please respond to this post based on your own

if you used reference please attach it as well as in cite citation

i will attach sample response from the post

Improve oxygen saturation: Mr. Johnson's oxygen saturation levels would be improved as a short-term goal. He is currently below the typical range of 95% to 100% on room air, with a pulse oximetry reading between 91% and 93%. Mr. Johnson's poor gas exchange can be corrected by raising his oxygen saturation, which will improve his oxygenation and reduce his shortness of breath. By routinely checking his pulse oximetry and striving for a target saturation level within the normal range, this objective can be measured.

An additional short-term objective for Mr. Johnson would be to promote effective airway clearance. The appearance of thick green/yellow sputum indicates that the mucus buildup in his airways must be treated. Mucus can be eliminated by encouraging efficient coughing and secretion mobilization, which will also help him breathe easier and feel less pain in his chest. The quality and volume of sputum output, as well as any changes in his chest pain and respiratory symptoms, can all be used to gauge the success of this goal.

crackles and wheezes disappear, it would be a sign of improved lung function if Mr. Johnson's expiratory wheezes and the fine crackles in the right lower lobe decreased or disappeared. This result would indicate that his airways have been successfully cleansed of mucus, allowing for better gas exchange and ventilation. Consequently, the top issue of decreased gas exchange brought on by mucus accumulation in the airways would be fixed.

Preventing the accumulation of mucus, it would be crucial to set a new objective of preventing the recurrence of mucus formation once the priority issue of reduced gas exchange has been addressed. By keeping an eye on the quantity and intensity of mucus formation and making sure that efficient airway clearance treatments are consistently applied, this objective can be monitored. Additionally, to avoid future difficulties and mucus buildup, it is imperative to inform Mr. Johnson about smoking cessation and develop tactics to help him stop smoking.

example reply from post 1

- hello , I enjoyed reading your post. I agree that the main goal should be to increase Mr. Johnson's oxygen saturation level above 95%. This can be done by placing him on 2 L of O2 using the nasal cannula. I like that you made one of the goals to eliminate the mucus in his airway. Eliminating the mucus can also help with increasing the O2 saturation levels, but most importantly will help keep the patient comfortable and closer to feeling better.

----------------------------------

2. Two measurable short-term goals are Mr. Johnson's oxygen saturation will be in the normal range which is 95-100% within an hour and his pain will be managed within an hour. According to his recent vital signs, his oxygen saturation was 91%-93%, which is below the normal range, which may lead to serious situations. Therefore, we must manage his oxygen saturation to become normal by administering the patient oxygen, monitoring, reassessing, and reevaluating the patient's oxygen saturation level to make sure that the patient's goal is met (Treas, 2021). Then we can determine if the patient needs further treatment. Another goal is to manage the patient's pain. It is very important to manage the patient's pain since being in a lot of pain not only brings discomfort to the patient but also brings his blood pressure up as well since the recent reading was out of normal range which could lead to other serious problems such as heart attack and cardiac arrest.

According to the findings, several possible outcomes would change the priority problem including other lab results and diagnostic imaging results showing abnormalities. Additional tests like a CT scan of the chest and pulmonary function test could show evidence of bronchitis or pneumonia. CBC may show evidence of ongoing infection and other abnormalities. A sputum test can show evidence of infection as well as the type of bacteria or fungus which helps us determine changes in the priority problem's detail.

One of the possible outcomes that I would like to discuss is if a chest x-ray and sputum test confirm that the patient has pneumonia The possibility is there since the patient is at risk due to being in the elderly age group and a smoker and has signs and symptoms indicating the possibility of pneumonia such as chest pain, tachycardia, producing greenish sputum, and coughing (CDC, 2022). The intervention will need to be changed to have the patient on antibiotics, monitor the patient, and reassess the patient. Therefore, the patient's measurable goals would be that the patient's blood work will be rechecked after the course of antibiotics and shows no sign of infection.

example post from 2

I agree with your two short term goals about the patient having decreased pain and regaining a stable oxygen saturation. The oxygen saturation level is very important because it tells us if the patient is getting enough oxygen, and this would be apart of the ABC's of the nursing process, where we make sure that the patients breathing and oxygen is restored to normal levels. (Treas, 2021) I believe the patient may have pneumonia but an outcome I think we should focus on will be the patient being able to breathe without pain and the patient reporting a pain level less than 3 out of 10. I would also counsel this patient on smoke cessation to give his lungs time to recover and improve his gas exchange.

-------------------------------------------

3. Identify two measurable short-term goals for Mr. Johnson. Explain why you chose these goals.

First, the patient is experiencing airway issues of coughing, excess thick yellow and green sputum for a week and chest pain with coughing. The crackling in the patients lungs when auscultating indicates airway obstruction that is leading to impaired gas exchange of a low 93% O2 SAT. My first short term goal is to clear the airway. This can be achieved by giving the patient fluids to break up uxcess musus by hydrating the patient. Also, sitting the patient upright and educating the patient on deep breathing and productive coughing to optimize breathing (Leader, 2022). This will reduce coughing and also reduce chest pain. All these in combination will help with clearing patients airway.

Next short term goal is to improve gas exchange and increase oxygen saturation from 93% to normal range which is between 95%-100%. We can achieve this by not only clearing the patients airway but but proving supplemental oxygen via NC. I chose these goals becuase they are the most pressing Cheif issues and must be adressed first in concurrence with the ABC guidelines of priority problems.

"How to Increase Blood Oxygen Level." Pulmonary Education and Research Foundation, 1 Mar. 2021, perf2ndwind.org/basics/decreasing-shortness-of-breath/.

• Consider what possible outcomes would change the priority problem.

There are a few possible outcomes to consider. A reduce in sputum which would clear the airway. Reduction in coughing and chest pain. Breathing will be improved. Which will also reduce the chances of Hypoxemia and cyanosis which is a outcome of insufficient gas exchange leasing to circulatory problems.

• Define one of these possible outcomes and explain how (and why) it would change the priority problem. Then, identify at least one new measurable goal related to the newly identified problem.

The priority problem was low O2 sat due to airway obstruction (crackling in lungs). According to the ABC guidelines of priority issues in patient, the airway would need to be adressed first and there for is a priority. Without addressing the extra mucus in the lungs it would be hard to elevate O2 gas exchange. If the Airway can be cleared the next priority issue to adress is to raise the O2 SAT from 93% to between 95% and 100% within 48 hours without supplemental O2. I think that is a measurable to attain once the airway is cleared. It is important to Also a educate the patient on the risks of smoking and how it effects oxygen saturation.

example reply from 3

Great post and I like how you mentioned using the nasal cannula as a way to get his Oxygen saturation up. What I did not know prior to the last clinical I was on is that Oxygen is something that the provider needs to write off on. My lack of experience, I just thought if someone's oxygen was low you could just hook them up to an oxygen machine to help them breathe. I had a patient the other day who was not wearing her oxygen and the CNA was unable to put it back on her because she had to get permission from the nurse and the nurse in turn had to get permission from the doctor in order to put the nasal cannula back on. I just thought that was interesting and it taught me something I did not know before. What I did learn from this discussion as well was that that dullness sounds during percussion can be a sign of pneumonia or a pleural effusion which is a buildup of fluid in the lungs (Thompson, 2022).