5 Croup Nursing Care Plans


Learn about nursing diagnosis and care plans for croup in young children with our comprehensive guide. Discover assessment and diagnostic criteria, as well as effective nursing interventions and nursing management for croup.

What is Croup?

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 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 obstruction below the level of the vocal cords. Spasmodic croup is a 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 the 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

Ineffective Airway Clearance

Croup is a viral infection that causes inflammation of the upper airways, leading to the narrowing of the air passages. This narrowing makes it difficult for the child to breathe, and can also make it harder to effectively clear mucus and other secretions from the airways. Additionally, the cough reflex can be impaired due to the inflammation, further contributing to ineffective airway clearance.

Nursing Diagnosis

  • Ineffective Airway Clearance

May be related to

  • Presence of thick, tenacious mucus
  • Edema and constriction of the airway

Possibly evidenced by

  • Persistent barking (croupy) cough
  • Thick secretions
  • Dyspnea
  • Diminished breath sounds, with diffuse crackles and rhonchi
  • Tachypnea, Tachycardia
  • Hoarseness
  • Hypercapnia, Hypoxemia
  • Cyanosis
  • Restlessness, irritability

Desired Outcomes

  • The client will maintain clear, open airways as evidenced by normal breath sounds, normal rate and depth of respiration, and the ability to effectively cough up secretions after treatments and deep breaths.

Nursing Assessment and Rationales

1. Observe the sound of a cough.
Grunting is produced during expiration by a premature glottic closure. It is an effort to maintain or increase functional residual capacity.

2. Assess the use of accessory muscles with nasal flaring.
As the trachea and larynx become inflamed and swollen, a child with croup produces a bark-like cough and hoarse or muffled vocal sounds. When it progresses, the child may manifest further upper airway obstruction with severely compromised oxygenation.

Nursing Interventions and Rationales

1. Advise increase fluid intake and maintain intravenous fluid as prescribed.
Adequate hydration can help loosen mucus in the oropharynx and prevent dehydration.

2. Place the child elevated in a semi-Fowler’s to high Fowler’s position; Reposition the child frequently.
Facilitates breathing and maximal lung expansion by lowering the diaphragm. Frequent repositioning prevents the pooling and stasis of secretions.

3. Use a cool mist humidifier or allow a hot shower to run for 10 minutes until the bathroom becomes humid and steamy, then let the child sit or stand in the bathroom.
Cool mist and humidity soothe inflamed airways and decrease the viscosity of the mucus thus helping in clearing the airway.

4. Perform chest physiotherapy as indicated.
Promotes expansion of the lungs, strengthens respiratory muscles, and mobilization of secretions.

5. Administer the following medications:

  • 5.1. Racemic epinephrine
    Epinephrine produces bronchodilation and widens the lumen of the airway.
  • 5.2. Corticosteroids (Inhalation)
    Decreases both laryngeal mucosal edema; Suppresses inflammation and normal immune response.

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.

NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for pediatric conditions and diseases:


Paul Martin R.N. brings his wealth of experience from five years as a medical-surgical nurse to his role as a nursing instructor and writer for Nurseslabs, where he shares his expertise in nursing management, emergency care, critical care, infection control, and public health to help students and nurses become the best version of themselves and elevate the nursing profession.

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