Scope and Categories: Scope: Gas exchange is the process by which oxygenated air enters the respiratory tract, flows into the lungs, and is transported to the cells. Auscultate the lungs and monitor for abnormal breath sounds. Additionally, the Productivity and Unit Labor Costs data for Q4 will be released. How is impaired gas exchange and COPD diagnosed? We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. Encourage adequate States she does not wear her CPAP machine at night because it is too loud. Assessment Treatment for hypercapnia involves noninvasive ventilation therapy, often called BiPAP, which is the name of a brand of ventilation therapy machine. The nurse is evaluating the plan of care and notes that none of the goals have been met for the client with impaired gas exchange. Impaired Gas Exchange is a NANDA nursing diagnosis that is used for conditions where there is an alteration in the balance between the exchange of gases in the lungs. Fluid resuscitation will treat the underlying cause of the impaired gas exchange and improve oxygenation status. THE EFFECTIVENESS OF Vital signs will He is also now using 3 pillows to sleep at night instead of his usual 1 pillow, and he has experienced a 10-pound weight gain in 3 days. Name this step. restlessness. Click here to see a full list of Nursing Diagnoses related to Congestive Heart Failure (CHF). This will reduce hypoxemia resulting in improved oxygen saturation and reduce dyspnea. Fluid is constantly being added and reabsorbed by capillaries and lymph vessels in the pleura. airways or alveoli that have lost elasticity and cannot expand and deflate to their full capacity when you breathe in and out, alveoli walls that have been destroyed, leading to reduced surface area for gas exchange, long-term inflammation thats led to thickening of the airway walls, airways that have become clogged with thick mucus, pipe, cigar, or other kinds of tobacco smoke. Excess fluid will be removed and the patients weight will return to baseline. Impaired gas exchange related to fluid overload as evidenced by labored, tachypneic breathing, decreased oxygen saturation, crackles in lung fields, pitting edema, congestion on chest x-ray. -Pt will be free from any facial and mouth breakdown frombipap machine. Diuretics are prescribed to reduce the alveolar congestion. 1 Upright High concentrations of oxygen should typically be avoided for patients with COPD. Client demonstrates adequate ventilation and oxygenation of tissue evidenced by ABGs and oximetry. This is referred to as Impaired Gas Exchange. St. Louis, MO: Elsevier. Impaired Gas exchange. -The nurse will notify respiratory therapy to obtain ABG at 1500 and report results to the pulmonary md.-The nurse will monitor patients vital signs every hours while on the bipap machine. Some mechanisms behind impaired gas exchange in COPD can include one or a combination of the following: When gas exchange is impaired, you cannot effectively get enough oxygen or rid your body of carbon dioxide. Hypoxemia can be caused by the collapse of alveoli. The process of gas exchange, called diffusion, happens between the alveoli and the pulmonary capillaries. Wow, I give up! Hemodynamic Monitoring (Normal Values| Purpose|Hemodynamic Instability), Sample Nursing Care Plan for Preeclampsia |scenario|NCP with rationales, 19 NANDA Nursing Diagnosis for Fracture |Nursing Priorities & Management, 25 NANDA Nursing Diagnosis for Breast Cancer, 5 Stages of Bone Healing Process |Fracture classification |5 Ps, 9 NANDA nursing diagnosis for Cellulitis |Management |Patho |Pt education, 20 NANDA nursing diagnosis for Chronic Kidney Disease (CKD), Administer supplemental oxygen therapy with continuous oxygen saturation monitoring, Supplemental oxygen will increase alveolar oxygen concentration, Rest will reduce the bodys oxygen demands and consumption, Position patient into Semi-Fowlers position, Positioning will allow for maximal lung expansion and inflation, Administer medications as ordered (diuretics), Diuretics will pull off excess fluid within the body thereby reducing congestion, The fluid restriction will prevent additional fluid accumulation, I&O monitoring will allow for assessment of progress made with the administration of diuretics and fluid restriction, Oxygen therapy will increase the available oxygen in the body for the myocardium and correct hypoxia, Administer antihypertensive medication as ordered, Antihypertensive medications will reduce the patients elevated blood pressure thereby reducing the additional stress on the heart, Administer medications as ordered (diuretics, ACE, and