5 Croup Nursing Care Plans


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


Nursing Diagnosis

  • Fatigue

May be related to

  • Dyspnea

Possibly evidenced by

  • Inability to eat
  • Emotional lability or irritability
  • Exhausted appearance
  • Lethargy or listlessness

Desired Outcomes

  • Child will sleep adequately without interruption.
  • Child will be able to eat and drink sufficiently.
Nursing Interventions Rationale
Assess for weakness and fatigue, ability to rest, sleep, and eat. Dyspnea and work of breathing create exhaustion over a period of time affecting the ability to rest, eat, drink.
Explain the importance of conserving energy and avoiding fatigue to parents and child. Promotes understanding of infant/young child’s response to respiratory distress and
importance of rest and support to prevent fatigue.
Provide rest periods in a quiet, comfortable environment. Rest decreases fatigue and respiratory distress.
Disturb only when needed, perform all care at one time instead of spreading over a long period of time. Conserves energy and prevents interruptions in rest.
Encourage quiet activities that do not require exertion. Quiet play prevents excessive activity, which depletes energy and increases respiration.
Instruct parents to maintain a calm, deliberate manner when providing care; Avoid any activities that stimulate crying and not allow the infant to cry longer than 1 to 2 minutes. Crying and tension can trigger coughing. Prolonged crying aggravates airway obstruction.
Suggest energy-saving comfort measures such as rocking infant/young child slowly, singing lullabies, playing with the child, feeding in small amounts. Provides support to infant/small child and conserves energy.
Assist parents in formulating a plan on bathing, feeding, changing diaper around rest periods. Prevents interruption in rest or sleep.

See Also

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Pediatric Nursing Care Plans

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