Mr. Johnson is a 70-year-old male complaining of shortness of breath for the past three weeks. Mr. Johnson is complaining that he has chest pain, and this pain increases when he coughs. He also reports thick green/yellow sputum for the past week. His current weight was stable at 100 kg from his previous visit six months ago. He admits to occasionally smoking cigarettes.
Mr. Johnson’s assessment is as follows:
· Inspection upper respiratory system: Nasal and mouth mucosa is pink; no bleeding, masses, or deformities are noted in the upper respiratory system.
· Inspection lower respiratory system: The client has a respiratory rate of 20 with even and unlabored respirations.
· During the history, the client is speaking freely and does not report any shortness of breath while talking.
· The client has skin appropriate for his ethnic background, with no skin integrity issues noted during the inspection.
· Palpation: No masses, deformities, or crepitus are noted. Trachea is midline and nontender.
· The client has equal lung expansion anterior and posterior; the client reports pain that increases with inspiration.
· Percussion: Dullness over right lower lobe, otherwise hyper resonance.
· Auscultation: Fine crackles in the right lower lobe with inspiration and expiratory wheezes and diminished breath sounds noted throughout.
· Vital signs: Temperature: 100°F (38°C); Respiratory rate: 22; Pulse oximetry on room air: 91% to 93%; Heart rate: 90 bpm; and Blood pressure: 130/80 mm Hg
As the nurse, you have determined the priority problem is impaired gas exchange related to the mucus collection in the airways, as evidenced by fine crackles in the right lower lobe.
Instructions
Using the assessment and nursing diagnosis provided in the scenario, write 200–250 words identifying goals for Mr. Johnson in your initial post. Then, respond to at least two of your peers’ posts.
Discussion Prompts
· Identify two measurable short-term goals for Mr. Johnson. Explain why you chose these goals.
· Consider what possible outcomes would change the priority problem.
· Define one of these possible outcomes and explain how (and why) it would change the priority problem. Then, identify at least one new measurable goal related to the newly identified problem.
