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This Concept Map, created with IHMC CmapTools, has information related to: COPD, COPD Mrs. J.C. is a 72 y.o. white female, 80-year- pack smoker. Presents with dyspnea, productive cough, low-grade temperature, fatigue, weight loss, weakness. Examination reveals, dyspnea, anxiety, yellow sputum production, anxiety, wheezing, hyperressonance. She admits to not taking all of her medication due to cost. energy expenditure increases Problem: Weight loss Nursing Diagnosis: Impaired nutritional status Data: Weight loss, anorexia, cachexia, serum albumin, serum ferritin, folate, B-12, Interventions: Provide high caloric protein rich regular meals, consider supplementation, provide activity, provide meal time social interactivity, consider psychological issues Outcomes: Increased weight gain, increased appetite., Problem: Psychological Decompensation Nursing Diagnosis: Ineffective coping strategies secondary to disease process and/or poor oxygenation Data: Positive Hamilton Anxiety score, patient verbalizations, depression scales physical assessment, Interventions: Encourage family support, focus patient on function not dysfunction, provide resources for victims with COPD, arrange for portable and home O2, review pharmacological interventions, Outcomes: Reduction in negative statements, improved mood, increased social interaction reduces desire Problem: Weight loss Nursing Diagnosis: Impaired nutritional status Data: Weight loss, anorexia, cachexia, serum albumin, serum ferritin, folate, B-12, Interventions: Provide high caloric protein rich regular meals, consider supplementation, provide activity, provide meal time social interactivity, consider psychological issues Outcomes: Increased weight gain, increased appetite., Problem: Exacerbation of COPD Nursing Diagnosis: Recurrent episodes of chronic disease or infection secondary to inappropriate medication regiment related to indigent status Data: Pt admissions of not taking medication Interventions: Review medication list to determine cheapest medication, review funding sources with patient, refer to charitable organizations, consider Medicaid/Medicare application process, education on adhering with prescribed medications, follow up home care to ascertain compliance. Outcome: Reduced admissions to the acute care setting. Reduced incidence of exacerbation of COPD and related infections. Pt obtains needed medications and exhibits compliance. results in Problem: Impaired Mobility Nursing Diagnosis: Reduced independence due to impaired mobility Data: Weight loss, OT and PT evaluations, requires assistance to perform ADLS, Interventions: Visiting nurses to assist with ADLS and meals, AROM exercises, walker, rearrange home for easier mobility, encourage physical activity. Outcomes: Greater physical independence, improved muscle strength., Problem: Exacerbation of COPD Nursing Diagnosis: Recurrent episodes of chronic disease or infection secondary to inappropriate medication regiment related to indigent status Data: Pt admissions of not taking medication Interventions: Review medication list to determine cheapest medication, review funding sources with patient, refer to charitable organizations, consider Medicaid/Medicare application process, education on adhering with prescribed medications, follow up home care to ascertain compliance. Outcome: Reduced admissions to the acute care setting. Reduced incidence of exacerbation of COPD and related infections. Pt obtains needed medications and exhibits compliance. increases Problem: Body Image Changes Nursing Diagnosis: Loss of social interaction secondary to body image changes Data: Patient reports of isolation, decreased sex, job loss/restriction. Family reports of isolation. Interventions: Support group participation, education of paitent and family regarding issues, workplace change/rearrange to promote social interaction. Outcomes: Reports continued or increased incidences of social interaction. Reports decreased sexual dysfunction and acceptance of body image., COPD Mrs. J.C. is a 72 y.o. white female, 80-year- pack smoker. Presents with dyspnea, productive cough, low-grade temperature, fatigue, weight loss, weakness. Examination reveals, dyspnea, anxiety, yellow sputum production, anxiety, wheezing, hyperressonance. She admits to not taking all of her medication due to cost. causes Problem: Impaired Mobility Nursing Diagnosis: Reduced independence due to impaired mobility Data: Weight loss, OT and PT evaluations, requires assistance to perform ADLS, Interventions: Visiting nurses to assist with ADLS and meals, AROM exercises, walker, rearrange home for easier mobility, encourage physical activity. Outcomes: Greater physical independence, improved muscle strength., COPD Mrs. J.C. is a 72 y.o. white female, 80-year- pack smoker. Presents with dyspnea, productive cough, low-grade temperature, fatigue, weight loss, weakness. Examination reveals, dyspnea, anxiety, yellow sputum production, anxiety, wheezing, hyperressonance. She admits to not taking all of her medication due to cost. causes Problem: Impaired Mobility Nursing Diagnosis: Reduced independence due to impaired mobility Data: Weight loss, OT and PT evaluations, requires assistance to perform ADLS, Interventions: Visiting nurses to assist with ADLS and meals, AROM exercises, walker, rearrange home for