Nursing Care Plan for Pneumonia - Nursing Diagnosis : Risk for Infection
Pneumonia is an inflammatory condition of the lung—affecting primarily the microscopic air sacs known as alveoli. It is usually caused by infection with viruses or bacteria and less commonly other microorganisms, certain drugs and other conditions such as autoimmune diseases.
The term pneumonia is sometimes more broadly applied to any condition resulting in inflammation of the lungs (caused for example by autoimmune diseases, chemical burns or drug reactions); however, this inflammation is more accurately referred to as pneumonitis. Infective agents were historically divided into "typical" and "atypical" based on their presumed presentations, but the evidence has not supported this distinction, thus it is no longer emphasized.
Risk factors :
Outcomes :
Interventions and Rationals :
1. Instruct patient concerning the disposition of secretions (e.g., raising and expectorating versus swallowing) and reporting changes in color, amount, odor of secretions.
R/ : Although patient may find expectoration offensive and attempt to limit or avoid it, it is essential that sputum be disposed of in a safe manner. Changes in characteristics of sputum reflect resolution of pneumonia or development of secondary infection.
2. Monitor vital signs closely, especially during initiation of therapy.
R/ : During this period of time, potentially fatal complications (hypotension/shock) may develop.
3. Change position frequently and provide good pulmonary toilet.
R/ : Promotes expectoration, clearing of infection.
4. Demonstrate/encourage good handwashing technique.
R/ : Effective means of reducing spread or acquisition of infection.
5. Encourage adequate rest balanced with moderate activity. Promote adequate nutritional intake.
R/ : Facilitates healing process and enhances natural resistance.
6. Monitor effectiveness of antimicrobial therapy.
R/ : Signs of improvement in condition should occur within 24–48 hr.
Pneumonia is an inflammatory condition of the lung—affecting primarily the microscopic air sacs known as alveoli. It is usually caused by infection with viruses or bacteria and less commonly other microorganisms, certain drugs and other conditions such as autoimmune diseases.
The term pneumonia is sometimes more broadly applied to any condition resulting in inflammation of the lungs (caused for example by autoimmune diseases, chemical burns or drug reactions); however, this inflammation is more accurately referred to as pneumonitis. Infective agents were historically divided into "typical" and "atypical" based on their presumed presentations, but the evidence has not supported this distinction, thus it is no longer emphasized.
Risk factors :
- Inadequate primary defenses (decreased ciliary action, stasis of respiratory secretions)
- Inadequate secondary defenses (presence of existing infection, immunosuppression), chronic disease, malnutrition
Outcomes :
- Achieve timely resolution of current infection without complications.
- Identify interventions to prevent/reduce risk/spread of/secondary infection.
Interventions and Rationals :
1. Instruct patient concerning the disposition of secretions (e.g., raising and expectorating versus swallowing) and reporting changes in color, amount, odor of secretions.
R/ : Although patient may find expectoration offensive and attempt to limit or avoid it, it is essential that sputum be disposed of in a safe manner. Changes in characteristics of sputum reflect resolution of pneumonia or development of secondary infection.
2. Monitor vital signs closely, especially during initiation of therapy.
R/ : During this period of time, potentially fatal complications (hypotension/shock) may develop.
3. Change position frequently and provide good pulmonary toilet.
R/ : Promotes expectoration, clearing of infection.
4. Demonstrate/encourage good handwashing technique.
R/ : Effective means of reducing spread or acquisition of infection.
5. Encourage adequate rest balanced with moderate activity. Promote adequate nutritional intake.
R/ : Facilitates healing process and enhances natural resistance.
6. Monitor effectiveness of antimicrobial therapy.
R/ : Signs of improvement in condition should occur within 24–48 hr.
