Problem Identified: Impaired breathing pattern Nursing Diagnoses: Impaired Breathing Pattern related to imbalance between oxygen supply

and demand secondary to Chronic Bronchitis Cause Analysis: Chronic Bronchitis causes depletion of oxygen delivery due to the presence of increase mucus production made by chronic inflammation thus making the oxygen demand and oxygen supply imbalance. This imbalance causes our brain to increase respiration to compensate the decrease oxygen supply. (Pathophysiology by Bullock p.551)
Cues Objectives Nursing Interventions Rationale Evaluation

Subjective: Paspas akong ginhawa as verbalized by the patient

STO: Within 8 hours of nursing intervention the patients will be able to identify comfortable position to ease work of breathing.

Independent: Assessed respiratory rate and depth. Note use of accessory muscles, pursed lips breathing and inability to speak or converse. Useful in evaluating the degree of respiratory distress and chronicity of the disease process

STO: After 8 hours of providing nursing interventions, the patient was able to practice techniques on how to ease the work of his breathing.

Objective: O2 sat-92% BP-140/70 LTO: RR-26 After 3 days of proving nursing PR-89 -presence of crackles all over upon auscultation - productive cough with white sputum -O2 inhalation @2L/min via nasal cannula -minimal pleural thickening ,left lower chest intervention in collaboration with administration of oxygen and patient respiratory rate will be on acceptable range from 26 cpm 18cpm.

Auscultated breath sounds, noting areas of decreased airflow and adventitious sounds.

Presence of wheezes may indicate bronchospasm or retained secretions.

LTO: After 3 days of providing nursing interventions,

Elevated head of bed and assist client to assume position to ease work of breathing.

Oxygen delivery may be improved by upright position and breathing exercises to decrease airway collapse, dyspnea, and work of breathing.

the patient became less tachypneic as evidenced by a respiratory rate of 22bpm and non-use of accessory muscles.

Provided quiet and cool environment to encouraged rest and sleep.

Rest and sleep decreases oxygen demand.

Assisted patient in doing ADL.

Decreases oxygen demand.

Collaborative: Administered O2 inhalation @2L/min via nasal cannula as indicated. Administer Pulmodual 5-6drops q 6 hours RTC. For bronchodilation to enhance oxygen delivery. To increase oxygen availability.

Reference: Pathophysiology by Bullock, Nursing Care Plan by Doenges 6th Edition