please i need a nursing care plan for ineffective breathing...

please i need a nursing care plan for ineffective breathing pattern.

Situation:

The patient is a 34-year-old male in residence at a Skilled Nursing Facility. The patient has coarse crackles in both lower lobes and pressure ulcers on both heels. He is incontinent of bowel and bladder function. He is depressed and has not wanted to get out of bed or participate in physical or occupational therapy for the last two weeks.

Background:

The patient experienced a T-11 spinal cord injury one year ago, resulting in paraplegia. He was in the hospital for two months before being transferred to the Skilled Nursing Facility. The patient has no known drug allergies. He keeps his eyes shut and head turned toward the wall. He refuses to answer questions.

Assessment:

Vital signs: HR 91, BP 106/53, RR 27, SpO2 92%, Temperature 36.8C

General Appearance: Depressed and withdrawn, flat affect, appears stated age Cardiovascular: Sinus rhythm

Respiratory: Breath sounds with crackles bilaterally

GI: Abdomen soft and nondistended, normal bowel sounds, poor appetite, incontinent of stool

GU: Incontinent of urine

Extremities: Upper extremities with adequate movement, lower extremities flaccid with no movement