NCP PTB
NCP PTB
NCP PTB
Diagnosis
Subjective Cues: Ineffective It is a state SHORT-TERM GOAL: EFFECTIVENESS:
Airway wherein the After an 8-hour Was the client able
Clearance client is unable to community duty, to maintain patent
The grandmother of related to clear secretions or the client’s airway?
the child said that her excessive obstructions from secretions __yes __no why?
grandson had been mucus as the respiratory would be lessened
manifested tract to maintain and maintain airway Was the client able
suffering for on and
by dyspnea, a clear airway. clearance to promote fluid
off cough and colds adventious hydration?
since it was a month breath sound Immediate LONG-TERM GOAL: __yes __no why?
old. “mga one week and changes Cause: After 2 days of shift,
meron tapos in respiratory Inflammatory the patient will Was the client able
mawawala tapos rate and response of the manifest improved to monitor
babalik ulit, minsan rhythm body against respiratory and regarding her
microorganism eliminate discomfort respiratiory
pumuputok putok pa
functioning?
nga ang ubo niya Intermediate Objectives: __yes __no why?
dahil sa plema. Cause: Established rapport
Nahihirapan na nga Infection from to the client EFFICIENCY:
siya huminga last MYCOBACTERIUM Was the
month, umiiyak na Tuberculosis A. After 30 intervention done
kaya pinacheck up na minutes the within the right
Root Cause: client will be time?
namin.” she added.
Weakened able to __yes __no why?
The patient was Immune system maintain
brought to a hospital adequate
to have a check up REFERENCE patent APPROPRIATENESSS:
last month because Doenges, airway by: Were the
of difficulty of Marilynn et. al, intervention suitable
Nurses Pocket Proper positioning of Position head Open or for the client’s
breathing and
Guide 11th the head in maintain open condition?
crackles, X-ray and edition accoradance airway at rest __yes __no why?
sputum exam was to her or compromise ACCESSIBILITY:
done. The child has condition individual Were the
been positive for interventions
Proper positioning of Elevate head To take acceptable by the
Primary Complex and
the bed of the bed advantage of client’s condition?
is prescribed to take the gravity __yes __no why?
Rifampicin for 6 decreasing
months. pressure on the ADEQUACY:
diaphragm and Were the
enhancing interventions made
According to the drainage of suitable for the
primary care ventilation to clients needs?
provider, they have different __yes __no why?
a history of segment of the
lungs
hypertension,
asthma and
TB,”mahina talaga B. After 30
yung mga baga minutes, the
namin, may mga client will be
asthma ang ilan sa able to expel
mga kapatid at mucous by:
pamangkin ko, ang
iba tb pero Doing proper Teach the The patient
naggagamot na coughing technique client proper needs to
ngayon at ako nga coughing cough to be
nagkaTB na din 2 technique able to
years ago” remove the
mucus
Objective Cues:
wheezes upon
auscultation Applying chest Apply Chest Chest
Dyspnea percussion Percussion to physiotherapy
RR is ___ cpm the Client. is important in
loosening and
Labooratory results mobilizing
secretions.
Indications for
chest
physiotherapy
include sputum
retention not
responsive to
spontaneous or
directed cough,
abnormal chest
x-ray