CONCEPT MAP
Recognizing Cues, (S&S)
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SOB
Poc critical 73
Altered mental status
Diminished lungs sounds
Disease Process/Pathophysiology/Risk factors
Hypercapnia - Elevation in the arterial
carbon dioxide. It affects people who have chronic
COPD. It changes the PH of your blood making it
look acidic. This can happen slowly or suddenly
(Http//www.health line.com)
Risk factors
age. COPD
smokers
SOB
Analyzing Cues/ Concerns
Supporting
Altered mental status when off Bipap
Increased PCo2
Increase Carbon serum
SOB
Diminished
Concerning lung sounds
Increase Co2 cont BIPAP
Prioritizing Hypotheses
1.
Impaired gas exchange R/T cont BIPAP
2. Ineffective tissue perfusion R/T diminished lung
sounds and SOB
3. Decrease activity intolerance R/T SOB
Generate Solutions Outcomes Interventions
SMART planning
1. Tpw have a min 3 for on the pain scale this
shift.
2. TPW maintain her baseline vitals this shift .
3.TPW t &p q 2Hr
4.TPW lungs will be auscultated this shift.
5.TPW be instructed to use the incentive
spirometer and cough & deep breath
this shift
6. TPW apply BIPAP this shift.
Evaluating Outcomes
Take Actions – (How to)
1. Use of pain scale to monitor pain
2. Closely monitor BP and pulse
3. The pt HOB elevated 30-40 angle to
decrease secretion and aspiration.
4. The presence of crackles and wheezing
may alert to airway exacerbation
5. Cough and deep breathing with higher
levels of pressure assistive ventilation
lowering CO2
6. BIPAP assists with lower of Co2
1. Goal was not met pt c/o pain 8/10
2. Goal met vitals @ baseline this shift
3. Goal met pt was turned and positioned q 2hrs and HOB is elevated
4. Goal met no abnormal lungs sounds noted this shift
5. Goal not met unable to follow verbal cues R/T increase CO2
6.Goal met BIPAP did bring CO2 levels down slightly.
Problem-Based Care Planning and Concept Mapping Instrument based on the Clinical Judgment Measurement Model
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