Question

Please help

The patient has bilateral lung transplant a few years ago. He currently a problem with chronic infection of a lung transplant, Fluid volume overload r/t CHF MANIFESTED BY DYSPNEA, Diabetes Mellitus type 2 he has chronic obstructive lung disease, oxygen dependent, atrial fibrillation, hypertension, coronary artery disease, active delirium.

Based on his problem please help to answers these question

1. Nursing and Safety Considerations

2. Nursing Consideration

3. Primary Medical Diagnosis:

4. Patient-specific pathophysiology and nursing considerations

5. Contributing Secondary Diagnosis/diagnoses:

6. Patient-specific pathophysiology and nursing considerations

7. Nursing Process - Nursing Diagnosis:

Identify 3 physiological nursing diagnosis based on above assessed patient needs and nursing considerations. Develop two nursing diagnoses below. Must have at least one problem addressing patient’s admitting diagnosis.

State rationale for choosing this diagnosis:

8. Nursing Process: Planning and Intervention: Goals and Interventions: Develop one goal and four interventions for each diagnosis. One intervention should include patient education.

Goal (S.M.A.R.T.):

9. Evaluation: Please describe how your patient met/did not meet goal:

10. (Nursing Diagnosis #2)

State rationale for choosing this diagnosis:

Goal (S.M.A.R.T.):

Nursing process: Evaluation: Please describe how your patient met/did not meet goal:

Answer 1

The patient has bilateral lung transplant a few years ago. He currently a problem with chronic infection of a lung transplant, Fluid volume overload r/t CHF MANIFESTED BY DYSPNEA, Diabetes Mellitus type 2 he has chronic obstructive lung disease, oxygen dependent, atrial fibrillation, hypertension, coronary artery disease, active delirium.

Based on his problem please help to answers these question

1. Nursing and Safety Considerations

The first consideration will be airway, then circulation and then breathing. Here all the problems must consider because the patient had dyspnea so airway and breathing has to be considered and along with coronary artery disease.

2. Nursing Consideration

Nursing care should start with assessment of the vitals, breathing and monitoring of the cardiac problems with ecg etc can be the nursing consideration.

3. Primary Medical Diagnosis:

Chronic obstructive lung disease with coronary artery disease + type 2 diabetes mellitus and hypertension

4. Patient-specific pathophysiology and nursing considerations

Patient is admitted with infection after the lung transplantation, it is common reason for admission after the transplantation. As the transplant will be getting affected the immune system the immune suppressants will be provided it can produce infection.

5. Contributing Secondary Diagnosis/diagnoses:

Atrial fibrillation, delirium,

6. Nursing Process - Nursing Diagnosis:

Fluid over load related to the disease conditions manifested by dyspnoea

Subjective data will be

Patients is in delirium

Objective data

Increased respiratory rate

Decreased spo2

Goal

Normal fluid level in the blood

Normal breathing

Normal breath sounds

Intervention

Monitor the intake out put chart

Provide iv infusion based on the chart

Evaluation

Check the respiratory are normal or not

Auscultate for abnormal breath sounds