Gloria is an 8-year-old girl who is admitted to the pediatric unit with a history of cystic fibrosis and difficulty breathing.




Gloria, an eight-year-old girl with difficulty breathing and cystic fibrosis is being admitted to the pediatric unit.


Nursing Diagnosis – Cystic Fibrosis Respiratory Failure

Goals:

  • Increase oxygenation and respiratory function
  • Reducing the severity and frequency of symptoms related to respiratory problems
  • Maintain or improve the patient’s level of activity and participation in daily activities

Interventions:

  • Prescribed medications such as mucolytics and bronchodilators should be administered according to the instructions
  • Encourage patients to utilize airway clearance methods such as chest physical and incentive spirometry.
  • Regularly monitor vital signs and oxygen saturation levels
  • Assessment and management of respiratory distress. Supplemental oxygen may be used if needed.
  • The patient’s family should be educated about the importance to follow treatment.
  • As appropriate, refer the patient to pulmonary rehabilitation
  • Collaborate with the healthcare team to develop a plan of care that addresses the patient’s physical, emotional, and social needs

Evaluation:

  • The patient’s respiratory function and oxygenation improve, as evidenced by improved vital signs, oxygen saturation levels, and ability to participate in daily activities
  • Patient reports a decrease in severity and frequency for respiratory symptoms
  • This patient is able to demonstrate proper airway clearance and self-care.

Nursing Diagnosis – Fluid and Electrolyte Imbalance relating to weight loss or decreased urine output

Goals:

  • Increase hydration and balance
  • Keep an eye out for weight gain and take preventative measures to stop it from happening again

Interventions:

  • As prescribed, administer fluids and electrolytes, such as IV fluids, oral solutions to electrolyte problems, and enteral nutrition, as necessary
  • Monitoring daily weight, intake and outflow, as well as laboratory values (such a electrolyte level and specific gravity of urine) is important.
  • The patient’s family should be educated about proper nutrition and fluid balance.
  • Collaborate with the healthcare team to develop a plan of care that addresses the patient’s nutritional needs
  • It is important to monitor for signs of overhydration.

Evaluation:

  • The patient’s hydration status and electrolyte balance improve, as evidenced by improved laboratory values, weight stability, and urine output
  • As evidenced by mucous membrane moisture and normal skin turgor, the patient has a proper fluid and electrolyte equilibrium.
  • Family members and patients understand the importance and necessity of nutrition and water.

Nursing Diagnosis: Spasticity or muscle weakness is a sign of impaired physical mobility

Goals:

  • Enhance physical mobility and functional efficiency
  • Promote the patient’s independence in self-care activities
  • Increase or maintain muscle flexibility and strength

Interventions:

  • As directed, administer prescribed medication to reduce spasticity and increase muscle function
  • As needed, encourage the use of assistive equipment such as braces, braces and walkers.
  • Assist with the patient’s mobility needs, including transferring, walking and exercising.
  • The patient’s family should be educated about ways to prevent and improve mobility.

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