Nursing Diagnosis and Nursing Interventions for Pneumonia

Nursing Diagnosis for Pneumonia

1. Ineffective airway clearance related to inflammation, accumulation of secretions.
2. Impaired gas exchange related to changes in alveolar capillary membrane.
3. The reduced volume of liquid related to inadequate oral intake, fever, tachypnoea.
4. Activity intolerance related to decreased blood oxygen levels.
5. Changes in the comfort related to fever, dyspnea, chest pain.
6. The increase in body temperature related to the infection process.
7. Anxiety related to the impact of hospitalization.

Nursing Interventions for Pneumonia

1. Ineffective airway clearance related to inflammation, accumulation of secretions
   
   Goal :
   Effective way of breath, lung ventilation is adequate and there is no buildup of secretions.
   
   Interventions :
   • Monitor respiratory status every 2 hours, review the increase in respiratory status and abnormal breath sounds.
   • Perform percussion, vibration and postural drainage every 4-6 hours.
   • Give appropriate oxygen therapy program.
   • Help cough up secretions / suction mucus.
   • Give the comfortable position that allows the patient to breathe.
   • Create a comfortable environment so that patients can sleep calmly.
   • Monitor blood gas analysis to assess respiratory status.
   • Give drink enough.
   • Provide sputum for culture / sensitivity test.
   • Manage provision of appropriate antibiotics and other drugs program.
   
   
2. Impaired gas exchange related to changes in alveolar capillary membrane.
   
   Goal :
   Patients showed improvement ventilation, optimal gas exchange and tissue oxygenation is adequate.
   
   Interventions :
   • Observation of the level of consciousness, respiratory status, cyanosis signs every 2 hours.
   • Give Fowler position semi-Fowler.
   • Give oxygen by program.
   • Monitor blood gas analysis.
   • Create an environment of calm and comfort patients.
   • Prevent the occurrence of fatigue in patients.
   
   
3. The reduced volume of liquid related to inadequate oral intake, fever, tachypnoea.
   
   Goal :
   Patients will maintain a normal body fluids.
   
   Interventions :
   • Record fluid intake and output.
   • Monitor fluid balance: mucous membranes, skin turgor, rapid pulse, decreased consciousness, vital signs.
   • Maintain the accuracy of the drip infusion based on the program.
   • Perform oral hygiene.
   
   
4. Activity intolerance related to decreased blood oxygen levels.
   
   Goal :
   Patients can do activities based on conditions.
   
   Interventions :
   • Assess the patient's physical tolerance.
   • Assist patients in activities of daily activities.
   • Provide age-appropriate games that patients with activities that do not spend a lot of energy, match the activity with the condition.
   • Give oxygenation by program.
   • Give the energy needs.
   
   
5. Changes in the comfort related to fever, dyspnea, chest pain.
   
   Goal :
   Patients will show tightness and pain is reduced, to cough effectively and normal temperature.
   
   Interventions :
   • Check the temperature every 4 hours.
   • Manage provision of antipyretic, anlgesik, antibiotics based on the program.
   • Help the patient in a comfortable position for him.
   • Help reduce chest, use a pillow when coughing.
   • Keep the patient to rest / sleep.