Bronchopneumonia - Nursing Diagnosis, Interventions and Evaluation

Nursing Diagnosis and Interventions for Bronchopneumonia -

1. Ineffective airway clearance related to accumulation of secretions.

Goal: Airway clearance back effectively.

Outcomes: secretions can come out.

Interventions:

• Monitor respiratory status every 2 hours, assess the increase in respiratory and abnormal breath sounds.
• Do suction as indicated.
• Give oxygen therapy every 6 hours.
• Create an environment / convenient so patients can sleep.
• Give a comfortable position for the patient.
• Monitor blood gas analysis to assess respiratory status.
• Perform chest percussion.
• Provide sputum for culture / sensitivity test.

2. Impaired gas exchange related to changes in alveolar capillaries.

Goal: back to normal gas exchange.

Outcomes: The client showed improved ventilation, gas exchange and oxygenation optimally adequately.

Interventions:

• Observation of level of consciousness, respiratory status, signs cianosis.
• Give appropriate sleeping position fowler / semi-Fowler.
• Give oxygen according to the program.
• Monitor blood gas analysis.
• Ciprtakan comfortable environment.
• Help prevent fatigue.

3. Fluid volume deficit related to excessive output.

Goal: Client will maintain normal body fluid.

Outcomes: no sign of dehydration.

Interventions:

• Record intake and output of fluids (fluid balance).
• Encourage the mother to continue to provide oral fluid.
• Monitor fluid balance, mucous membranes, skin turgor, rapid pulse, decreased consciousness, vital signs.
• Maintain a drip infusion accuracy.
• Observation of vital signs (pulse, temperature, respiration).

4. Risk for Imbalanced nutrition less than body requirements related to inadequate nutritional intake.

Goal: The nutritional requirements are met.

Outcomes: The client can maintain / improve nutritional intake.

Intervetions:

• Assess the client's nutritional status.
• Perform a physical examination of the abdomen (auscultation, percussion, palpation, and inspection).
• Measure the client's body weight every day.
• Assess for nausea and vomiting.
• Give the diet a little but often.
• Provide food in a warm state.
• Collaboration with the nutrition team.

5. Increased body temperature related to the infection process.

Goal: There is an increase in body temperature.

Outcomes: Hyperthermia / increase in temperature can be resolved with no infection process.

Interventions:

• Observation of vital signs.
• Provide and encourage families to provide water compress on the forehead area and armpits.
• Involve the family in every action.
• Give drink orally.
• Replace wet clothing with sweat.
• Collaboration with doctors in febrifuge.

6. Knowledge Deficit : parents, about the care of clients related to a lack of information.

Goal: Knowledge parents about the child's illness increased after the act of nursing.

Outcomes: Parents know about the child's illness.

Interventions:

• Assess the level of parental knowledge about the child's illness.
• Assess the client's level of parental education.
• Help parents to develop a plan of nursing care in the hospital such as: diet, rest and activity accordingly.
• Emphasize the need to protect children ..
• Explain to the client's family about the definition, causes, signs and symptoms, treatment, and prevention of complications by providing health education.
• Give parents the opportunity to ask clients about things not yet understood.

7. Anxiety children related to the effects of hospitalization.

Goal: Anxious children is reduced / lost.

Outcomes: The client can be quiet, anxious lost, comfortable feeling fulfilled after the act of nursing.

Interventions:

• Assess the client's level of anxiety.
• Encourage the mother / family to give suport to the child by way of the mother is always near to the client.
• Facilitating a sense of comfort by way of participating mothers caring for their children.
• Make a visit, contact with clients.
• Encourage other family visiting clients.
• Give A toy according client's home.

Evaluation

The evaluation is expected in patients with Brochopneumonia are:

1. Normal gas exchange.
2. Effective airway clearance.
3. Intake and output balance.
4. Adequate nutritional intake.
5. Body temperature within normal limits.
6. Increase family knowledge.
7. Anxiety resolved.

