Nursing Care Plan for Joyce Coombe

This nursing care plan provides interventions for immobility, imbalanced nutrition, and dehydration in Joyce Coombe. It also discusses the medication prescribed to her and the importance of quitting smoking.

joyce coombe
care plan

Contents
Nursing Care Plan for Joyce Coombe:............................................................................................3
PART 2............................................................................................................................................1
Medication prescribed to Joyce...................................................................................................1
PART 3............................................................................................................................................2
Why Joyce needs to stop smoking...............................................................................................2
REFERENCES................................................................................................................................4

Nursing Care Plan for Joyce Coombe:
1) Problem: Immobility
Underlying cause or reason: It has been analyzed from the case study that patient has been diagnosed with a chest infection. She also have a medical history
of asthma and also she was a chain smoker, this has resulted in shortness of breath and exertion.
Goal of care( a simple
statement is sufficient here)
Nursing interventions/actions(Fundamentals
of care are to be included here and must be referenced).
Rationale: Indicators your plan is working
It has been analyzed
from the case study that
Joyce is been suffering
from the shortness of
breath and asthma. She
is unable to manage her
movement and also
unable to take few
steps. She is currently
facing the problem of
immobility. In order to
overcome this, it is
really necessary to
mobilize her and also
There are various types of nursing
interventions which must be used in order
to cure the problem of immobility. They
can make use of intervention such as
postural drainage exercises such as high
fowlers position, postural drainage. This
will help nurses in enhancing the health
outcome of patients (Coleman and et.al.,
2017). Nurses are also been involved in
taking other intervention such as regular
deep breathing and coughing exercises.
Nurses will also be engaged in Ensuring
the use of her ipratropium bromide
medication. They will also be involved in
These interventions are been taken by
nurses in order to enhance the health
outcome of patient suffering from
problem of immobility. It has been
analyzed that Coughing exercise will
helps mobilize respiratory secretions to
larger airways for expulsion. It has also
been analyzed that when nurses will
manipulate the position of body, it will
support Joyce to expel sputum which
has been caused because of smoking
cigars. It has also been analyzed that
taking Joyce out of bed will help in
reducing the sputum from the airspaces.
There are various indicators on which plan
is trying to work. It is based on that
coughing is reduce and also deep and
effective. It will also help them in reducing
the impact of SOB. Nurses will also make
sure that sputum is coming up. They will
also be involved in ensuring that Joyce is
able to come out of the bed more often and
also do not find any problem related to the
mobility. Nurses will also make sure that no
pain is faced by her during the time when
she coughs and moves out of bed every time
fearless without the fear of falling out from
the bed. They will ensure that Joyce

clear her lungs from
sputum so that Joyce
can feel comfortable.
making sure to provide Joyce with pain
management medication. They will also try
to mobilize patient out of her bed.
This will assist nurses in clearing down
the lungs of patients and will also
improvise their health outcome.
participate in drainage exercise so that her
health outcome is improved.
2) Problem: Imbalanced nutrition
Underlying cause or reason: It has been analyzed from the case study that Joyce is been facing problem related to imbalance nutrition, poor appetite because
of the infection and fatigue.
Goal of care It has
been analyzed from the
Nursing interventions/actions
There are various nursing interventions
Rationale
In this validation will help Joyce in
Indicators your plan is working
The indicator related to make this plan

case study that Joyce is
been facing problem
related to imbalance
nutrition, poor appetite
because of the infection
and fatigue. This can be
because of the reason
that she has the past
medical history of
depression and also
patient is also facing
other problem which is
immobility. It can also
because of the infection
faced by her.
which will be adopted. In this Joyce is to
be encouraged to increase her intake of oral
fluids. It has also been analysed that nurses
will also make sure that She is to be
commenced on a fluid balance chart and
diabetic food chart and is to have second
daily weighs. They will also be engaged in
Joyce ability to obtain and use essential
nutrients. They will also be involved in
encouraging exercise (Matney and et.al.,
2016.). Nurses will also be engaged in
validating their feelings related to current
life style. High protein supplements can
also be encouraged by nurses.
recognizing that her problem is been
heard. Encouraging exercise will also
assist patient in increasing their
metabolism and also it will help them in
improving the mobility of patient. High
supplements used by nurses can assist
in increasing calories and protein
without conflict with voluntary food
intake.
working includes that health outcome of
Joyce is improved and she is been engaged
in taking better nutrient diet. This will assist
her in improvising their mobility power and
also her metabolism will also be improved.
This will help her in fighting from infection.

3) Problem: Dehydration
Underlying cause or reason: It has been analyzed from the case study that Joyce is been suffering from the problem of dehydration because of Insensible fluid
loss &decreased fluid intake.
Goal of care Nursing interventions/actions Rationale Indicators your plan is working
It has been analyzed
from the case study that
Joyce is been suffering
from the problem of
dehydration because of
Insensible fluid loss
&decreased fluid
intake. This can be
because of the improper
nutrient balance
because of the infection
and problem in
breathing.
In this nurses will be engaged in motivating
Joyce to consume extra fluids with meals.
Record accurate I & O. Cumulate each
shift. Evaluate daily compared with
resident’s minimum fluid requirements
(Elo, 2017).
These interventions are been used so
that problem like dehydration and other
infections are been reduced. It will
reduce the risk related to ineffective
tissue pervasion.
The indicators related to which plan is
working upon includes that the infection
faced by Joyce is been reduce and health
outcome is been enhanced.