easier mobility, encourage physical activity. Outcomes: Greater physical independence, improved muscle strength., Problem: Impaired Mobility Nursing Diagnosis: Reduced independence due to impaired mobility Data: Weight loss, OT and PT evaluations, requires assistance to perform ADLS, Interventions: Visiting nurses to assist with ADLS and meals, AROM exercises, walker, rearrange home for easier mobility, encourage physical activity. Outcomes: Greater physical independence, improved muscle strength. happens when Problem: Psychological Decompensation Nursing Diagnosis: Ineffective coping strategies secondary to disease process and/or poor oxygenation Data: Positive Hamilton Anxiety score, patient verbalizations, depression scales physical assessment, Interventions: Encourage family support, focus patient on function not dysfunction, provide resources for victims with COPD, arrange for portable and home O2, review pharmacological interventions, Outcomes: Reduction in negative statements, improved mood, increased social interaction, Problem: Pneumonia Nursing Diagnosis: Ineffective breathing pattern Impaired gas exchange Data: ABGs, CXR, CT scan, CBC results, physical exam, continuous pulse oximetry, tachycardia, discolored sputum Interventions: O2, BiPap, I.V. Antibiotics, Outcomes: Normalization of WBC, temperature, respirations, improved CxR, improved O2 saturation above 91%, ???? Problem: Weight loss Nursing Diagnosis: Impaired nutritional status Data: Weight loss, anorexia, cachexia, serum albumin, serum ferritin, folate, B-12, Interventions: Provide high caloric protein rich regular meals, consider supplementation, provide activity, provide meal time social interactivity, consider psychological issues Outcomes: Increased weight gain, increased appetite., Problem: Weight loss Nursing Diagnosis: Impaired nutritional status Data: Weight loss, anorexia, cachexia, serum albumin, serum ferritin, folate, B-12, Interventions: Provide high caloric protein rich regular meals, consider supplementation, provide activity, provide meal time social interactivity, consider psychological issues Outcomes: Increased weight gain, increased appetite. changes Problem: Body Image Changes Nursing Diagnosis: Loss of social interaction secondary to body image changes Data: Patient reports of isolation, decreased sex, job loss/restriction. Family reports of isolation. Interventions: Support group participation, education of paitent and family regarding issues, workplace change/rearrange to promote social interaction. Outcomes: Reports continued or increased incidences of social interaction. Reports decreased sexual dysfunction and acceptance of body image., Problem: Impaired Mobility Nursing Diagnosis: Reduced independence due to impaired mobility Data: Weight loss, OT and PT evaluations, requires assistance to perform ADLS, Interventions: Visiting nurses to assist with ADLS and meals, AROM exercises, walker, rearrange home for easier mobility, encourage physical activity. Outcomes: Greater physical independence, improved muscle strength. complicates Problem: Pneumonia Nursing Diagnosis: Ineffective breathing pattern Impaired gas exchange Data: ABGs, CXR, CT scan, CBC results, physical exam, continuous pulse oximetry, tachycardia, discolored sputum Interventions: O2, BiPap, I.V. Antibiotics, Outcomes: Normalization of WBC, temperature, respirations, improved CxR, improved O2 saturation above 91%,, COPD Mrs. J.C. is a 72 y.o. white female, 80-year- pack smoker. Presents with dyspnea, productive cough, low-grade temperature, fatigue, weight loss, weakness. Examination reveals, dyspnea, anxiety, yellow sputum production, anxiety, wheezing, hyperressonance. She admits to not taking all of her medication due to cost. when impaired Problem: Psychological Decompensation Nursing Diagnosis: Ineffective coping strategies secondary to disease process and/or poor oxygenation Data: Positive Hamilton Anxiety score, patient verbalizations, depression scales physical assessment, Interventions: Encourage family support, focus patient on function not dysfunction, provide resources for victims with COPD, arrange for portable and home O2, review pharmacological interventions, Outcomes: Reduction in negative statements, improved mood, increased social interaction, Problem: Body Image Changes Nursing Diagnosis: Loss of social interaction secondary to body image changes Data: Patient reports of isolation, decreased sex, job loss/restriction. Family reports of isolation. Interventions: Support group participation, education of paitent and family regarding issues, workplace change/rearrange to promote social interaction. Outcomes: Reports continued or increased incidences of social interaction. Reports decreased sexual dysfunction and acceptance of body image. results in Problem: Psychological Decompensation Nursing Diagnosis: Ineffective coping strategies secondary to disease process and/or poor oxygenation Data: Positive Hamilton Anxiety score, patient verbalizations, depression scales physical assessment, Interventions: Encourage family support, focus patient on function not dysfunction, provide resources for victims with COPD, arrange for portable and home O2, review pharmacological interventions, Outcomes: Reduction in negative statements, improved mood, increased social interaction, COPD Mrs. J.C. is a 72 y.o. white female, 80-year- pack