NCP for Bronchopneumonia with 7 Nursing Diagnosis

Nursing Care Plan for Bronchopneumonia

Definition

Bronchopneumonia is an inflammation of the lungs that affects one or more lobes of the lungs characterized by patches of infiltrates (Whalley and Wong, 1996).

Bronchopneumonia is the frequency of pulmonary complications, long productive cough, signs and symptoms usually increased temperature, increased pulse rate, increased respiration (Suzanne G. Bare, 1993).

Bronchopneumonia also called lobularis pneumonia, is inflammation of the lungs caused by bacteria, viruses, mold and foreign objects (Sylvia Anderson, 1994).


Etiology

• Bacteria : Diplococcus Pneumoniae, Pneumococcus, Streptococcus Haemolyticus Aureus, Haemophilus Influenzae, Bacillus Friedlander, Mycobacterium Tuberculosis.
• Virus : Respiratory syncytial virus, influenza virus, citomegalic virus.
• Fungi : Histoplasma capsulatum, Cryptococcus Nepromas, Blastomyces Dermatitidis, Coccidioides Immitis, Aspergillus Sp, Candida Albicans, Mycoplasma Pneumonia.
• Foreign body aspiration: Factors that influence the incidence of bronchopneumonia was decreased endurance for example due to protein energy malnutrition (MEP), chronic disease, antibiotic treatment is not perfect.

Clinical Manifestations

Usually preceded by upper respiratory tract infection. This disease usually occurs suddenly, rising temperatures 39-40 OC with shaking chills, shortness of breath and rapid coughing non productive "breath sound" percussion dim when the lung examination, auscultation of breath sounds smooth wet crackles and loud.

Cough and cold which may weigh up to respiratory insufficiency begins with upper tract infection, patients with a dry cough, headache, muscle pain, anorexia, and difficulty swallowing.


Complication

Complications of bronchopneumonia are:

• Atelectasis is the development of the lungs that are not perfect or lung collapse is due to a lack of mobilization or cough reflex is lost.
• Emphysema is a condition in which the accumulation of pus in the pleural space are in one place or the entire pleural cavity.
• Lung abscess is a collection of pus in the inflamed lung tissue.
• Systemic infection.
• Endocarditis is an inflammation of the endocardial each valve.
• Meningitis is an infection that attacks the lining of the brain.

Assessment for Bronchopneumonia

1. Health history

• A history of previous respiratory tract infection: cough, runny nose, fever.
• Anorexia, difficulty swallowing, nausea and vomiting.
• History of immune-related diseases such as malnutrition.
• Other family members were experiencing respiratory illness.
• Productive cough, breathing nostrils, rapid and shallow breathing, anxiety, cyanosis.

2. Physical examination

• Fever, tachypnea, cyanosis, respiratory nostril.
• Auscultation of pulmonary crackles wet.
• Laboratory leukocytosis, increased erythrocyte sedimentation rate or normal.
• Abnormal chest x-ray (spotting, scattered consolidation in both lungs).

3. Psychological factors / developments to understand actions.

• Age level of development.
• Tolerance / ability to understand actions.
• Coping.
• Separate experiences of family / parents.
• Previous experience respiratory infections.

4. Knowledge families / parents

• The level of knowledge of respiratory disease families.
• Family experience of respiratory disease.
• Readiness / willingness to learn to take care of her family.

Nursing Diagnosis for Bronchopneumonia

1. Ineffective airway clearance related to accumulation of secretions.
2. Impaired gas exchange related to changes in alveolar capillaries.
3. Fluid volume deficit related to excessive output.
4. Risk for Imbalanced nutrition less than body requirements related to inadequate nutritional intake.
5. Increased body temperature related to the infection process
6. Knowledge Deficit : parents, about the care of clients related to a lack of information.
7. Anxiety children related to the effects of hospitalization.