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.
Here are five (5) nursing care plans (NCP) for croup:
Ineffective Airway Clearance: Inability to clear secretions or obstructions from the respiratory tract to maintain a clear airway.
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.
You may also like the following posts and care plans:
- 1,000+ Nursing Care Plans List – the ultimate database of nursing care plans for different diseases and conditions! Get the complete list!
- What is a Nursing Care Plan? 9 Steps on How to Write a Care Plan – learn how to write an excellent care plan. We explain the concepts and walk you through the steps.
- Nursing Diagnosis: The Complete List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
- The Ultimate Guide to Nursing Diagnosis – learn how to formulate nursing diagnoses correctly in this easy-to-follow guide!
Pediatric Nursing Care Plans
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
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans