These nanda nursing care plans include a diagnosis, and many interventions for the following conditions: COPD.
What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?
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.
Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.
Care Plans are often developed in different formats. The formatting isn’t always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.
Nursing Care Plan for: COPD
If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.
Scenario: |
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A 70 year old female presents from the ER to your PCU unit. The patient is excessively sleepy and falls asleep easily even with stimuli. Pt is oriented times 4 though. Patient exhibited dyspnea on ambulation from stretcher to bed. Pt family member tells you that the patient has been sleeping constantly for 2 weeks. The patient is on 3L nasal cannula with oxygen saturation of 88%. You note when the patient is asleep she has apneic episodes where her oxygen saturation will decrease to 82%. 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”. The patient is a current smoker and has been since she was 19 years old. VS: HR 85, BP 130/82, Temp 98.6, RR irregular 19. ABGs were collected and the patient’s pCO2 74, pH 7.24, P02 55, HCO3 33.2. Bipap ordered with the following settings Ipap 20, Epap 8, Oxygen Percentage 30%, Rate 12.
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Nursing Diagnosis: |
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Impaired Gas Exchange related to decreased lung compliance and altered level of consciousness as evidence by dyspnea on exertion, decreased oxygen content, decreased oxygen saturation, and increased PCO2.
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Subjective Data: |
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Pt family member tells you that the patient has been sleeping constantly for 2 weeks. States she does not wear her CPAP machine at night because it is “too loud”.
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Objective Data: |
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A 70 year old female presents from the ER to your PCU unit. The patient is excessively sleepy and falls asleep easily even with stimuli. Pt is oriented times 4 though. Patient exhibited dyspnea on ambulation from stretcher to bed. The patient is on 3L nasal cannula with oxygen saturation of 88%. You note when the patient is asleep she has apneic episodes where her oxygen saturation will decrease to 82%. The patient has a history of obstruction sleep apnea. The patient is a current smoker and has been since she was 19 years old. VS: HR 85, BP 130/82, Temp 98.6, RR irregular 19. ABGs were collected and the patient’s pCO2 74, pH 7.24, P02 55, HCO3 33.2. Bipap ordered with the following settings Ipap 20, Epap 8, Oxygen Percentage 30%, Rate 12.
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Nursing Outcomes: |
| -Pt’s ABGs will be within normal limits with 24 hours of hospital stay.-Pt will be verbalize the understanding of smoking cessation and how it relates to COPD.
-Pt will list 3 signs and symptoms of high PCO2 level and when to notify her doctor. -Pt will tolerate the bipap machine. -Pt will be free from any facial and mouth breakdown from bipap machine. -Pt will verbalize 4 benefits of wearing a CPAP machine at home when she sleeps. -Pt will be provided with a CPAP machine to take home that meets her expectations. |
Nursing Interventions: |
| -The nurse will notify respiratory therapy to obtain ABG at 1500 and report results to the pulmonary md.-The nurse will monitor patient’s vital signs every hours while on the bipap machine.
-The nurse will offer mouth care and fluids every 2 hours while the patient is on bipap. -The nurse will teach the patient 3 signs and symptoms that indicate PCO2 level may be high and when to contact her md. -The nurse will provide the patient with smoking cessation materials and how it relates to COPD educational material. -The nurse will administer Ativan 0.5 mg PO every 6 hours to the patient as needed for anxiety when on the bipap machine. -The nurse will teach the patient 4 benefits of wearing a CPAP machine at home when she sleeps. -The nurse will consult with discharge planning to help patient obtain a CPAP machine that meets her expectations to wear at home. |