CUES NURSING PLANNING INTERVENTION RATIONALE EVALUATION

INTERVENTION
SUBJECTIVE: Ineffective breathing LONG TERM: DEPENDENT: GOAL MET:
pattern related to After 1 week of >Auscultate chest to > To identify the
respiratory muscle effective nursing evaluate presence of character of >The patient was able
fatigue as manifested intervention the patient breath sounds. breath sound to establish a normal
OBJECTIVE: by irregular will be able to: breathing pattern.
> No use of breathing. > Establish a normal >Inadequate
accessory respiratory pattern as >Monitor VS oxygenation causes >the patient was able to
muscle evidenced by other sign increase PR. demonstrate appropriate
> Irregular and symptoms of coping behavior.
breathing hypoxia. >to identify the type
> Breath SHORT TERM: of breathing pattern
sounds: After 3 days the patient > Monitor rate and
wheezes will be able: depth of respirations,
> Weak > Demonstrate type of breathing
peripheral appropriate coping pattern. >to promote deeper
pulse mechanisms. respiration
• INDEPENDENT:
>Medicate with
analgesics ordered by
the physician.