Impaired Gas Exchange related to Asthma

Nursing Care Plan for Asthma

Impaired Gas Exchange : Excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane

Defining Characteristics:

• Visual disturbances;
• decreased carbon dioxide;
• dyspnea;
• abnormal arterial blood gases;
• hypoxia;
• irritability;
• somnolence;
• restlessness;
• hypercapnia;
• tachycardia;
• cyanosis (in neonates only);
• abnormal skin color (pale, dusky);
• hypoxemia;
• hypercarbia;
• headache on awakening;
• abnormal rate, rhythm, depth of breathing;
• diaphoresis;
• abnormal arterial pH;
• nasal flaring

Asthma is a chronic, or life long, disease that can be serious—even life threatening. There is no cure for asthma. The good news is that it can be managed so you can live a normal, healthy life.

Asthma is a lung disease that makes it harder to move air in and out of your lungs. There are three things that you should know about asthma:

1. Asthma is chronic. In other words, you live with it every day.
2. It can be serious – even life threatening.
3. There is no cure for asthma, but it can be managed so you live a normal, healthy life.

Nursing Diagnosis for Asthma

Impaired Gas Exchange related to CO2 retention, increased secretion, increased respiration, and a disease process.

1) Goal

• The client will maintain adequate gas exchange and oxygenation.

2) Expected Outcomes

• Frequency of breathing 16-20 times / min
• Pulse frequency 60-120 times / min
• Normal skin color, no dipnea and blood gas analysis within normal limits

3) Interventions

• Monitoring of respiratory status every 4 hours, blood gas analysis, income and output.
• Place client in semi-Fowler position.
• Give intravenous therapy as directed.
• Give oxygen through a nasal cannula 4 l / min, then adapt the results of PaO 2.
• Give the medication that has been prescribed and observe if there are signs of toxicity.

4) Rational

• To identify the indications towards progress or deviations from the client.
• Upright position allowing better lung expansion.
• To enable rapid rehydration and can assess the situation for vascular administration of emergency drugs.
• Giving oxygen to reduce the burden of respiratory muscles.
• Treatment to restore bronchial conditions as the previous conditions.
• For ease breathing and prevent atelectasis.

Impaired Gas Exchange of Tuberculosis

 Nursing Diagnosis - Impaired Gas Exchange of Pulmonary Tuberculosis

Tuberculosis, MTB, or TB (short for tubercle bacillus) is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis typically attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit their saliva through the air. Most infections are asymptomatic and latent, but about one in ten latent infections eventually progresses to active disease which, if left untreated, kills more than 50% of those so infected.

The classic symptoms of active TB infection are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss (the latter giving rise to the formerly prevalent term "consumption"). Infection of other organs causes a wide range of symptoms. Diagnosis of active TB relies on radiology (commonly chest X-rays) as well as microscopic examination and microbiological culture of body fluids. Diagnosis of latent TB relies on the tuberculin skin test (TST) and/or blood tests. Treatment is difficult and requires administration of multiple antibiotics over a long period of time. Social contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in multiple drug-resistant tuberculosis (MDR-TB) infections. Prevention relies on screening programs and vaccination with the bacillus Calmette–Guérin vaccine.

Nursing Diagnosis - Impaired Gas Exchange of Pulmonary Tuberculosis


related to:

• reduced effectiveness of the surface of the lung,
• atelectasis,
• alveolar capillary membrane damage,
• secretions are thick,
• bronchial edema.

with the expected outcomes:

• Reported dyspnea did not occur.
• Showed improvement adequate ventilation and oxygenation of tissues with blood gas analysis in the normal range.
• Free from symptoms of respiratory distress.

Nursing Interventions - Impaired Gas Exchange of Pulmonary Tuberculosis

a. Assess dyspnea, tachypnea, abnormal breath sounds. Increased respiratory effort, chest expansion limitations and weaknesses.

b. Evaluation of the level of consciousness-changing, noted signs of cyanosis and discoloration of the skin, mucous membranes, and nail color.

c. Demonstrate / encourage you to exhale with disiutkan lips, especially in patients with fibrosis or parenchymal damage.

d. Suggest to bedrest, limit and auxiliary activities as needed.

e. Monitor blood gas analysis.

f. Collaboration: Give oxygen as indicated.

Rational:

a. Pulmonary tuberculosis may lead to widespread coverage in the lungs that comes from bronchopneumonia which extends into inflammation, necrosis, pleural effusion and widespread fibrosis with symptoms of respiratory distress.

b. Secret accumulation can interfere with oxygenation in vital organs and tissues.

c. Increased resistance to air flow to prevent the collapse of the airway.

d. Reduce oxygen consumption in the period of respiration.

e. Decrease in oxygen saturation (PaO2) or increased PaC02 show the need for further treatment. Inadequate or changing therapy.

f. Help correct the hypoxemia that occurs secondary alveolar hypoventilation and decreased lung surface.