Decreasing oxygen saturation levels mean hypoxia. Supplemental oxygen can help maintain oxygen saturation at a normal level. Do not treat a patient based on this care plan. These risks and uncertainties include, without limitation, the impact of public health crises, including pandemics (such as the coronavirus ("COVID-19") pandemic) and epidemics and any related company or governmental policies or actions, the risk that our and Cimarex's businesses will not be integrated successfully, the risk that the cost . Reduced congestion will improve gas exchange. Reduced gas exchange from pulmonary edema can progress to ARDS. Reposition the patient by elevating the head of the bed and encouraging him/her to sit on an upright position. Assist the physician to initiate intubation and mechanical ventilation of the patient, if required. Elsevier. Oxygen and carbon dioxide are exchanged across the alveolar-capillary barrier in a passive manner, depending on both gases concentrations. Pascoal LM, et al. Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-large-mobile-banner-1','ezslot_4',662,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-large-mobile-banner-1-0');When assessing this patient, the nurse will want to remember ABCs (airway, breathing, circulation) of care. The consent submitted will only be used for data processing originating from this website. NCLEX Review Care Plan for Ineffective Gas Exchange, Ineffective Airway Clearance, Pneumonia, COPD, Emphysema, & Common Cold The free nursing care plan example below includes the following conditions: Ineffective Gas Exchange, Ineffective Airway Clearance, Pneumonia, COPD, Emphysema, & Common Cold. Respiratory acidosis and hypoxemia are evidenced by increasing PaCO2 and decreasing PaO2. Encourage expectoration of sputum; suction when indicated Rationale: thick secretions are a major cause in impaired gas exchange by the airways; Excess fluid will be removed and the patients weight will return to baseline. Oxygenation and ventilation may need to be supported mechanically. What are the symptoms of impaired gas exchange and COPD? Learn more about COPD, Theres no cure for COPD, but you can feel better and stay more active by changing your lifestyle. EVALUATION, Pathophysiological process Chair/bedrest will limit the bodys oxygen demand beyond the usual requirements. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Assess the lungs for decreased ventilation and adventitious lung sounds. 1 Upright The patient is on 3L nasal cannula with oxygen saturation of 88%. Oxygen from the air moves through the walls of the alveoli and enters into the bloodstream via tiny blood vessels called. Nursing care plans: Diagnoses, interventions, & outcomes. Desired Outcome: Within 1 hours of nursing interventions, the patient will have improved ventilation and gas exchange as evidenced by oxygen saturation within normal range, and respiratory rate greater than 8. Assess the patients willingness to refer to pulmonary rehabilitation. To limit activity to decrease oxygen demand while also increasing oxygen supply. I was going to go with ineffective gas exchange, impaired swallowing, risk for infection ( he was on an infectious disease floor) and knowledge deficit. This nursing diagnosis can be a serious health threat usually closely associated with other nursing diagnoses like ineffective breathing pattern or ineffective airway clearance. -Pt will be free from any facial and mouth breakdown frombipap machine. See our full, Important Disclosure: Please keep in mind that these care plans are listed for, Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on Pinterest (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on WhatsApp (Opens in new window), Click to share on Pocket (Opens in new window), Click to share on Telegram (Opens in new window), Click to share on Skype (Opens in new window), IV Drug Use Complications & Dangers: (Endocarditis, Infection, Infectious Diseases). 2023 nurseship.com. Manage Settings auscultation. Impaired gas exchange related to alveolar-capillary membrane changes D (The related to factor of alveolar-capillary membrane changes is accurately written because it is a patient response to the disease process of pneumonia that the nurse can treat. impaired Gas Exchange may be related to decreased oxygen-carrying capacity of blood, reduced RBC life span, abnormal RBC structure, increased blood viscosity, predisposition to bacterial pneumonia/pulmonary infarcts, possibly evidenced by dyspnea, use of accessory muscles, cyanosis/signs of hypoxia, tachycardia, changes in mentation, and . According to the Centers for Disease Control and Prevention (CDC), about 15.7 million people in the United States, or about 6.4 percent of the population, have COPD, making it the fourth leading cause of death in the United States in 2018. Whats the outlook for people with impaired gas exchange and COPD? The patient has labored, tachypneic, breathing. To enable to patient to receive more information and specialized care in enabling of improved gas exchange. Because gas exchange remains the main physiological abnormality assessed by the clinician, understanding the complexity of the factors at play remains a cornerstone in the management of ARDS. You note when the patient is asleep she has apneic episodes where her oxygen saturation will decrease to 82%. Heart failure is a chronic, progressive condition. -The nurse will teach the patient 4 benefits of wearing a CPAP machine at home when she sleeps. Assess respirations for rate and quality, as well as use of accessory muscles. Healthline Media does not provide medical advice, diagnosis, or treatment. Desired Outcome: The patient will demonstrate adequate oxygenation as evidenced by reaching the prescribed target oxygen saturation and ABG levels. Prepare to administer fluid bolus as ordered. How is impaired gas exchange and COPD diagnosed? See our full, Important Disclosure: Please keep in mind that these care plans are listed for, Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on Pinterest (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on WhatsApp (Opens in new window), Click to share on Pocket (Opens in new window), Click to share on Telegram (Opens in new window), Click to share on Skype (Opens in new window), IV Drug Use Complications & Dangers: (Endocarditis, Infection, Infectious Diseases). Early recognition of signs and symptoms of impaired gas exchange allows for prompt intervention. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. diminished VS: HR 85, BP 130/82, Temp 98.6, RR irregular 19. It is a collection of fluid in the pleural space of the lungs. Reversal agents will diminish the respiratory depression caused by opiates. Brill SE, et al. Assess for changes in level of consciousness or activity level. SUPPORTING This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions. Finally, on Friday, March 3, the IHS Markit Services PMI for February will be released. We avoid using tertiary references. -Pt will verbalize 5 benefits of the pneumococcal vaccine within 48 hours. Nursing Diagnosis: Impaired gas exchange related to altered oxygen-carrying capacity of blood secondary to sickle cell anemia as evidenced by irritability, dusky skin color, and oxygen saturation 84%. What is the treatment for impaired gas exchange and COPD? Nursing Diagnosis: Impaired gas exchange related to ventilation perfusion imbalance secondary to hypovolemic shock as evidenced by cyanosis, heart rate 162 bpm, and oxygen saturation 76%. Monitor vital signs for oxygen saturation and changes in heart rate, blood pressure, or cardiac rhythm. Encourage adequate synonyms) ASSESSMENTS ALLOW What are nursing care plans? Care Plans are often developed in different formats. During this process, oxygen enters the bloodstream while carbon dioxide is removed. Three nursing diagnoses--ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE)--were among the most frequently used, yet no reported clinical studies validated the defining characteristics of these diagnoses. Lung disease can lead to severe abnormalities in blood gas composition.Because of the differences in oxygen and carbon dioxide transport, impaired oxygen exchange is far more common than impaired carbon dioxide exchange. Proper diagnosis is important for coming out with the right nursing care plan for pneumonia. Nursing Diagnosis: Impaired gas exchange related to decreased ventilation secondary to opioid use as evidenced by respiratory rate of 6 respirations per minute, oxygen saturation 70%, and extreme lethargy.
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