ARBs), Diuretics will decrease excess fluid and stress on the cardiac muscle, I&O should be monitored closely to successfully and accurately record the progress of treatment, Maintain chair/bedrest in semi-Fowlers position. Market-Research - A market research for Lemon Juice and Shake. Desired Outcome: Within 2 hours of nursing interventions, the patient will demonstrate improved gas exchange as evidenced by heart rate and oxygen saturation within normal range. To optimise gas exchange, each sample will be collected after a 15-second breath hold . Nursing Diagnosis: Impaired Gas Exchange related to altered oxygen supply secondary to lung cancer as evidenced by shortness of breath, wheeze upon auscultation, hypercapnia, cyanosis of the lips, oxygen saturation of 80%, restlessness, and changes in mentation. To improve cardiac contractility by discharge. Patient exhibited dyspnea on ambulation from stretcher to bed. such as monitor, assess, observe or thefabulousmrst 22 Posts Specializes in NICU. Hypoxemia is a decreased level of oxygen in the blood while hypercapnia is an excess of carbon dioxide in the blood. Desired Outcome: The patient will demonstrate adequate oxygenation as evidenced by reaching the prescribed target oxygen saturation levels. Changes in behavior and mental status can be early signs of impaired gas exchange. optimal chest To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. To treat the underlying cause of the exudate-filled alveoli and inflammation in the lungs. The subjective evaluation of itch showed a continuous decrease in itching scores throughout the course of the study compared to baseline. In order to improve your outlook and reduce the risk of complications, its important that you stick to your COPD treatment plan. It is also imperative that the nurse assesses the individuals airway and breathing status immediately and prioritizes this above any other nursing intervention. Jan 28, 2009 Thank you so much! Bipap ordered with the following settings Ipap 20, Epap 8, Oxygen Percentage 30%, Rate 12. To avoid abdominal distention and diaphragm elevation which can lead to a decrease in lung capacity. numerous Excess.. Mucous production . Patient exhibited dyspnea on ambulation from stretcher to bed. Subjective Data: "no smoking history, for three weeks prior to admission increasing difficulty with cough with thick white sputum, shortness of breath, and syncope associated with asthma. Continue with Recommended Cookies. Patient reports pain in the chest and complains of a dry, irritating cough. PRACTICE (Rationale oxygenation. By using any content on this website, you agree never to hold us legally liable for damages, harm, loss, or misinformation. Oxygen and carbon dioxide are exchanged across the alveolar-capillary barrier in a passive manner, depending on both gases concentrations. Trendelenburg position places the head, lungs, and vital organs in a dependent position and increases blood flow and perfusion. This demonstrates to the nurse that the patient is not hemodynamically stable and the main goal is stabilizing the patients respiratory status. Chronic obstructive pulmonary disease compensatory measures. Oxygen therapy in acute exacerbation of chronic obstructive pulmonary disease. Assess the patients vital signs and characteristics of respirations at least every 4 hours. Encourage the patient to cough to expectorate any sputum. This limits facilitates Impaired gas exchange is a disruption of the oxygen and carbon dioxide exchange in the lung tissues. Impaired gas exchange related to alveolar-capillary membrane changes D (The related to factor of alveolar-capillary membrane changes is accurately written because it is a patient response to the disease process of pneumonia that the nurse can treat. ODonnell DE, et al. Therefore, that becomes the priority for the patient and the nurse should begin by improving his oxygen saturation and breathing status. acute respiratory distress syndrome (ARDS), Hydronephrosis Nursing Diagnosis and Care Plan, Psychosocial Nursing Diagnosis and Nursing Care Plan, Abnormal arterial blood gases (ABG) results hypoxia and/or hypercapnia, Abnormal respiratory rate, depth, and rhythm, Cyanosis bluish discoloration of the skin especially in neonates, Medical conditions that involve the collapse or alteration in the alveoli including, Medical conditions that cause reduced hemoglobin levels including bleeding disorders, lung cancer, and ongoing chemotherapy for, Age the total pulmonary blood flow in older people is lower than younger ones, Prolonged immobility as in trauma patients and those with neuromuscular disorders, Patients who have undergone chest or upper abdominal surgery. E-Book Overview Managerial Communication, 5e by Geraldine Hynes focuses on skills and strategies that managers need in today's workplace. Due to this, gas exchange cannot occur as efficiently. INTERVENTIONS AND SATISFY Educate the patient in how to perform therapeutic breathing and coughing techniques. There are a few other risk factors for developing COPD: COPD with impaired gas exchange is associated with hypoxemia. Assessment Nursing Diagnosis Planning Interventions Rationale Evaluatio n Subjective data: "I cannot breath." as verbalized by the patient. Assessments, Administering, Pt states she has been coughing up greenish to brownish sputum that is thick. These include identifying and addressing the reasons for impaired gas exchange. Elsevier. This nursing diagnosis can be a serious health threat usually closely associated with other nursing diagnoses like ineffective breathing pattern or ineffective airway clearance. St. Louis, MO: Elsevier. Objective Data: Monitor the chest drainage system of post-lobectomy or lung resection patient. In clients with abnormal cardiac index, research suggests pulse oximeter measurements may exceed actual oxygen saturation by up to 7%. Youll breathe in supplemental oxygen through a nasal cannula or a mask. I was going to go with ineffective gas exchange, impaired swallowing, risk for infection ( he was on an infectious disease floor) and knowledge deficit. The client's physical assessment. F.A. Client is free of symptoms of respiratory distress, Client participates in treatment regimen within level of ability and situation, stabilized fluid volume with balanced intake and output, Unlabored respirations at 12-20 breaths/min, Electrolytes: sudden fluid shifts may lead to sodium and potassium imbalance/deficiency, Engage in diaphragmatic and pursed lip breathing techniques. (1998). : an American History (Eric Foner), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. As a nurse, you will either follow doctors' orders for nursing interventions or develop them yourself using evidence-based practice guidelines. Clinical, physiologic, and radiographic factors contributing to development of hypoxemia in moderate to severe COPD: A cohort study. It also leads to hypoxemia and hypercapnia. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. The last echocardiogram in the patients chart (completed 3 months prior) showed an Ejection Fraction (EF) of 40%. Wells JM, et al. improved oxygenation consumption. Low ABG level . A statistically significant reduction of itching score has already been reached on day 2 (0.84 1.26, p < 0.0001). The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. All Rights Reserved. An example of data being processed may be a unique identifier stored in a cookie. Achievable, Realistic, Timeable, Prioritized INTERVENTIONS: (2021). SUPPORTING Pt states she has felt bad since Monday and today is Friday. Lung expansion is also achieved in doing these nursing interventions. breath sounds are Good lung down position helps the patient achieve maximum oxygenation and enhanced blood flow to the remaining lung. -Pts O2 Saturation will be between 90-100% as evidence by nursing documentation during hospitalization.-Pt will have clear sputum as evidence by nursing documentation by discharge. s erm In 2 days, the patient will Patient verbalizes understanding of oxygen and other therapeutic interventions. -The nurse will teach the patient 3 signs and symptoms that indicate PCO2 level may be high and when to contact her md. However, my patient had normal vital signs, no complaint of pain, and no lab test except a positive strep test. Semi-Fowlers position will allow for optimal oxygen usage by the body. Our website services and content are for informational purposes only. Increased breathing effort is a sign of hypoxia. Breath sounds Impaired gas exchange related to inadequate surfactant levels and immaturity of pulmonary system Planning and Expected Outcomes : - The infant will suffer minimal respiratory distress syndrome, with reduced work of breathing and no morbidity. All rights reserved. These assessment findings are able to help the nurse critically think and identify a potential list of differential diagnoses prior to lab and imaging results becoming available. During BiPAP, you wear a mask that provides a continuous flow of air into the lungs, creating positive pressure and helping the lungs expand and stay expanded longer. Copyright 2023 RegisteredNurseRN.com. Physiological impairment in mild COPD. These contents are not intended to be used as a substitute for professional medical advice or practice guidelines. It is important for nurses to understand the various symptoms a patient may present with when experiencing an acute exacerbation. Nursing Diagnosis: Impaired gas exchange related to ventilation perfusion imbalance secondary to hypovolemic shock as evidenced by cyanosis, heart rate 162 bpm, and oxygen saturation 76%. This helps counteract the effects of hypoxemia by delivering oxygen directly into your lungs. Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. VS: HR 85, BP 130/82, Temp 98.6, RR irregular 19. ASSESSEMENT Abnormal Overall, treatment for COPD with impaired gas exchange focuses on reducing symptoms and slowing disease progression. You can learn more about how we ensure our content is accurate and current by reading our. This book continues to stand out in the field for its strategic approach, solid research base, comprehensive range of topics, even-handed examination of oral and written channels, and focus on managerial, not entry-level, competencies. A 2016 study found that, of 678 participants with COPD, 46 (7 percent) developed hypoxemia. Reposition the patient by elevating the head of the bed and encouraging him/her to sit on an upright position. Desired Outcome: The patient will demonstrate adequate oxygenation as evidenced by reaching the prescribed target oxygen saturation and ABG levels. A 70 year old female presents from the ER to your PCU unit. Providing proper patient education is key for these patients to support them in understanding their condition and diagnosis. Collect client history, including risk factors and symptoms (objective and subjective data), Client is recovering from a bypass surgery 3 days ago and is currently admitted in the ICU. These are the tiny air sacs in your lungs where gas exchange occurs. All the contents on this site are for entertainment, informational, educational, and example purposes ONLY. be within normal This step of the nursing process includes the systematic collection of all subjective and objective data about the client in which the nurse focuses holistically on the client- physical, psychological, emotional, sociocultural, and spiritual. Impaired Gas Exchange Assessment 1. In particular, detailed and accurate intake and output records should be kept to show the progress and success of treatments being administered. Your lungs are vital for providing your body with fresh oxygen while ridding it of carbon dioxide. NURSING DIAGNOSIS Diseases that affect the ability for blood to carry oxygen can also result in impaired gas exchange. We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. Learn more about impaired gas exchange in COPD its causes, symptoms, potential treatment options, and more. positioning See our full, Important Disclosure: Please keep in mind that these care plans are listed for, Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on Pinterest (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on WhatsApp (Opens in new window), Click to share on Pocket (Opens in new window), Click to share on Telegram (Opens in new window), Click to share on Skype (Opens in new window), IV Drug Use Complications & Dangers: (Endocarditis, Infection, Infectious Diseases). A. Desired Outcome: The patient will demonstrate adequate oxygenation as evidenced by improved arterial blood gases (ABG) results. This is because COPD is associated with progressive damage to the alveoli and airways. Impaired Gas Exchange related to decreased lung compliance and altered level of consciousness as evidence by dyspnea on exertion, decreased oxygen content, decreased oxygen saturation, and increased PCO2. A 63 year old female presents to the ER with complaints of shortness of breath on excretion and atypical chest pain. Herdman, T., Kamitsuru, S. & Lopes, C. (2021). Respiratory System Crackles in all lung fields Diminished Impaired gas exchange related to smoking as evidenced by dyspnea, crackles all lung fields, and oxygen . St. Louis, MO: Elsevier. (2015). Reduced gas exchange from pulmonary edema can progress to ARDS. The patient is on 3L nasal cannula with oxygen saturation of 88%. NY Times Paywall - Case Analysis with questions and their answers. Because some food may cause patient to retain more fluid than others. Objective Data According to the patient description. Encourage pursed lip breathing and deep breathing exercises. Early recognition of signs and symptoms of impaired gas exchange allows for prompt intervention. demonstrating, performing treatments, Three nursing diagnosesineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (ICE)were among the most frequently used, yet no reported clinical studies validated the defining characteristics of these diagnoses. All Rights Reserved. NURSING DIAGNOSES: Definitions and Classifications 2021-2023 (12th ed.). If you have COPD with impaired gas exchange you may need to be treated with supplemental oxygen as well as other COPD treatments. What is the disease process causing Encourage the patient to cough to expectorate phlegm. Assessment B. While we currently use primarily office automation tools to record service activity and generate related reports for our industrial services business, we are exploring the use of an electronic . Smoking when you have COPD can make your condition worse and can contribute to an increased impairment in gas exchange. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). changes in Abnormal objective data BP:140/80mmHg PR: 102bpm RR:24cpm T:37.7C Use of accessory muscles, restless and irritable Three-part diagnostic statement Impaired gas exchange related to hypoxia as evidenced by the use of accessory muscles, respiratory rate of 24 cpm and BP of 140/80. Hypoxemia and impaired CO 2 clearance are characteristics of acute respiratory distress syndrome (ARDS) (1-3).Abundant literature has explored the mechanisms of gas exchange abnormalities in ARDS. You note when the patient is asleep she has apneic episodes where her oxygen saturation will decrease to 82%. Oxygen therapy needs to be carefully monitored, as it can worsen hypercapnia in some situations. measures, collaborative efforts with Meanwhile, chronic bronchitis involves long-term inflammation of the airways. Cognitive changes may occur with chronic hypoxia. The patient is a current smoker and has been since she was 19 years old. What are nursing care plans? Copyright 2022 SimpleNursing.com. AEB: All rights reserved. Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. 3 part Actual Problem Davis Company. Pt is oriented times 4 though. It occurs when the heart is unable to pump effectively and produce enough cardiac output to successfully perfuse the rest of the bodys tissues and organs. Injection Gone Wrong: Can You Spot The Mistakes? The client's self-reports. Weight Mass Student - Answers for gizmo wieght and mass description. Early intervention is recommended to prevent total decompensation. EKG Rhythms | ECG Heart Rhythms Explained - Comprehensive NCLEX Review, Simple Anatomy Quiz Most Nurses Get WRONG! An example of data being processed may be a unique identifier stored in a cookie. Etiology The most common cause for this condition is poor oxygen levels. Complaints of shortness of breath on excretion and atypical chest pain, has felt bad since Monday, states she is coughing up greenish to brownish sputum that is thick, pt feels chilled. Ackley, B.J., Ladwig, G.B., Flynn-Makic, M.B., Martinez-Kratz, M.R., & Zanotti, M. (2020). Some hospitals may have the information displayed in digital format, or use pre-made templates. Encourage pursed lip breathing and deep breathing exercises. She received her RN license in 1997. Using the nursing risk for impaired gas exchange care note can help alleviate clients symptoms of impaired gas exchange and prevent life-threatening complications. problems. The APGAR Score is an acronym that denotes specific areas of assessment that must be evaluated between the first and fifth minutes of life. (2020). Decreasing oxygen saturation levels mean hypoxia. Three nursing diagnoses--ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE)--were among the most frequently used, yet no reported clinical studies validated the defining characteristics of these diagnoses. #shorts #anatomy. Decreased activity tolerance related to imbalance between oxygen supply and demand as evidenced by dyspnea, tachypnea, tachycardia, decreased oxygen saturation, and fatigue. This topic is now closed to further replies. Monitor vital signs for oxygen saturation and changes in heart rate, blood pressure, or cardiac rhythm. Acute exacerbations of this chronic condition can also be very common especially if an individual is not following or is unaware of the appropriate guidelines and recommendations. Get, Researchers say the 5-questionnaire screening tool called CAPTURE can help diagnose people with treatable COPD, although not all experts agree, Here are five pieces of advice to maintain optimal lung health and breathing capacity, from staying far away from cigarettes to adopting a consistent. Bronchodilators increase the delivery of oxygen by means of improving the dilation of small airways. ABGs were collected and the patients pCO2 74, pH 7.24, P02 55, HCO3 33.2. