Ineffective Breathing Patterns

Ineffective Breathing Patterns

(_)Actual (_) Potential

Related To:
[Check those that apply]
(_) Allergic response
(_) Anesthesia
(_) Aspiration
(_) COPD
(_) Decreased lung compliance
(_) Fatigue
(_) History of smoking
(_) Immobility
(_) Medications (narcotics, sedatives, analgesics)
(_) Neuromuscular impairment (eg. MS, Guillain-Barre)
(_) Surgery or trauma
(_) Pain
(_) Other:_____________________________
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As evidenced by:
[Check those that apply]
Major:
(
Must be present)
(_) Changes is respiratory rate or pattern from baseline.
(_) Changes in pulse (rate, rythm).
Minor:
(
May be present)
(_) Orthopnea (_) Tachypnea (_) Hyperpnea
(_) Splinted, guarded respirations.

 

Date &
Sign.
Plan and Outcome
[Check those that apply]
Target
Date:
Nursing Interventions
[Check those that apply]
Date
Achieved:
  The patient will:

(_) Demonstrate an effective respiratory rate, depth, and pattern A.E.B.:

  • Color pink/ absence of cyanosis.
  • Absence of diminished breath sounds.

(_) Other:

  (_) Assess color, respiratory rate, depth, effort, rythm and breath sounds q ___ hours.

(_) Position to facilitate optimum breathing patterns:

  • HOB elevated ___ degrees.
  • Turn q ___ hours.

(_) Cough and deep breath q ___ hours.

(_) Increase activity as tolerated to promote maximum diaphragmatic excursion: _______________
________________________
________________________
________________________

(_) Other:________________
________________________
________________________
________________________

 

 

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Patient/Significant other signature

 

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RN signature