GERIATRIC

NURSING
MA.ALICIA GRACE S. KAIMO, RN, MAN
INSTRUCTOR

Universidad de Manila, College of Health Sciences

Module Title Theoretical Foundation of Nursing

Module No. 3

Total study hours Hrs. Lecture

Module writer: Ma. Alicia Grace S. Kaimo

Introduction Objectives and Terminologies

Module Aims This aims to impart to the learners’ how to properly manage older adult
problem on impaired gas exchange.
Module Learning Outcomes For the learners to understand the nursing management applicable to
impaired gas exchange.

Content Impaired Gas Exchange

Teaching/Learning Activities Online, Synchronous, Asynchronous

Assessment methods
Program Bachelor of Science in Nursing

Level/Placement 3rd year, 1st semester

Course Title Geriatric Nursing

Course code NCM 114

No. of Units units

Pre-requisite

Course Description

Rationale This course deals with the development of proper nursing care management on older client with
impaired gas exchange problem.

Focus
The nursing care plan for older adult with impaired gas exchange.

Outcome At the end of the course, the learners are expected to appreciate and utilize relevant nursing
management of older adult with problem on impaired gas exchange.
LEARNING OBJECTIVES
By the end of this course, the learners will be able to:
Assess the needs of older adult experiencing deficit gas exchange.
Implement nursing measures to alleviate problem on impaired gas
exchange.
11 Nursing Care Plans (NCP) and
Nursing Diagnosis for Geriatric
Nursing
1. Impaired Gas Exchange
Nursing Diagnosis
o Impaired Gas Exchange

Related Factors
o Reduced oxygenation with decreased functional lung tissue
Defining Characteristics
The following are the common subjective and objective data or
nursing assessment cues (signs and symptoms) that could serve as
your “as evidenced by” for this care plan:

o Dyspnea
o Irritability; restlessness
o Lethargy
o Tachycardia
o Decreased mental acuity
o Abnormal ABGs
Desired Outcomes
Below are the commonly used expected outcomes or patient goals
for Impaired Gas Exchange nursing diagnosis:

Patient’s respiratory pattern and mental status will be normal for the
client.
Patient’s pulse oximetry or arterial blood gas results will be within
the patient’s normal limits.
Nursing Interventions and Rationale
In this section are the nursing actions or interventions and their
rationale or scientific explanation for the nursing diagnosis
impaired gas exchange:
Nursing Intervention Rationale
Nursing Assessment
Monitor and record the following
during admission and routinely Provides baseline data for subsequent
thereafter: respiratory rate, depth, assessments of the
and pattern; breath sounds, cough, patient’s respiratory system.
sputum, and mental status.
 Nursing Assessment
These changes in the sensorium can
indicate decreasing oxygen levels. To
Assess subtle changes in patient’s comprehensively monitor pulse
behavior or mental status e.g., anxiety, oximetry, the hemoglobin (Hgb) must
disorientation, hostility, and be determined. Patients with low
restlessness. Check oxygen levels using hemoglobin levels can have a higher
pulse oximetry (higher than 92%) or pulse oximetry level and still
reviewing ABG values (optimally exhibit acute confusion or restlessness.
Pao2 80%-95% or higher). This happens as a result of diminished
hemoglobin to deliver oxygen through
the body.
 Nursing Assessment
When people get older, lungs elasticity
decreases. The lower portion of the
lung is not sufficiently aerated resulting
in the occurrence of crackles (usually
heard in individuals 75 years of age and
above). This sign alone does not imply
Auscultate the lungs for adventitious the presence of a disease condition.
sounds. Crackles (rales) that do not clear with
coughing in an individual with no
additional symptoms such as increased
temperature, increasing anxiety,
changes in sensorium, increasing
respiratory depth are considered
benign.
 Therapeutic Interventions
Encourage breathing and coughing
exercises. Instruct patient in use of
incentive spirometry if applicable.
Encourage increased fluid intake
(greater than 2.5 liters daily) unless
contraindicated by a renal or cardiac
condition.
Treat hyperthermia immediately,
reduce pain, lessen pacing activity, and
decrease anxiety.
Teach the patient in the use of support
devices such as nasal cannulas or
oxygen masks.
These measures provide alveolar
expansion and remove the secretions
from the bronchial tree, resulting to
optimal gas exchange.
Adequate hydration promotes
mobilization of secretions.
These measures decrease the demand
for increased oxygen consumption.
Knowledge about these equipment
promotes adherence to the treatment.
“If oxygen mask drops down, it’s time to take a breather.”
Thank you!!