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.
ASSESSMENT
Subjective:
"I still kept on smoking, even though I know I had my emphysema," as
verbalized by the patient.
Objectives:
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.
DIAGNOSIS
Risk-prone health
behavior related to continuous smoking secondary to respiratory condition.
PLANNING
After 2 hours of nursing
intervention, the patient will initiate lifestyle changes that will permit
adaptations to current life situation.
INTERVENTION
- 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.
EVALUATION
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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