NURSING CARE PLAN AGE: 70YRS GENDER: MALE DX: ASSESSMENT Subjective data: Difficulty of breathing as verbalized by the

pt. Objective data: T=38C PR=90bpm RR=30cpm BP=130/70mmhg >weakness >low grade fever >productive cough DIAGNOSIS Ineffective breathing pattern R/T presence of secretion in the bronchioles, as manifested by difficulty of breathing and weakness as verbalized by pt. PLANNING After 8hrs of nursing intervention the pt RR will decrease from 30-20cpm. INTERVENTION INDEPENDENT RATIONALE EVALUATION After 8hrs of nursing intervention goal was partially meant as patients RR reduced from 30cpm to 22cpm

>monitored the v/s

especially the RR Q2 >positioned the pt in a high fowlers position raising the head of the bed. >advised pt to increase fluid intake. >raise bed rails up at all time. >teach pt about the dx and how to manage his health.

>to obtain baseline

data

>to promote effective airway.

>to eliminate virus in the body to promote health. >to prevent fall and injury >to have the knowledge and preventive measures about dx.

DEPENDENT >administer O2 as ordered. >gave medication as prescribed and ordered.

COLABORATIVE >Referred nebulisation of pt every Q2.

>to promote effective oxygenation. >to improve health.

>to report the present health status.

REFLECTION PAPER ON FUNDAMENTALS OF NURSING. (NCM100) Ncm100 was a subject we took during this 2nd semester; we were told that if we didnt pass this subject we would not do the capping during our set. Our professor on this subject was Mrs. Cerina Joy M. Alarca(RN, MAN). So everyone was really scared and serious when it came to ncm100, I too was scared because everything was looking new to me, because we were all looking forward to the capping ceremony. As we progressed with the lecture it became fun for me, understanding every bit of it and even became more serious and interested in nursing as a profession. The part of the lecture I love most was therapeutic communication when we got to act a part in explaining 4 types of the therapeutic communication that was discussed earlier in the class. I love the course the most because the professor is very caring, kind and honest she tries to explain everything in a simple way so that we can understand, using plays, examples, stories and even herself. I am so happy now that the subject has ending hoping to continue it again in the next academics session, by the grace of God am hoping to pass the course with good grades not below 85. Thank you so much maam Cerina Joy M. Alarca for the tremendous knowledge that you have impacted on us, I pray that the lord continue to give you more strength to do the good works u have started on us.