5 Croup Nursing Care Plans

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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) and nursing diagnosis (NDx) for croup:

  1. Ineffective Airway Clearance
  2. Ineffective Breathing Pattern
  3. Anxiety
  4. Fatigue
  5. Deficient Knowledge
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Anxiety 

Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response.

May be related to

  • Change in health status of infant/small child
  • Threat to or change in environment (hospitalization)

Possibly evidenced by

  • Crying and clinging behaviors, refusal to eat or engage in activity (infant or small child)
  • Persistent cough and difficulty in breathing (infant/small child)
  • Increased apprehension that condition might worsen and hospitalization might be necessary (parental)

Desired Outcomes

  • Parents/child will remain calm and experience decreased anxiety.
Nursing InterventionsRationale
Assess level and sources of anxiety of parents and child and recognize behaviors causing anxiety.Provides learning about the need for interventions to alleviate anxiety and concern.
Provide a calm, quiet environment for the child.Anxiety affects respirations and calm environment lessens anxiety.
Encourage parents to verbalize concerns and to ask inquiries about the condition and what to expect.Provides an opportunity to express feelings, gather information needed to decrease anxiety.
Encourage parents to stay with infant/small child during hospitalization, bring book/toy, blanket from home; allow visits from siblings.Enable parents to participate in the care for the child and provide familiar objects and people to decrease child’s anxiety.
Explain all procedures including the use of croup tent, care and any changes in condition.Fear of the unknown produces anxiety.
Explain course of the disease to parents and child, that recovery is fairly prompt with appropriate therapy, and that cough may persist for a week or more after recovery.Reduces anxiety caused by the sound of the breathing and appearance of the infant/small child.
Inform and discuss signs and symptoms indicating further severity of the condition and measures to take.Reduces anxiety caused by increasing acuteness of condition by knowledge of what actions to make and when to notify the physician.
Clarify any misinformation and answer all questions regarding the disease condition.Prevents unnecessary anxiety resulting from inaccurate information or beliefs.
Instruct and assist parents in interacting with the child when using a tent.Promotes support to the child and relieves anxiety.
If hospitalized, carry out home routines for grooming, feeding, sleeping preparation.Prevents anxiety associated with daily ritual changes.
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See Also

You may also like the following posts and care plans:

Pediatric Nursing Care Plans


Nursing care plans for pediatric conditions and diseases: 

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