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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 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
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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
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- Long-term illness that wears out the supportive capacity of significant people
- Lack of coping skills
Possibly evidenced by
- 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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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, 2021-2023Â (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:
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- Nursing Care Plans (NCP): Ultimate Guide and Database
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]
Nice work
Wonderful information bravo.