Priority Nursing Diagnosis

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The priority nursing diagnosis for this patient is ineffective airway clearance. This is related to the patient’s history of smoking, inability to cough and clear secretions, and presence of an artificial airway. When suctioning, the nurse should assess the color and viscosity of the secretions. A sudden change in the color or a new odor usually indicates an infection. The patient showed signs of dyspnea before suctioning, and rhonchi was present in the anterior portion of the lungs. Interventions for this individual should include those that help clear the airway and ensure adequate oxygenation is received by the patient. The oxygen saturation should be assessed more frequently in this patient because of the viscosity of the secretions;
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