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.

QUESTION

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:

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  • 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.

  • 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

ANSWER

Improving Respiratory Function: Setting Short-Term Goals for Mr. Johnson

Introduction

 In order to address the priority problem of impaired gas exchange related to mucus collection in the airways, it is essential to establish measurable short-term goals for Mr. Johnson. These goals will guide the nursing interventions and help monitor progress in improving his respiratory function. By identifying key outcomes and interventions, we can ensure effective care delivery and alleviate Mr. Johnson’s symptoms.

Short-Term Goals

Improve Oxygen Saturation Levels: One of the crucial short-term goals for Mr. Johnson is to increase his oxygen saturation levels from the current 91-93% to within the normal range of 95-100%. This goal is significant as adequate oxygenation is vital for optimal physiological functioning and tissue perfusion (Hafen, 2022). By achieving this goal, we can enhance gas exchange and alleviate the symptoms of shortness of breath.

Promote Effective Airway Clearance: Another short-term goal is to facilitate effective airway clearance to reduce mucus accumulation in the airways. This goal aims to enhance lung ventilation and decrease the risk of infection. By assisting Mr. Johnson in clearing the thick green/yellow sputum, we can improve his lung function, alleviate chest pain, and promote better respiratory outcomes.

Outcome

 Increased Lung Auscultation Clarity

One possible outcome that would change the priority problem is the absence of fine crackles in the right lower lobe during lung auscultation (Grott, 2022). This change indicates improved gas exchange and clearance of mucus in the airways. By addressing the impaired gas exchange, the associated symptoms such as shortness of breath and chest pain would be alleviated.

New Measurable Goal

 To address the outcome mentioned above, a new measurable goal would be to achieve clear lung sounds during auscultation. This involves the absence of fine crackles, wheezes, and diminished breath sounds (Dünser et al., 2018). Achieving clear lung sounds reflects improved ventilation, reduced airway obstruction, and enhanced gas exchange, which would positively impact Mr. Johnson’s overall respiratory function.

Conclusion

 Setting measurable short-term goals for Mr. Johnson is crucial for addressing the priority problem of impaired gas exchange. By aiming to improve oxygen saturation levels and promote effective airway clearance, we can enhance his respiratory function and alleviate related symptoms. Additionally, achieving clear lung sounds during auscultation would further validate the effectiveness of interventions and contribute to overall improved respiratory outcomes for Mr. Johnson.

References

 Dünser, M. W., Dankl, D., Petros, S., & Mer, M. (2018). The Airway and Lungs. In The Airway and Lungs. https://doi.org/10.1007/978-3-319-77365-0_5 

Grott, K. (2022, October 12). Atelectasis (Nursing). StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK572133

Hafen, B. B. (2022, November 23). Oxygen Saturation. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK525974/ 

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