Comprehensive Nursing Care Plan and Reflective Analysis

The assignment presents a detailed nursing care plan for Carol Jones, addressing issues like impaired gas exchange (hypoxaemia) and hypertension. The patient exhibits symptoms such as sudden breathlessness, nausea, high blood pressure, tachycardia, and pale skin. Problem identification focuses on impaired gas exchange or hypoxaemia with goals to normalize blood pressure (SBP 120-130, DBP 60-80) and breathing patterns within 24-48 hours. Interventions include monitoring breathing patterns, administering respiratory relaxants and beta adrenergic agonists, positioning the patient upright, and providing humidified oxygen. The rationale emphasizes understanding abnormal breathing for effective care planning, using medications to relax airways and reduce vascular resistance, and utilizing diuretics to manage hypertension. Outcomes indicate improved breathing rates, stabilized skin color, and lowered blood pressure. The reflection highlights the opportunity to enhance diagnostic skills, acknowledges limitations in equipment operation, and commits to ongoing professional development. It underscores the importance of patient-centered care for a lifestyle-related case with potential cardiovascular risks.

Running head: NURSING CARE PLAN AND REFLECTION ASSIGNMENT
Nursing care plan and reflection assignment
Name of the student:
Name of the university:
Author note:

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NURSING CARE PLAN AND REFLECTION ASSIGNMENT
Table of Contents
Care plan: 2
Reflection: 6
Reference: 7

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NURSING CARE PLAN AND REFLECTION ASSIGNMENT
Care plan:
Assessment Cues: The patient had been suffering from conditions like sudden
breathlessness, nausea, and her blood pressure had been high in the range of 160 to 170/93
mg/hg. The patient had been mildly tachycardic and had felt sudden episode of
breathlessness and her skin had been pale.
Problem identification: impaired gas exchange or hypoxaemia.
Goal: The patient will have return to having normal blood pressure with SBP at 120-130
and DBP at 60-80. The patient will return to having normal breathing pattern and will feel
more at ease within the next 24-48 hours
Expected
Outcomes
Interventions Rationale Evaluation
The next outcome is
to reduce the
breathlessness or
hypoxaemia of the
patient and help
revive the normal
breathing pattern in
the patient within
the next 24 to 48
hours.
 Observing the
breathing patterns
for the patient to
monitor the
abnormalities and
address the
complications that
the patient is
associated with.
 Administer
respiratory
relaxants and
other medications
like the beta
andrenergic
 Understanding the
breathing patterns
or abnormality
will help in
designing and
implementing a
much more
effective and
person centred
care plan for the
patient.
 Administering the
beta andrenergics
will help in
relaxing the
The
breathing
pattern and
oxygen
saturation
pattern was
monitored
diligently.
The patient
regained
normal
breathing
rate and felt
easier to
breath with

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NURSING CARE PLAN AND REFLECTION ASSIGNMENT
agonists along
with oxygen (
James et al. 2014).
 Place the
patient in upright
position and
encourage
breathing
exercises.
 Administration
of humified
oxygen to the
patient with the
help of
appropriate
devices like nasal
cannular face
masks.
smooth muscles
in the airways and
will also help in
bronchodilation to
widen air
passages and
facilitate
enhanced air
passage ( Masjuan
et al. 2011).
 The upright
positioning will
help relax the
respiratory
muscles and will
help to make
optimal and
maximal use of
the accessory
respiratory
muscles.
 The humified
oxygen will help
to hypoventilate,
which in turn will
help him to
breathe more
easily.
time. The
paleness of
the patient
reduced
gradually
and was
stabilized.
The first desired
outcome is the
 Administration
of vasodilating
 Vasodialators are
extremely crucial
The blood
pressure of the

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NURSING CARE PLAN AND REFLECTION ASSIGNMENT
blood pressure
of the patient
lowered to SBP
at 120-130 and
DBP at 80-95
mg/hg within 24
to 48 hours.
medications like
hydralazine and
minoxidil.
 Administration
of diuretics like
chlorothiazide,
hydrochlorothiazi
de, furosemide,
indapamide,
metolazone, and
quinethazone (
Azadbakht et al.
2011).
oral medication
that helps to
reduce and
control the blood
pressure
fluctuations in the
body. These
medications
administered
orally helps in
relaxing the
vascular smooth
muscles and help
in turn to reduce
the vascular
resistance.
 Diuretics can be
considered the fist
in line medication
intervention to
manage or
minimize
hypertension.
They help to
inhibit the
reabsorption of
sodium and
chloride in the
blood and act as
efficient
antihypertensive
patient was
constantly
monitored and
documented.
The blood
pressure
reduced
significantly
and the patients
felt visibly more
at ease

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NURSING CARE PLAN AND REFLECTION ASSIGNMENT
agents (
Hodgkinson et al.
2011)

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NURSING CARE PLAN AND REFLECTION ASSIGNMENT
Reflection:
It has to be understood that this care planning and execution of the plan had been an excellent
opportunity for me to reflect on my own diagnostic and clinical reasoning skills that I have
generated as a fractioning nurse myself. Carol Jones, the patient under consideration had been
leading a more or less sedentary and uncaring lifestyle with almost regular alcohol consumption.
Along with that, the patient history revealed that she had not been into exercising and the
lifestyle for her hectic career has led her to hypoxeamia and nausea with high blood pressure.
The breathlessness, nausea and extremely high blood pressure diagnosed had been the main
concerns in the care plan for her, which were contributing to the decreased cardiac output and
could have been the possible causes of an ischemic attack. The monitoring and administration
process included performing a few key clinical skills, which gave me ample opportunities to
enhance my performance and competence further. The only limitation that I had been facing with
had been operating the equipments used in providing humified oxygen and airway management
to the patient, and I will be participating in performance improvement programs and workshops
to improve my skills in this area. Lastly, I hope to be able to provide effective patient centred and
holistic care.

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NURSING CARE PLAN AND REFLECTION ASSIGNMENT
Reference:
Azadbakht, L., Fard, N.R.P., Karimi, M., Baghaei, M.H., Surkan, P.J., Rahimi, M.,
Esmaillzadeh, A. and Willett, W.C., 2011. Effects of the dietary approaches to stop
hypertension (DASH) eating plan on cardiovascular risks among type 2 diabetic
patients. Diabetes care, 34(1), pp.55-57.
Hodgkinson, J., Mant, J., Martin, U., Guo, B., Hobbs, F.D.R., Deeks, J.J., Heneghan, C.,
Roberts, N. and McManus, R.J., 2011. Relative effectiveness of clinic and home blood
pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of
hypertension: systematic review. Bmj, 342, p.d3621.
James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison-Himmelfarb, C., Handler, J.,
Lackland, D.T., LeFevre, M.L., MacKenzie, T.D., Ogedegbe, O. and Smith, S.C., 2014. 2014
evidence-based guideline for the management of high blood pressure in adults: report from
the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5),
pp.507-520.
Masjuan, J., Álvarez-Sabín, J., Arenillas, J., Calleja, S., Castillo, J., Dávalos, A., Tejedor,
E.D., Freijo, M., Gil-Núñez, A., Fernández, J.L. and Maestre, J.F., 2011. Stroke health care
plan (ICTUS II. 2010). Neurología (English Edition), 26(7), pp.383-396.