Problem: Impaired Gas Exchange related to altered oxygen supply secondary to aspiration pneumonia as evidenced by O2 sat: 83%, RR: 24 , congested lungs ,labored breathing ,The venous pH was 7.30, slightly acidic. the venous Pco2 was high at 58, thick, yellow secretion, congestion noises, not improved by repositioning and additional suctioning . improve sentence, place evidence in order or urrgence