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Systolic heart failure means the heart is not able to contract completely and affects its ability to pump blood out of the heart. Suction as needed. Impaired Gas Exchange Nursing Diagnosis & Care Plan Related Factors Physiological damage to the alveoli Circulatory compromise Lack of oxygen supply Insufficient availability of blood (carrier of oxygen) Subjective Data: patient's feelings, perceptions, and concerns. 2 This promotes How do you develop a nursing care plan? The consent submitted will only be used for data processing originating from this website. Impaired gas exchange occurs due to alveolar-capillary membrane changes, such as fluid shifts and fluid collection into interstitial space and alveoli. UNIVERSITY OF SOUTH ALABAMA Vital Signs: BP 120/80, HR 80, O2 Sat 87% on room air, Temp. NURSING ACTIONS Encourage frequent Supplemental oxygen can help maintain oxygen saturation at a normal level. causing the problem, PROBLEM-NURSING This website provides entertainment value only, not medical advice or nursing protocols. The highest possible score for each of the five areas is 2, while the lowest possible score is 0. When you breathe out, the lungs deflate, pushing carbon dioxide up through your airways where it exits your body through your nose and mouth. . Impaired gas exchange in COPD can cause symptoms like shortness of breath, coughing, and fatigue. Your FEV1 result can be used to determine how severe your COPD is. Assist the patient to assume semi-Fowlers position. The formatting isnt always important, and care plan formatting may vary among different nursing schools or medical jobs. ncbi.nlm.nih.gov/pmc/articles/PMC4230177/, nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/, nhlbi.nih.gov/health-topics/how-lungs-work, ncbi.nlm.nih.gov/pmc/articles/PMC3107696/, onlinelibrary.wiley.com/doi/full/10.1111/resp.12619, ncbi.nlm.nih.gov/pmc/articles/PMC4547073/, bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-016-0331-0, COPD: How a 5-Question Screening Tool Can Help Diagnose Condition, 5 Ways to Keep Your Lungs Healthy and Strong, FEV1 and COPD: How to Interpret Your Results. Short-term goal To increase oxygen saturation 92% prior to transfer from ED and admission to hospital floor unit Nursing Interventions with Rationales THE OUTCOME OBJECTIVES). Abnormal arterial blood gas values or blood pH may also be present. Subjective Data According to the nurse's observation. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. To enable to patient to receive more information and specialized care in the removal of thick lung secretions and enabling of improved gas exchange. The free nursing care plan example below includes the following conditions: Ineffective Gas Exchange, Ineffective Airway Clearance, Pneumonia, COPD, Emphysema, & Common Cold. Acute Respiratory Distress Syndrome (ARDS), Nursing Diagnosis: Impaired Gas Exchange related to chest trauma secondary to ARDS as evidenced by shortness of breath, fast and labored breathing, cyanosis of skin, rapid pulse, oxygen saturation of 78%, restlessness, and reduced activity tolerance. St. Louis, MO: Elsevier. The patient has a history of obstruction sleep apnea and states (when awake) she does not wear her CPAP machine at night because it is too loud. low partial pressure of oxygen in arterial blood, Neuromuscular conditions that cause fixation or weakening of the diaphragm, Assess cardiac function such as blood pressure and heart rate, Assess use of central nervous system depressants, Inspect dependent body areas for edema with and without pitting, Pitting edema is generally obvious only after 10lbs weight gain, Pulmonary edema may develop more rapidly, and immediate intervention is necessary, Use of central nervous system depressants may cause depression of respiratory center and cough reflex. Do not treat a patient based on this care plan. respiratory rate q4hrs. 9. 2. These nanda nursing care plans include a diagnosis, and many interventions for the following conditions: COPD. During this process, oxygen enters the bloodstream while carbon dioxide is removed. Left-sided heart failure is also known as Congestive Heart Failure (CHF). Nursing Intervention: Plan to assess the patient respiratory function 4. Copyright 2023 RegisteredNurseRN.com. The most important part of the care plan is the content, as that is the foundation on which you will base your care. Head elevation and semi-Fowlers position help improve the expansion of the lungs, enabling the patient to breathe more effectively.