Croup refers to a variety of conditions characterized by a harsh “barking” (croupy) cough, inspiratory stridor, hoarseness, and marked respiratory retraction. The condition usually affects infants and small children between 3 months and 3 years of age and occurs during the cold weather.
The most common form of croup is laryngotracheobronchitis (LTB). It is caused by an acute viral infection of the larynx, trachea, and bronchi resulting in the obstruction below the level of the vocal cords. Spasmodic croup is croup of sudden onset, developing at night and characterized by laryngeal obstruction at the level of the vocal cords caused by viral infections or allergens. Both occur as a result of upper respiratory infection, edema, and spasms that cause respiratory problems in varying degrees depending on the severity of obstruction.
Nursing Care Plans
Nursing care planning goals for a child with croup include maintaining airway clearance, demonstrating increased air exchange, relieving anxiety, decreasing fatigue, and (parental) management of the condition.
Ineffective Airway Clearance
May be related to
- Presence of thick, tenacious mucus
- Edema and constriction of the airway
Possibly evidenced by
- Persistent barking (croupy) cough
- Thick secretions
- Diminished breath sounds, with diffuse crackles and rhonchi
- Tachypnea, Tachycardia
- Hypercapnia, Hypoxemia
- Restlessness, irritability
- Client will maintain clear, open airways as evidenced by normal breath sounds, normal rate and depth of respiration, and ability to effectively cough up secretions after treatments and deep breaths.
|Observe the sound of cough.||Grunting is produced during expiration by a premature glottic closure. It is an effort to maintain or increase functional residual capacity.|
|Assess the use of accessory muscles with nasal flaring||As the trachea and larynx become inflamed and swollen, a child with croup produces a bark-like cough and hoarse or muffled vocal sounds. When it progresses, the child may manifest further upper airway obstruction with severely compromised oxygenation.|
|Advise increase fluid intake and maintain intravenous fluid as prescribed.||Adequate hydration can help loosen mucus in the oropharynx and prevent dehydration.|
|Place the child elevated in a semi-Fowler’s to high Fowler’s position; Reposition the child frequently.||Facilitates breathing and maximal lung expansion by lowering the diaphragm. Frequent reposition prevents pooling and stasis of secretions.|
|Use a cool mist humidifier or allow a hot shower to run for 10 minutes until the bathroom becomes humid and steamy, then let the child sit or stand in the bathroom.||Cool mist and humidity soothe inflamed airways and decreases the viscosity of the mucus thus helps in clearing the airway.|
|Perform chest physiotherapy as indicated.||Promotes expansion of the lungs, strengthen respiratory muscles and mobilization of secretions.|
|Administer the following medications:|
||Epinephrine produces bronchodilation and widening lumen of airway.|
||Decreases both laryngeal mucosal edema; Suppress inflammation|
and normal immune response.
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Brain Tumor | 3 Care Plans
- Bronchiolitis | 5 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans