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Samael is a 40 year old bank teller who smokes so much that he can take 2 packs of cigarette in a single day. Did you know someone who is like Samael? Some people said that smoking is better than to have a disease cause from secondary smoking. However, on part of Samael, it is different. He was diagnosed 4 months ago with emphysema and yet he still do smoke. He manifested some respiratory problems but he just ignoring the facts and considered it normal since he is a smoker. Does his respiratory problems really normal to a smoker? Below is a sample of risk-prone health behavior nursing care plan of Samael who cannot quit smoking even with respiratory problems.


"I still kept on smoking, even though I know I had my emphysema," as verbalized by the patient.

The patient have productive cough and he/she is positive to barrel chest. Rapid breathing and wheezing also manifested. Vital signs are taken and noted as follows: Body temperature is 36.8 degrees Celsius, blood pressure is 130/90 mmHg, respiratory rate of 25 cycles per minute, and pulse rate of 72 beats per minute. All of his/her vital signs are above normal except pulse rate which is on the other hand, below normal. That means he/she had an abnormal vital signs. 


Risk-prone health behavior related to continuous smoking secondary to respiratory condition.


After 2 hours of nursing intervention, the patient will initiate lifestyle changes that will permit adaptations to current life situation.


- Review previous life situations of and role changes of Samael to determine coping skills used if any. Explain to him the disease process; causative factors and prognosis to his enhance understanding. Perform to Samael a physical and psychological assessment to determine the extent of the limitations of the current condition. Listen to the patient's perception of inability and reluctant to adapt to his situations that are currently occurring. Survey with Samael's past and present significant support systems such as his family, church, groups, and organizations to identify what resources can help him. Explore his expressions of emotions signifying impaired adjustment by patient such as overwhelming anxiety, fear, anger, and worry, passive and active denial. Note Samael's interaction with parent because development of coping behaviors is limited at this age, and primary caregivers provide support for the him and serve as role models. Determine whether he displays problems with school performance, withdraws from family or peers, or demonstrates aggressiveness behavior toward others or self. 

- Listen to Samael's perception of the factors leading to the present dilemma, noting onset, duration, presence or absence of physical complaints, and social withdrawal. Determine his lack of inability to use available resources. Review available documentation and resources to determine Samael's actual life experiences such as medical records or consultant's notes. In situations of great stress, physical and emotional, the patient may not accurately assess occurrences leading to the present situation. 

- Organize a team conference including Samael and ancillary services to focus on contributing factors effecting adjustment and plan for management of his situation. Acknowledge patient's efforts to adjust because these can lessen his feelings of blame or guilt and defensive response. Share information with Samael's peers as indicated when illness affects body image. His friend can be a support for this age group. Provide an open environment encouraging communication so that his expression of feelings concerning impaired function can be dealt with realistic and openly. Use therapeutic communication skills such as active listening, acknowledgement, silence and statements. 


After 2 hours of nursing intervention, the patient initiated lifestyle changes that would permit adaptations to current life situation.


For more samples of nursing care plan you are free to check it out in our NCP LIST page.


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