A client who has been discharged home after a cerebral vascular accident and has trouble swallowing 2. A hospitalized patient with a decreased level of consciousness and a closed head injury 3. A patient hospitalized while recovering from a transurethral prostatectomy 4. An elderly client attending a class at the recreation center 5. A young adult having outpatient surgery for a torn meniscus 6. Client gastric tube receiving intermittent tube feedings on a medical/surgical floor a. Nosocomial Pneumonia b. Aspiration Pneumonia c. Community Acquired Pneumonia - 1. b,c 2. a,c 3. a 4. c 5. a,c 6. a,b 1. Elevate the head of the bed (45-90 degrees/semi to high Fowler's position) 2. Monitor respiratory rate, breathing pattern and oxygen saturation. 3. Assess for adventitious lung sounds (crackles, rales, stridor or absent etc). 4. Encourage deep/purse lip breathing exercises, ambulation, active/passive range of motion (ROM) and use of incentive spirometer. 5. Report new abnormal findings or changes to health care provider. - 1. This will expand the lungs by taking pressure off the diaphragm and forcing any fluid in the lungs towards the bottom so more surface area is available for gas exchange. 2. Change in respiratory rate, breathing pattern, and oxygenation can suggest the need for further action
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