Abstract
The present study work was applied to a patient with a medical diagnosis: pneumonia and arterial hypertension in the emergency service. The objective of the present work was to apply the nursing care process to an older adult with Pneumonia. The assessment was carried out with the guide based on the 11 functional patterns of Marjori Gordon. After identifying the problems, 11 nursing diagnoses are enunciated taking into account the NANDA taxonomy and the following diagnoses are prioritized: Impairment of gas exchange related to changes in the capillary alveolus membrane evidenced by O2 Sat: 91% Abnormal arterial blood gas (PO2: 63 mmHg) abnormal respiratory pattern, respiratory rate 26 per minute, ineffective cleaning of the airways related to changes in the capillary alveolus membrane evidenced by altered respiratory pattern, altered respiratory rate and abnormal respiratory sounds, and CP Hypertension. Subsequently, planning is carried out using the NOC and NIC taxonomy, the interventions and planned activities are executed. The results obtained gave a score of +1, +2 and +2. It is concluded that the nursing care process is the application of care in a systematic and orderly manner, helping to provide quality care and humanism.
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