Bronchopulmonary dysplasia (BPD) is the most common chronic pulmonary disease that affects low birth weight and premature infants who received assistive ventilation due to respiratory distress syndrome. This condition occurs from a deficiency in lung surfactant, damage to the lungs caused by ventilator pressure, and exposure to high oxygen concentrations. Infants experiencing BPD may develop labored breathing, tachypnea, wheezes, oxygen dependence, cyanosis, abnormal ABGs and chest findings, poor weight, and repeated lung infections that may require frequent and prolonged hospitalizations. BPD may resolve by the time the child reaches 3 to 4 years of age.
Nursing Care Plans
The nursing care planning goals for a patient with bronchopulmonary dysplasia (BPD) centers on decreasing further lung injury, maintaining adequate ventilation, providing nutritional needs to promote lung maturity and development, preventing infections and enabling the family to cope up with the condition.
Here are five nursing care plans and nursing diagnoses for bronchopulmonary dysplasia (BPD):
- Impaired Gas Exchange
- Imbalanced Nutrition: Less Than Body Requirements
- Compromised Family Coping
- Disorganized Infant Behavior
- Risk for Infection
Impaired Gas Exchange
Impaired Gas Exchange: Excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane.
May be related to
- Tissue damage
Possibly evidenced by
- Abnormal breathing (rate, depth, rhythm)
- Hypoxemia
- Hypercapnia
- Restlessness
- Confusion
- Irritability
- Somnolence
Desired Outcomes
- Infant/Child will maintain clear lung fields and remains free of signs of respiratory distress.
| Nursing Interventions | Rationale |
|---|---|
| Assess respiratory rate, depth, and effort, including rapid breathing, use of accessory muscles, grunting sounds and flaring of the nostrils. | An infant with bronchopulmonary dysplasia display signs and symptoms of respiratory distress syndrome such as tachypnea, labored breathing, nasal flaring, grunting sounds, and chest retractions. |
| Assess for any alterations in the behavior. | Restlessness is an early sign of hypoxia. Chronic hypoxemia may result in cognitive changes, such as memory changes. |
| Observe for nail beds, cyanosis in the skin; especially note color of the lips, tongue, and oral mucous membranes. | Bluish discoloration of the skin around the lips and nails occurs when there is a low oxygen concentration in the blood. |
| Monitor arterial blood gases (ABGs) and note changes. | Reveals the occurrence of hypoxia, acidosis, and hypercarbia as the requirement for oxygen increases. |
| Assess the lungs for areas of decreased ventilation and auscultate presence of adventitious sounds. | A soft, tight whistling sound (wheezing) may be heard with each breath that may indicate narrowed airways or inflammation. |
| Assess oxygen saturation using pulse oximetry during feeding, sleeping, and crying. | Pulse oximetry is a useful tool to detect changes in oxygenation. O2 saturation should be maintained at 90% or greater. |
| Encourage frequent positional changes. | Promotes expansion of the lungs and helps mobilization of secretions out of the airways. |
| Suction the nose and mouth with a bulb syringe as needed. | Suctioning clears out secretions. |
| Administer medications as prescribed: | |
| Decreases airway resistance by relaxing the bronchial smooth muscle. |
| Reduces inflammation within the lungs and lessen the mucus production. |
| Decreases the development of alveolar and pulmonary interstitial edema. |
| Inform parents that the infant may be prescribed with a surfactant-replacement therapy. | Surfactant if administered in the early course of treatment, decreases the development of BPD. |
| Educate parents that a breathing support or oxygen inhalation either through nasal continuous positive airway pressure (NCPAP) or a ventilator may be required for the infant. | Maintains adequate ventilation and ensures the delivery of concentrated amount of oxygen. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- 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.
See Also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
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 related to respiratory system disorders:
- Asthma | 8 Care Plans
- Bronchiolitis | 5 Care Plans
- Bronchopulmonary Dysplasia (BPD) | 5 Care Plans
- Chronic Obstructive Pulmonary Disease (COPD) | 7 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Hemothorax and Pneumothorax | 3 Care Plans
- Influenza (Flu) | 5 Care Plans
- Lung Cancer | 5 Care Plans
- Mechanical Ventilation | 6 Care Plans
- Near-Drowning | 5 Care Plans
- Pleural Effusion | 6 Care Plans
- Pneumonia | 11 Care Plans
- Pulmonary Embolism | 4 Care Plans
- Pulmonary Tuberculosis | 5 Care Plans
- Tracheostomy | 5 Care Plans
References and Sources
The following are the references and sources for the nursing diagnosis and nursing care plan for asthma:
- Ackley, B. J., Ladwig, G. B., Msn, R. N., Makic, M. B. F., Martinez-Kratz, M., & Zanotti, M. (2019). Nursing Diagnosis Handbook E-Book: An Evidence-Based Guide to Planning Care. Mosby. [Link]
- Carpenito-Moyet, L. J. (2006). Handbook of nursing diagnosis. Lippincott Williams & Wilkins. [Link]
- Joyce, B. M., & Jane, H. H. (2008). Medical surgical nursing. Clinical management for positive outcome. Volume 1. Eight Edition. Saunders Elsevier. St. Louis. Missouri. [Link]
- Pellico, L. H., Bautista, C., & Esposito, C. (2012). Focus on adult health medical-surgical nursing. [Link]
- Yang, B. H., Chen, Y. C., Chiang, B. L., & Chang, Y. C. (2005). Effects of nursing instruction on asthma knowledge and quality of life in schoolchildren with asthma. The journal of nursing research: JNR, 13(3), 174-183. [Read Abstract]
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