PART 2
Medication prescribed to Joyce
It has been analysed from the case study that Joyce is been provide with various type of
medication in order to cure her health related problems. Patient has been given certain type of
medication which includes Oral prednisone, Ipratropium bromide delivered with a spacer, Oral
amoxicillin. In this it is one of the major responsibility of nurse to make patient aware about the
various side effects related to the medicine which is been provided to her. They also have the
responsibility to make Joyce know about potential benefits of the medicines been given to her.
The example can be taken such as oral prednisone is been given in varying doses and this
medication needs to be tapered off slowly as it has the possibility to increase the complication
related to endocrine and also various type of kidney disease can be faced by patient, if the dosage
related to medication is high. Oral prednisone is basically been given to Joyce as she is facing
problem in breathing (Desai and et.al., 2019). There are also various other type of side effects
which can be faced by patient because of the consumption of this medication.
Nurses have the responsibility to monitor the effects of this medicine. It has been analysed
that if it has been taken in excess than Joyce can face problem such as sleep disorders, headache,
nausea, dizziness. It can reduce the quality of life and well-being of Joyce. It has been analysed
that various precautionary measures needs to be taken while consuming this type of medications.
The other side effects that can be faced by Joyce include puffy face. The other medication which
is been given to Joyce includes Ipratropium bromide. This is basically been given in order to
improve the airways in lungs. This will help Joyce in overcoming the problem related to
breathing and wheezing. This medication also has certain side effects which need to be
communicated to patient. It will assist Joyce in preventing signs and symptoms related to
shortness in breathe. There are also various side effects related to it. This medication only must
be taken when prescribed by the health care professionals. The excessive use of this medication
can have severe and mild side effects. The severe risk factor can include problem during the time
of urination or Joyce can also face the condition where her heart beat rises. It is the duty of
nurses to make patient aware about all consequences related to medication which has been
consumed by her. This will help nurses in enhancing the health outcome of Joyce. The other
medication which has been given to patient includes Oral amoxicillin. This is basically been
given in order to treat the variety of bacterial infections which has been faced by the patient.
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There are various type of side effects which has been associated with this medication, nurses
have the responsibility to make Joyce aware and educate about the various type of problems
which is been related to this medicine. This medication can cause nausea, vomiting and
diarrhoea. It also has some serious side effects that need to be analysed by the nurses to enhance
well being of Joyce.
PART 3
Why Joyce needs to stop smoking
The topic which has been selected for this question includes that Joyce needs to stop
smoking. As everyone knows those smokings of cigars are injurious to health. This needs to be
made understood to patient so that her health outcome is been enhanced. It has been analysed
from the case study that patient is a chain smoker. Smoking can be considered as one of the
major reason that Joyce is been suffering from the problem of asthma. It can also be noted that
She is unable to manage her movement and also unable to take few steps because of the
shortness in breathe and wheezing. In order to improve her health outcome it is really necessary
for the patient to quit smoking so that risk factor related to Bronchitis and asthma can be
decreased. This will help Joyce in improvising her quality of life. Smoking can also become
cause for other type of disease such as chronic obstructive pulmonary disease. It can lay severe
negative impact on health outcome of Joyce and also will reduce her physical and mental ability
to perform task. It has also been analyzed from the case study that certain type of medications are
also been provided to patient in order to enhance her health outcome (Tuinman and et.al., 2017).
The medicines include the Oral prednisone, Ipratropium bromide delivered with a spacer,
Oral amoxicillin. There are various side effects of these medications. It has also been analysed
that these medicines have certain consequences and they cannot be taken when patient is been
involved in smoking cigars. It is necessary for Joyce to stop smoking in order to enhance her
health outcome (Lin and et.al., 2019). It can also lower down the risk related to death. Several
other consequences can also be faced such as heart related problems, lung cancer. Joyce is prone
to all such type of disease. The benefits of not smoking will include that in future patient will not
face shortness in breathe. Smoking can also make Joyce depressed. It is really necessary for
patient to smoking so that In order to mobilize her and also clear her lungs from sputum so that
Joyce can feel comfortable. This will assist nurses in enhancing the health and well being of
Joyce. This will also reduce the potential risk related to various type of disease. It will also help
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Joyce in being back to normal. It has also been analyzed that she must not be involved in
smoking while taking so many type of medications. It will reduce her health and well being. It
will also assist in not facing problem like shortness in breathe, coughing and wheezing. Joyce
needs to stop smoking.
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REFERENCES
Books and Journals
Tuinman, A. and et.al., 2017. Accuracy of documentation in the nursing care plan in long-term
institutional care. Geriatric nursing, 38(6), pp.578-583.
Desai, S. and et.al., 2019. A Review for development of Concise Nursing Care Plan
(CNCP). International Journal of Advances in Nursing Management, 7(4), pp.371-377.
Lin, S.K. and et.al., 2019. Integrating traditional Chinese medicine healthcare into dementia care
plan by reducing the need for special nursing care and medical expenses. Medicine, 98(7).
Elo, A., 2017. Designing a Nursing Care Plan Application for Nursing Education in Finland.
Matney, S.A. and et.al., 2016. Communicating nursing care using the health level seven
consolidated clinical document architecture release 2 care plan. CIN: Computers,
Informatics, Nursing, 34(3), pp.128-136.
Coleman, J. and et.al., 2017. Using a new end-of-life care plan in nursing homes. Nursing and
Residential Care, 19(1), pp.38-41.
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