Assessment Subjective: pwede bang iincrease yung oxygen to 20(L/min) Objective: Restlessness RR: 11 rpm 02 saturation: 93% Nasal

Nasal Flaring and Dyspnea

Objectives After 6 hours of nursing interventions the patient will demonstrate ease in breathing

Intervention Monitor vital signs and assess patients conditions. Assess LOC, distress and irritability. Observe skin color and capillary refill.

Rationale To establish baseline data

Evaluation After 6 hours of nursing interventions the patient demonstrated ease in breathing

This signs may indicate hypoxia. Determine circulatory adequacy, which is necessary for gas exchange to tissues To maintain airway stimulates the patient to achieve maximum voluntary lung expansion to control shortness of breath Improves gasexchange decrease work of breathing.

Elevate the head of bed to a low fowlers position Instruct the client to perform bottle blowing exercises

Teach client on proper pursed lip breathing

Dependent: Provide supplemental oxygen at 5L/min