CYSTIC FIBROSIS IHP Student's Name * First Middle Last Suffix This field is required. Please complete the following fields: First,Last. PhotoAccepted file types: jpg, gif, png, jpeg, Max. file size: 100 MB.DoB Month Incorrect Value for Month field Day Incorrect Value for Month field Year Incorrect Value for Month field Please enter a valid date. GR/LevelDaycareEEPKKN010203040506070809101112Post-GraduateWould you like to add the student's ID number? Yes No ID Campus/Building Would you like to add the student's homeroom number and teacher's name? 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Yes No ContactContact Name Add RemoveRelationship Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Name RelationshipChoose one:ParentGuardianOtherContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFaxContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFax Add More Treating Physician Add RemovePhysician Phone Number Add RemovePhysician Fax Number Add RemoveTreating Physician Physician Phone Number Physician Fax Number Add More Preferred Hospital City MEDICAL DIAGNOSIS(ES)Add a medication or procedure? Yes No MEDICATIONS/PROCEDURES Medication/Procedure Strength Dose ModeChoose one:OralTopicalInhaledIntranasalSQNebulizerSublingualRectalIMIVSched/PRN?Choose OneScheduledPRNTime Frequency If PRN, administer for Medication/Procedure Add RemoveStrength Add RemoveDose Add RemoveMode Add RemoveSched/PRN? Add RemoveTime Add RemoveFrequency Add RemoveIf PRN, administer for Add Remove Add More MEDICAL HISTORYASSESSMENT NursingList InterventionList OutcomesList Nursing Diagnosis: Risk for impaired gas exchange Related to airway and alveoli inflammation. Related to bronchiectasis with decreased surface area for gas exchange and loss of lung function Interventions The school nurse will consult with parent/guardian, student, and healthcare providers to develop emergency plan. Plan will be shared with authorized school staff. The school nurse will monitor respiratory and heart rate. The school nurse will assess for changes in respiratory status such as cyanosis, pallor, changes in the level of consciousness, labored breathing and tachypnea. The school nurse will provide for adequate rest between activities. The school nurse will arrange for medications and special healthcare procedures as ordered at schooll. The school nurse will educate staff about CF, coughing importance and managing it in classroom, potential need for enzymes for snacks/meals, need for free access to water and restroom, etc. The school nurse will administer, instruct, and monitor management techniques - medication administration. The school nurse will administer, instruct, and monitor management techniques - nebulizer treatment. The school nurse will instruct and monitor management techniques - coughing exercises. The school nurse will instruct and monitor management techniques - increased fluid intake. The school nurse will instruct and monitor management techniques - physical exercise and participation in activities. The school nurse will perform, instruct, and monitor management techniques - CPT. Expected Outcomes The student's optimal respiratory function and airway clearance as evidenced by adequate oxygen saturation, relaxed breathing, baseline heart rate, and alert response mentation. Nursing Diagnosis: Ineffective airway clearance Related to increased mucopurulent production and mucous plugging in response to new or increased airway bacterial growth as evidenced by ineffective cough, chest pain, crackles, rhonchi, dyspnea, fatigue, labored breathing, reduced breath sounds. Interventions The school nurse will assess cough for effectiveness. The school nurse will assess respiratory rate, work of breathing, use of accessory muscles, and the presence of retractions. The school nurse will assess the chest wall for even chest expansion. The school nurse will auscultate lung for adventitious sounds. The school nurse will assess sputum for color, amount, and consistency. The school nurse will monitor oxygen saturation. The school nurse will encourage a frequent and effective cough, particularly around airway clearance therapy. Expected Outcomes The student will be proficient in using effective airway clearance therapies to clear secretions. The student will maintain clear, open airway. Nursing Diagnosis: Imbalanced nutrition - less than body requirements Related to chronic malabsorption Related to increased caloric needs Interventions The school nurse will administer medications before all meals, snacks as ordered The school nurse will instruct student, parents, and teachers on importance of maintaining well-balanced, high calorie, high protein diet. The school nurse will allow flexible educational program, snacks per physician's orders, bathroom PRN, and extra fluid intake. The school nurse will instruct and encourage use of pancreatic enzymes and vitamins as prescribed by physician. The school nurse will instruct and encourage extra salt and fluid intake as prescribed by physician. Expected Outcomes The student will maintain good nutritional management at school. The student will maintain adequate growth pattern. Nursing Diagnosis: Deficient knowledge Related to ineffective or incomplete prior education Interventions The school nurse will assess student's knowledge of nutritional needs. The school nurse will assess student's knowledge of infection control. The school nurse will assess the knowledge of medications, airway clearance therapies, and equipment. The school nurse will review CPT and breathing techniques to dislodge mucous. Expected Outcomes The student will verbalize age-appropriate understanding of disease process, treatment, and goals of therapy. Nursing Diagnosis: Self-esteem disturbance Related to chronic illness Interventions The school nurse will provide privacy and confidentiality for student regarding medications and treatments. The school nurse will maintain least interruptive schedule for medications and treatment to provide normal routine. The school nurse will educate students and staff to interact with student to promote acceptance. The school nurse will encourage student's involvement with peers, extracurricular activities, and school activities. Expected Outcomes The student will take medications as ordered while at school. The student will accept treatment as ordered and needed while at school. The student will interact appropriately with peers. Would you like to add another nursing diagnosis? Yes No Nursing DiagnosisNursing DiagnosisAdd your own nursing diagnosisInterventionsAdd your own nursing interventionsExpected OutcomesAdd your own expected outcomesNursing Diagnosis Add RemoveInterventions Add RemoveExpected Outcomes Add Remove Add More EVALUATIONNOTESIHP Developed ByName First Last Title Date Month Day Year Please enter a valid date. Do you want to include physician and parent signature lines? Yes Download IHP Clicking this button will download this IHP to your computer and return you to the blank IHP. Return Clicking this button will return you to the IHP to make changes.
