Pneumonia is a general term that refers to an infection of the lungs, which can be caused by a variety of microorganisms, including viruses, bacteria, fungi, and parasites.
Most cases of pneumonia are caused by viruses, including adenoviruses, rhinovirus, influenza virus (flu), respiratory syncytial virus (RSV), and parainfluenza virus (which causes croup).
Often, pneumonia begins after an upper respiratory tract infection (an infection of the nose and throat), with symptoms of pneumonia beginning after 2 or 3 days of a cold or sore throat.
Nursing Diagnosis for Pneumonia
Most cases of pneumonia are caused by viruses, including adenoviruses, rhinovirus, influenza virus (flu), respiratory syncytial virus (RSV), and parainfluenza virus (which causes croup).
Often, pneumonia begins after an upper respiratory tract infection (an infection of the nose and throat), with symptoms of pneumonia beginning after 2 or 3 days of a cold or sore throat.
Nursing Diagnosis for Pneumonia
Ineffective airway clearance related to the tracheal bronchial inflammation, increased sputum production
characterized by:
Effective airway,
characterized by:
- Changes in frequency, depth of respiration
- Abnormal breath sounds
- Dyspnea, cyanosis
- Effective or ineffective cough with / without sputum production.
Effective airway,
with the following criteria:
Nursing Interventions and Rational - Ineffective Airway Clearance for Pneumonia
- effective cough
- breath normal
- Breath sounds clean
Nursing Interventions and Rational - Ineffective Airway Clearance for Pneumonia
Assess the frequency / depth of breathing and chest movement
Rational: tachypnea, shallow breathing and asymmetrical chest movement often occurs because of discomfort.
Auscultation of lung area, note area one time there was a decrease of air flow and breath sounds
Rational: decrease in blood flow occurred in the area of consolidation with fluid.
Let the effective coughing techniques
Rational: cough is a natural airway clearance mechanisms to maintain a patent airway.
Suction as indicated
Rational: to stimulate coughing or clearing the airway mechanical voice on the factors that are not able to perform effectively as a cough or a decreased level of consciousness.
Give fluids at least
Rational: liquids (especially warm) mobilizing and removing secretions
Collaboration with physicians for drug delivery as indicated: mukolitik, ex.
Rational: a tool to reduce the mobilization of secretions with bronchial spasms, analgesic given to improve the cough by reducing the discomfort but should be used carefully, because it can reduce cough effort / suppress breathing.
Rational: tachypnea, shallow breathing and asymmetrical chest movement often occurs because of discomfort.
Auscultation of lung area, note area one time there was a decrease of air flow and breath sounds
Rational: decrease in blood flow occurred in the area of consolidation with fluid.
Let the effective coughing techniques
Rational: cough is a natural airway clearance mechanisms to maintain a patent airway.
Suction as indicated
Rational: to stimulate coughing or clearing the airway mechanical voice on the factors that are not able to perform effectively as a cough or a decreased level of consciousness.
Give fluids at least
Rational: liquids (especially warm) mobilizing and removing secretions
Collaboration with physicians for drug delivery as indicated: mukolitik, ex.
Rational: a tool to reduce the mobilization of secretions with bronchial spasms, analgesic given to improve the cough by reducing the discomfort but should be used carefully, because it can reduce cough effort / suppress breathing.
