Question

On admission to the hospital a client with an acute asthma episode has intermittent nonproductive coughing and a pulse oximeter reading of 88%. The client states, "I feel like this is going to be a bad time this admission. I wish I would not have gone into that bar with all

those people who smoke last night." Which nursing diagnoses would be most important for this client?
A) Anxiety related to hospitalization
B) Ineffective airway clearance related to potential thick secretions
C) Altered health maintenance related to preventative behaviors associated with asthma
D) Impaired gas exchange related to broncho constriction and mucosal edema

Answer 1

For the client with an acute asthma episode and hypoxemia, the most important nursing diagnoses are Impaired gas exchange, Ineffective airway clearance, and Anxiety related to hospitalization, due to symptoms and concerns expressed by the client.

Step-by-step explanation:

The most important nursing diagnoses for a client admitted to the hospital with an acute asthma episode, a nonproductive cough, and a pulse oximeter reading of 88% include:

1. Impaired gas exchange related to bronchoconstriction and mucosal edema.
2. Ineffective airway clearance related to potential thick secretions.
3. Anxiety related to hospitalization.

The presence of hypoxemia (a low blood oxygen level), difficulty breathing, and history of exposure to a known trigger (smoke and a crowded environment) primarily support the diagnosis of Impaired gas exchange. The symptom of nonproductive cough supports the diagnosis of Ineffective airway clearance. The client's expressed concerns about the admission indicate Anxiety. The client's past behavior regarding asthma prevention is recognized in the diagnosis of Altered health maintenance related to preventative behaviors associated with asthma; however, it is less immediately acute than the need to address the oxygenation.