Question

An older adult patient reports fatigue, decreased energy, and difficulty breathing. The medical diagnosis is respiratory acidosis with metabolic compensation. The nurse formulates a nursing diagnosis of Fatigue. Which goal statement should the nurse include in the plan of care?

1) The patient will report decreased fatigue within 24 hours.
2) The patient will demonstrate increased energy levels.
3) The patient will maintain oxygen saturation above 95%.
4) The patient will exhibit improved breathing patterns.

Answer 1

The nurse should focus on goal 4) The patient will exhibit improved breathing patterns, which directly addresses the underlying respiratory issue causing the patient's symptoms of fatigue and difficulty breathing.

Step-by-step explanation:

The appropriate goal statement the nurse should include in the plan of care for a patient diagnosed with respiratory acidosis with metabolic compensation experiencing fatigue, decreased energy, and difficulty breathing would be 4) The patient will exhibit improved breathing patterns. This goal is most relevant to the condition of respiratory acidosis with metabolic compensation and directly addresses the underlying cause of the patient's symptoms, which is the inefficient exchange of gases and resulting fatigue.

In respiratory acidosis, there is an excess of CO2 in the blood, and the body compensates metabolically by increasing bicarbonate levels. Asthma, as in the case study provided, contributes to respiratory acidosis by causing airway constriction and hampering CO2 exchange, leading to an elevated pCO2. With metabolic compensation, the kidneys react to increased carbonic acid by retaining bicarbonate, which normalizes the pH over time. However, despite compensation, the primary issue of poor gas exchange in the lungs remains, making the improvement of breathing patterns a logical priority for care.