Nursing Care Plan for Pneumonia
Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately 5% will die from pneumonia. Pneumonia is the sixth leading cause of death in the United States.
Symptoms and Signs
Most people who develop pneumonia initially have symptoms of a cold (upper respiratory infection, for example, sneezing, sore throat, cough), which are then followed by a high fever (sometimes as high as 104 F), shaking chills, and a cough with sputum production. The sputum is usually discolored and sometimes bloody. Depending on the location of the infection, certain symptoms are more likely to develop. When the infection settles in the air passages, cough and sputum tend to predominate the symptoms. In some, the spongy tissue of the lungs that contain the air sacs is more involved. In this case, oxygenation can be impaired, along with stiffening of the lung, which results in shortness of breath. At times, the individual's skin color may change and become dusky or purplish (a condition known as "cyanosis") due to their blood being poorly oxygenated.
The only pain fibers in the lung are on the surface of the lung, in the area known as the pleura. Chest pain may develop if the outer aspects of the lung close to the pleura are involved. This pain is usually sharp and worsens when taking a deep breath and is known as pleuritic pain or pleurisy. In other cases of pneumonia, depending on the causative organism, there can be a slow onset of symptoms. A worsening cough, headaches, and muscle aches may be the only symptoms.
Children and babies who develop pneumonia often do not have any specific signs of a chest infection but develop a fever, appear quite ill, and can become lethargic. Elderly people may also have few symptoms with pneumonia.
Nursing Care Plan for Pneumonia
Nursing Assessment for Pneumonia
- Health History :
- A history of previous respiratory tract infection / cough, runny nose, takhipnea, fever.
- Anorexia, difficulty swallowing, vomiting.
- History of disease associated with immunity, such as; morbili, pertussis, malnutrition, immunosuppression.
- Other family members who suffered respiratory illness.
- Productive cough, breathing nostrils, rapid and shallow breathing, restlessness, cyanosis.
- Physical Examination :
- Fever, takhipnea, cyanosis, nostrils.
- Auscultation of lung: wet ronchi, stridor.
- Laboratory: leukocytosis, AGD abnormal, the LED increases.
- Chest X-rays: abnormal (scattered patches of consolidation in both lungs).
- Psychosocial Factors :
- Age, growth.
- Tolerance / ability to understand the action.
- The experience of parting with the family / parents.
- The experience of previous respiratory tract infections.
- Family Knowledge, Psychosocial :
- The level family knowledge about the disease bronchopneumonia.
- Experience in dealing with the family of respiratory disease.
- Readiness / willingness of families to learn to care for her child.
- Family Coping
- The level of anxiety.