Nursing Care Plan for Pneumonia
8 Pneumonia Nursing Care Plans
August 3, 2015 – 02:59 pm
Preventing Aspiration Pneumonia by Addressing Three Key Risk
Assess the rate and depth of respirations and chest movement. | Tachypnea, shallow respirations, and asymmetric chest movement are frequently present because of discomfort of moving chest wall and/or fluid in lung. |
Auscultate lung fields, noting areas of decreased or absent airflow and adventitious breath sounds: crackles, wheezes. | Decreased airflow occurs in areas with consolidated fluid. Bronchial breath sounds can also occur in these consolidated areas. Crackles, rhonchi, and wheezes are heard on inspiration and/or expiration in response to fluid accumulation, thick secretions, and airway spams and obstruction. |
Elevate head of bed, change position frequently. | Doing so would lower the diaphragm and promote chest expansion, aeration of lung segments, mobilization and expectoration of secretions. |
Teach and assist patient with proper deep-breathing exercises. Demonstrate proper splinting of chest and effective coughing while in upright position. Encourage him to do so often. | Deep breathing exercises facilitates maximum expansion of the lungs and smaller airways. Coughing is a reflex and a natural self-cleaning mechanism that assists the cilia to maintain patent airways. Splinting reduces chest discomfort and an upright position favors deeper and more forceful cough effort. |
Suction as indicated: frequent coughing, adventitious breath sounds, desaturation related to airway secretions. | Stimulates cough or mechanically clears airway in patient who is unable to do so because of ineffective cough or decreased level of consciousness. |
Force fluids to at least 3000 mL/day (unless contraindicated, as in heart failure). Offer warm, rather than cold, fluids. | Fluids, especially warm liquids, aid in mobilization and expectoration of secretions. |
Assist and monitor effects of nebulizer treatment and other respiratory physiotherapy: incentive spirometer, IPPB, percussion, postural drainage. Perform treatments between meals and limit fluids... |
Source: nurseslabs.com
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