Client’s Initials: JD Key Problem #_1__ Nursing diagnosis: Impaired gas exchange r/t mismatch of ventilation and perfusion aeb O2 90%, R- 24, pCO2 - 46 Subjective/objective assessment data: Client says she hasn’t taken her asthma medication in past 2 days; working hard to breathe as she speaks; SOB; O2 90%, pCO2 46 (Vera, 2012) (Taylor, Lynn, & Bartlett, 2019, p. 1488, 1497, 1499) Key Problem #_2__ Key Problem #_3__ Nursing diagnosis: Ineffective airway clearance r/t bronchospasms and increased pulmonary secretions aeb dyspnea, non-productive cough, wheezing, R-24, bilateral lung congestion, O2 90%, pCO2 - 46 Nursing diagnosis: Subjective/objective assessment data: Client says she hasn’t taken her asthma medication in past 2 days; working hard to breathe as she speaks; SOB (Martin, 2016) Ineffective breathing pattern r/t spasm of the airway aeb SOB, wheezing, pCO2 - 46 Subjective/objective assessment data: Difficulty speaking without struggling to breathe, (Taylor, Lynn, & Bartlett, 2019, p. 1488, 1497, 1499) Key Problem #___ Key Problem #___ Nursing diagnosis: Diagnoses/Surgical Procedure: n/a Nursing diagnosis: Subjective/objective assessment data: Medical diagnosis: Status asthmaticus Subjective/objective assessment data: Reason for needing health care: SOB Key Assessments: 0800 vital signs – B/P 130/80, P- 108, R – 28, T - 100.0 F, O2 sat 89% ABG- pH-7.35 pCO2- 46 HCO3- 26, paO2- 88 1030 vital signs - B/P 130/80, P-101, R- 24, T- 100.1F, O2 sat- 90% bilateral lung congestion with wheezing throughout, non-productive cough.