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5 Bronchopulmonary Dysplasia (BPD) Nursing Care Plans

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By Paul Martin, BSN, R.N.
5 Bronchopulmonary Dysplasia (BPD) Nursing Care Plans
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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 (5) nursing care plans (NCP) for Bronchopulmonary Dysplasia (BPD):

  1. Impaired Gas Exchange
  2. Imbalanced Nutrition: Less Than Body Requirements
  3. Compromised Family Coping
  4. Disorganized Infant Behavior
  5. Risk for Infection

2. Imbalanced Nutrition: Less Than Body Requirements

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Imbalanced Nutrition: Less Than Body Requirements

Imbalanced Nutrition: Less Than Body Requirements: Intake of nutrients insufficient to meet metabolic needs

May be related to

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  • Hypoxia during feeding
  • Poor feeder
  • Decreased weight gain
  • Increased energy/metabolic need for work of breathing
  • Altered physical growth

Possibly evidenced by

  • Aversion to or lack of interest in eating
  • Body weight 20% or more under ideal weight
  • Inadequate food intake (less than recommended daily allowances)
  • Perceived inability to ingest food
  • Poor muscle tone

Desired Outcomes

  • Family members will demonstrate an understanding of nutritional principles and requirements, feeding techniques, and special needs.
Nursing Interventions Rationale
Assess the family member’s knowledge on the importance and advantages of attaining normal nutritional body requirements. Determine the degree of caregiver’s knowledge on having a good nutritional status.
Obtain and record the child’s weight each morning before the first feeding. Accurately monitor the response or progress to nutritional therapy.
Provide small, frequent feedings. Reduce fatigue and enhance intake.
Provide a diet that fulfills child’s daily caloric requirements. Caloric requirements are raised due to increased work of breathing and to assist lung recovery and growth.
For infants older than age 6 months, offer solid foods before formula or breast milk. Place solid foods in the center of the tongue, using a small spoon to press downward slightly to facilitate swallowing. Older infants and young toddlers may resist solid foods, preferring milk or formula
Administer tube feedings for those clients who continue to rely on mechanical ventilators. Infants with severe BPD often experience feeding difficulty that may require a placement of a permanent feeding tube to provide nutritional support.
Provide parenteral fluids, as ordered With increased energy requirements, parenteral fluids ensure adequate fluid and electrolyte levels.

Compromised Family Coping

Compromised Family Coping: A usually supportive primary person (family member, significant other, or close friend) insufficient, ineffective, or compromised support, comfort, assistance or encouragement that may be needed by the individual to manage or master adaptive tasks related to his or her health challenge.

May be related to

  • Long-term illness that wears out the supportive capacity of significant people
  • Lack of coping skills

Possibly evidenced by

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  • Frequent and prolonged hospitalizations
  • Preoccupation of significant persons with anxiety, guilt, fear regardless of infant/child illness
  • Display of protective behaviors by significant persons that are disproportionate to infant/child needs (too much or too little)

Desired Outcomes

  • Family will express major stressors accompanying infant’s ailment.
  • Family will identify 3 coping mechanisms/support systems they can utilize.
Nursing Interventions Rationale
Assess anxiety, fear, erratic behavior, perception of crisis situation by family members. Provides information affecting the family ability to adjust with infant/child long-term disease.
Encourage verbalization of feelings and questions openly in an accepting, nonjudgmental manner. Lessens anxiety and improves family’s understanding of the condition of the infant.
Encourage family to discuss and develop previous coping methods used. Recognizes coping methods that were effective and the need to come up with new coping mechanisms.
Encourage family involvement in care during and after hospitalization. Provides for reduction of anxiety and fear of equipment used in care.
Provide a resting place for family members. Promotes family’s comfort.
Encourage open visitation and allow telephone calls to the hospital by family members. Facilitates bonding and helps the infant/child adjust with hospitalization if the family is unable to stay.
Provide positive feedback and recognize family efforts in creating coping and problem-solving techniques and caring for
the infant.		 Encourages parents and family to join in care and gain some control over the situation.
Suggest a referral to a social worker as needed. Assist family to obtain support and resources for financial or infant/childcare relief.
Suggest and reinforce appropriate
coping behaviors.		 Promotes behavior change and adaptation to care of the infant with oxygen dependence.
Suggest that assistance may be secured by telephoning hospital after discharge. Provides family with a resource in a crisis situation.
Reinforce need to preserve the health of family members and emotional status of parents. Chronic anxiety, fatigue will impair the health and care capabilities of family.
Provide knowledge about infant’s condition and progress, oxygen dependence needs, and reason for care and medications. Lessens parents and family’s anxiety and foresees the need for information about disease and care.
Provide teachings about cardiopulmonary resuscitation (CPR), oxygen administration, and safety measures to eliminate fire hazards. Empowers family to deal with an emergency situation and maintain safe oxygen administration.
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2. Imbalanced Nutrition: Less Than Body Requirements

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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Respiratory Care Plans

Care plans about respiratory system disorders:

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Paul Martin, BSN, R.N.
Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.

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