Nursing educator Christina Rafano teaches how to build a COPD care plan using NANDA diagnoses. She covers selecting the right diagnosis, writing patient goals like oxygen saturation ≥ 88% by discharge, and listing nurse interventions such as breathing exercises and bronchodilator administration. The plan ends with evaluation to check if goals were met.
Chapters
In this video, we are going to walk through a COPD nursing care plan. I want you to ace all your care plans in nursing school. So in this video, I'm going to walk you through how to write a great care plan. And we're going to use COPD as an example so that you can rock the next one that you write. Let's do it. So as I go through the COPD care plan, I'm actually going to be using the study guide inside our nursing SOS membership community. So if you are a nursing SOS member, be sure to check it out in your dashboard so you can kind of follow along with this video. I am just going to be pulling a lot of information from that study guide and putting it into the care plan so that you can kind of see how it works and you can follow along better. So the first part of your nursing care plan, of course, is the nursing diagnosis. Now this is a standardized nursing diagnosis that you will choose. It's like the NANDA nursing diagnosis, right? There's a whole list of them. You do not make them up yourself, my friend. Okay? It's so, so easy. You just choose from the list of NANDA nursing diagnoses. And if you need help with that, check out this video here where I walk you through exactly how to do that. So that's the first thing that you will need to do for your nursing care plan is to choo a NANDA approved nursing diagnosis. So some that work really well for COPD are ineffective breathing pattern, ineffective airway clearance and impaired gas exchange. Any of those could be a really good fit for your patient. Of course, you will want to make sure that they do fit your patient. If your patient doesn't have one of those problems as much, then you wouldn't want to choose that one. You'd want to choose one that fits your patient better. So it's the first step to writing an amazing care plan is to choose the right nursing diagnosis. Now, the second part of this nursing diagnosis is the related two factor. Now, friend, I always say this and I really, really, this is so important. So please, please listen up. When you submit your nursing care plan to your nursing instructor, they're looking for one thing. They want to make sure that you understand what is going on with your patient. And one of the best ways to do that is to show them that you understand the pathophysiology behind what is actually going on with your patient. And that's where the related two factor comes in. So, so when you do the related two factor in Your nursing diagnosis, I want you to be thinking patho, Think about the pathophysiology. So here in copd, really what's happening is that there's a trigger in the body that is triggering the inflammatory response in the lungs. Then that inflammation decreases the gas exchange in the lungs and it causes mucus buildup and bronchospasm and edema in the lungs. So when you think about that related to factor, you have to be thinking pathophysiology. That is really going to impress your instructor if you, you can explain it really well. Now, the third part is the as evidenced by this is the third part of your nursing diagnosis. Now, this is really just the signs and symptoms of what's happening with your patient. So the as evidenced by is the evidence as to why you chose that NANDA nursing diagnosis, right? So for a patient with copd, some things that you might want to include is that they have a unproductive or a productive cough, they have a fever, they have dyspnea, accessory muscle use, maybe they're fatigued, they have wheezes, you're hearing wheezes in their lungs on auscultation, their respiratory rate is increased. All of those things you can definitely put in that, as evidenced by section of your nursing diagnosis, because it will prove your NANDA nursing diagnosis of ineffective breathing pattern, ineffective airway clearance, those kinds of things. So make sure that they fit though. So any nursing diagnosis that you use, you need to make sure that the as evidenced by factors actually provides evidence and the reason for you selecting that particular NANDA diagnosis. Now, the second part to your nursing care plan is the patient goals. Now here is where in this column you will create goals for your patient to achieve. And you'll always want to write these as the patient will, so the patient will do this. And these patient goals need to be linked back to the original problem. We want to solve that original problem. We want to solve for that underlying pathophysiology physiology. Like we want to solve for what the patient is experiencing, okay? We want to fix it, right? So the patient goals link back to that NANDA nursing diagnosis and they try to fix the underlying problem. So for this example of copd, we could use patient goals such as the patient will have an increased blood oxygen level and you can put the exact number based on your patient too. Like if your patient started in the 70s, maybe you would increase it to 80s or even 90s. You know, depending on your patient, the patient, patient will have less accessory muscle use. That would be another good patient goal. Right. The patient's airway will be clear. Now, one thing that I do want to mention is that some nursing schools require you to put a deadline to it or a time frame on your patient goals. So in that case, you'll want to check with your school, check with your instructor on what they require specifically. But for these patient goals, you could put the patient will have less accessory muscle use by, oh, 700 tomorrow morning, something like that, or 1900 today, you know, so you just put a deadline to it. You could say even by discharge, you could say the patient will have a blood oxygen level of at least 88% by discharge, something like that. So you would just put a deadline to it at the end of that patient goal. Now, in the next column of your nursing care plan are the nursing interventions. Now, this is what you will do as the nurse or nursing staff student in order to help your patient meet those goals. So this column is all about you. So you will write them as the nurse will. All right, so they're different from the previous column with patient goals, which is very patient centric. Now this is your time to shine on what you will be doing as the nurse in order to help them meet their goals. So some really great nursing interventions that you can use for a patient with COPD are monitoring their respiratory and cardiac status. So the nurse will monitor their respiratory status, monitor their cardiac status. The nurse will help the patient perform breathing exercises like controlled coughing or abdominal breathing. So, so good. The nurse will reposition the patient every two hours. The nurse will administer bronchodilators as prescribed, or corticosteroids as prescribed, or mucolytics as prescribed. Right. So the nurse will, in this column, the nurse will educate the patient on repositioning and medication management. So this column starts with the nurse will. Whereas the previous column was the patient will. You see the difference? And now the last column is the evaluation. You need to evaluate whether or not your patient met their goal. Now, evaluation is just basically another name for the nursing assessment all over again. So you just go assess your patient again and see, did they meet their goal or did they not meet their goal? If they did meet their goal, great, that care plan is complete. If they did not meet their goal, then you'll go back and you'll look and see, well, why didn't they meet their goal? And what can you do differently next time in your new care plan to help them meet their goal the next time? So that's what the evaluation column is all about. And I have some more fantastic care plan examples for you. I'll put the link down below in the description for you to check those out. And in this video I walk you through how to write an A plus nursing diagnosis. So if you are getting stuck on that, you definitely do not want to miss that video and go become the nurse that God created only you to be. And I'll see you in the next video. Take care. Bye bye.