smoker. Presents with dyspnea, productive cough, low-grade temperature, fatigue, weight loss, weakness. Examination reveals, dyspnea, anxiety, yellow sputum production, anxiety, wheezing, hyperressonance. She admits to not taking all of her medication due to cost. poor adherence causes Problem: Exacerbation of COPD Nursing Diagnosis: Recurrent episodes of chronic disease or infection secondary to inappropriate medication regiment related to indigent status Data: Pt admissions of not taking medication Interventions: Review medication list to determine cheapest medication, review funding sources with patient, refer to charitable organizations, consider Medicaid/Medicare application process, education on adhering with prescribed medications, follow up home care to ascertain compliance. Outcome: Reduced admissions to the acute care setting. Reduced incidence of exacerbation of COPD and related infections. Pt obtains needed medications and exhibits compliance., COPD Mrs. J.C. is a 72 y.o. white female, 80-year- pack smoker. Presents with dyspnea, productive cough, low-grade temperature, fatigue, weight loss, weakness. Examination reveals, dyspnea, anxiety, yellow sputum production, anxiety, wheezing, hyperressonance. She admits to not taking all of her medication due to cost. go together Problem: Pneumonia Nursing Diagnosis: Ineffective breathing pattern Impaired gas exchange Data: ABGs, CXR, CT scan, CBC results, physical exam, continuous pulse oximetry, tachycardia, discolored sputum Interventions: O2, BiPap, I.V. Antibiotics, Outcomes: Normalization of WBC, temperature, respirations, improved CxR, improved O2 saturation above 91%,, COPD Mrs. J.C. is a 72 y.o. white female, 80-year- pack smoker. Presents with dyspnea, productive cough, low-grade temperature, fatigue, weight loss, weakness. Examination reveals, dyspnea, anxiety, yellow sputum production, anxiety, wheezing, hyperressonance. She admits to not taking all of her medication due to cost. distorts Problem: Body Image Changes Nursing Diagnosis: Loss of social interaction secondary to body image changes Data: Patient reports of isolation, decreased sex, job loss/restriction. Family reports of isolation. Interventions: Support group participation, education of paitent and family regarding issues, workplace change/rearrange to promote social interaction. Outcomes: Reports continued or increased incidences of social interaction. Reports decreased sexual dysfunction and acceptance of body image., Problem: Exacerbation of COPD Nursing Diagnosis: Recurrent episodes of chronic disease or infection secondary to inappropriate medication regiment related to indigent status Data: Pt admissions of not taking medication Interventions: Review medication list to determine cheapest medication, review funding sources with patient, refer to charitable organizations, consider Medicaid/Medicare application process, education on adhering with prescribed medications, follow up home care to ascertain compliance. Outcome: Reduced admissions to the acute care setting. Reduced incidence of exacerbation of COPD and related infections. Pt obtains needed medications and exhibits compliance. further reduces Problem: Weight loss Nursing Diagnosis: Impaired nutritional status Data: Weight loss, anorexia, cachexia, serum albumin, serum ferritin, folate, B-12, Interventions: Provide high caloric protein rich regular meals, consider supplementation, provide activity, provide meal time social interactivity, consider psychological issues Outcomes: Increased weight gain, increased appetite., Problem: Weight loss Nursing Diagnosis: Impaired nutritional status Data: Weight loss, anorexia, cachexia, serum albumin, serum ferritin, folate, B-12, Interventions: Provide high caloric protein rich regular meals, consider supplementation, provide activity, provide meal time social interactivity, consider psychological issues Outcomes: Increased weight gain, increased appetite. loss of Problem: Impaired Mobility Nursing Diagnosis: Reduced independence due to impaired mobility Data: Weight loss, OT and PT evaluations, requires assistance to perform ADLS, Interventions: Visiting nurses to assist with ADLS and meals, AROM exercises, walker, rearrange home for easier mobility, encourage physical activity. Outcomes: Greater physical independence, improved muscle strength., Problem: Exacerbation of COPD Nursing Diagnosis: Recurrent episodes of chronic disease or infection secondary to inappropriate medication regiment related to indigent status Data: Pt admissions of not taking medication Interventions: Review medication list to determine cheapest medication, review funding sources with patient, refer to charitable organizations, consider Medicaid/Medicare application process, education on adhering with prescribed medications, follow up home care to ascertain compliance. Outcome: Reduced admissions to the acute care setting. Reduced incidence of exacerbation of COPD and related infections. Pt obtains needed medications and exhibits compliance. worsens Problem: Pneumonia Nursing Diagnosis: Ineffective breathing pattern Impaired gas exchange Data: ABGs, CXR, CT scan, CBC results, physical exam, continuous pulse oximetry, tachycardia, discolored sputum Interventions: O2, BiPap, I.V. Antibiotics, Outcomes: Normalization of WBC, temperature, respirations, improved CxR, improved O2 saturation above 91%,