Influenza (also known as flu, or grippe) is an acute inflammation of the nasopharynx, trachea, and bronchioles, with congestion, edema, and the possibility of necrosis of these respiratory structures. Influenza is a highly contagious infection of the respiratory tract caused by three different types of Myxovirus influenzae. It occurs sporadically or in epidemics which peaks usually during colder months.
Nursing Care Plans
Unless complications occur, influenza doesn’t require hospitalization and patient care usually focuses on the relief of symptoms.
Here are six (5) nursing care plans (NCP) and nursing diagnosis (NDx) for Influenza (Flu):
Ineffective Breathing Pattern
Nursing Diagnosis
May be related to
- Inflammation from viral infection
- Pneumonia
- Hemorrhagic bronchitis
Possibly evidenced by
- Coughing
- Tachypnea
- Hemoptysis
- Cyanosis
- Dyspnea
- Pulmonary edema
- Fever
- Weakness
- Diaphoresis
- Fatigue
- Leukopenia
- Sputum
- Warm flushed skin
- Erythema to tonsils, soft and hard palate and pharyngeal wall
- Abnormal chest X-rays
Desired Outcomes
- Patient will achieve and maintain normal respiratory pattern and rate, with no adventitious breath sounds to auscultation.
- Patient will be able to expectorate secretions effectively.
- Patient will maintain and adhere to isolation precautions.
- Patient will be able to utilize relaxation techniques to improve pain and facilitate breathing.
Nursing Interventions | Rationale |
---|---|
Assess vital signs, carefully monitoring respiratory status for baseline rate, rhythm, and character, and notify the physician or significant changes. | Changes may reflect early signs of respiratory compromise and insufficiency. |
Monitor pulse oximetry readings and notify the physician if <90% | Oximetry approximates arterial blood gas oxygen saturation and helps to identify oxygenation dysfunction and respiratory status changes. |
Auscultate breath sounds every 2-4 hours and as needed. Notify physician of changes. | Assists with the identification of changes in respiratory status, the presence of adventitious breath sounds or decreased breath sounds. The elderly patient may have infiltrates in the interstitium, bilateral lobes, and anterior and lower lung fields. |
Administer oxygen as ordered. | Provides supplemental oxygen and helps alleviate respiratory distress caused by hypoxemia. |
Assess patient for complaints of pain and medicate as needed. | Pain decreases respiratory effort and chest excursion, which decreases ventilation and perfusion. Analgesia relieves pain and promotes improved respiratory effort. |
Encourage patient to maintain semi-Fowler’s or high Fowler’s position as tolerated. | Promotes chest expansion and enhances respiratory effort. |
Encourage patient and assist with the use of incentive spirometry, nebulizers, etc., as ordered | Assists to prevent atelectasis or lung collapse and ensure proper use of equipment. |
Perform chest physiotherapy, chest percussion, and postural drainage as ordered. | Helps improve airway clearance and respiratory effort. Helps clear secretions. |
Encourage patient to change position every 2 hours and as needed, and assist as needed. | Facilitate comfort and mobilizes pulmonary secretions. |
Provide and encourage fluid intake of at least 2 L/day unless contraindicated. | Maintain hydration and helps to liquefy secretions to enable patients to expectorate sputum. |
Maintain ordered isolation techniques. | Prevents cross contamination and exposure to pathogens. |
Instruct patient and/or SO regarding isolation requirements and ensure that they adhere to the proper techniques. | Provides knowledge, decreases fear and helps prevent further spread of infection. |
Teach the patient how to use a pillow to split chest with cough efforts. | Assists to reduce pain associated with cough. |
Instruct patient in relaxation techniques, guided imagery, muscle relaxation, and breathing exercises. | Assist in pain reduction and alleviates anxiety which may improve respiratory effort and oxygenation. |
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:
- 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