Nurs 5

Ongoing Patient Care and Planning

• Continuous assessment and planning occur during patient care to ensure evolving needs are met.

• Care plans should be revisited systematically every shift:

  • Example: If Mr. Smith no longer complains of pain after 24 hours on antibiotics, the pain management plan may be completed.

  • However, if fatigue and weakness increase due to respiratory issues affecting appetite, reassessment of the care plan is necessary.

Respiratory and Nutritional Needs

• Understanding the interconnectedness of respiratory issues and nutrition is key:

  • Patients with respiratory problems (e.g., labored breathing) may struggle to eat properly.

  • Lack of nutrition may lead to increased fatigue and weakness.

• Regular evaluation of goals and interventions:

  • If pain worsens or breathing difficulties continue, goals and approaches should be modified accordingly.

Discharge Planning

• Discharge planning is an integral part of patient care, often starting before admission:

  • Anticipation of discharge needs is crucial, including arrangements for physical therapy and mobility aids at home.

  • The case manager (usually an RN) plays a key role in this process and must assess and plan for ongoing needs based on changes to the patient’s condition.

Prioritization of Patient Problems

• Prioritization is based on both clinical judgments and patient preferences:

  • Common top concerns for patients include pain management and safety.

  • Engaging the patient in discussions about their primary concerns can lead to better tailored care.

• Situational examples:

  • A patient with sepsis may prioritize receiving quality care and feeling safe over other issues.

Implementation of Interventions

• Interventions should be goal-directed:

  • For instance, with low oxygen saturation (e.g., from 85% to 70%), immediate interventions may include:

    • Administering oxygen and positioning the patient appropriately.

    • Encouraging fluid intake which may assist in improving oxygenation.

  • Use of supportive devices:

    • Incentive Spirometer: Helps patients visualize breathing goals and increase lung capacity. Patients are instructed on the use of it to improve respiratory function.

    • Flutter Valve: A device to help break up lung congestion through expiration.

Role of Nursing Care

• Nursing care should focus on developing a partnership with patients:

  • Engaging with patients not only addresses physiological needs but also reinforces feelings of safety and security in their care environment.