In this guide are pneumonia nursing care plans and nursing diagnosis, nursing interventions and nursing assessment for pneumonia. Nursing interventions for pneumonia and care plan goals for patients with pneumonia include measures to assist in effective coughing, maintain a patent airway, decreasing viscosity and tenaciousness of secretions, and assist in suctioning.
Pneumonia is an inflammation of the lung parenchyma, associated with alveolar edema and congestion that impair gas exchange. Pneumonia is caused by a bacterial or viral infection that is spread by droplets or by contact and is the sixth leading cause of death in the United States.
The prognosis is typically good for people who have normal lungs and adequate host defenses before the onset of pneumonia. Pneumonia is a particular concern in high-risk patients: persons who are very young or very old, people who smoke, bedridden, malnourished, hospitalized, immunocompromised, or exposed to MRSA.
Types of Pneumonia
There are two types of pneumonia: community-acquired pneumonia (CAP), or hospital-acquired pneumonia (HAP) or also known as nosocomial pneumonia.
Pneumonia may also be classified depending on its location and radiologic appearance. Bronchopneumonia (bronchial pneumonia) involves the terminal bronchioles and alveoli. Interstitial (reticular) pneumonia involves inflammatory response within lung tissue surrounding the air spaces or vascular structures rather than the area passages themselves. Alveolar (or acinar) pneumonia involves fluid accumulation in the lung’s distal air spaces. Necrotizing pneumonia causes the death of a portion of lung tissue surrounded by a viable tissue.
Pneumonia is also classified based on its microbiologic etiology – they can be viral, bacterial, fungal, protozoan, mycobacterial, mycoplasmal, or rickettsial in origin.
Signs and Symptoms
The main symptoms of pneumonia are coughing, sputum production, pleuritic chest pain, shaking chills, rapid shallow breathing, fever, and shortness of breath. If left untreated, pneumonia could complicate to hypoxemia, respiratory failure, pleural effusion, empyema, lung abscess, and bacteremia.
Nursing care plan (NCP) and care management for patients with pneumonia start with an assessment of the patient’ medical history, performing respiratory assessment every four (4) hours, physical examination, and ABG measurements. Supportive interventions include oxygen therapy, suctioning, coughing, deep breathing, adequate hydration, and mechanical ventilation. Other nursing interventions are detailed on the nursing diagnoses in the subsequent sections.
Here are 11 nursing diagnosis common to pneumonia nursing care plans (NCP), they are as follows:
- Ineffective Airway Clearance
- Impaired Gas Exchange
- Ineffective Breathing Pattern
- Risk for Infection
- Acute Pain
- Activity Intolerance
- Risk for Deficient Fluid Volume
- Risk for Imbalanced Nutrition: Less Than Body Requirements
- Deficient Knowledge
- Deficient Fluid Volume
Deficient Knowledge nursing diagnosis for pneumonia nursing care plan includes all the teaching plan and interventions for the patient and caregiver to achieve understanding of the disease condition and prognosis.
- Deficient Knowledge
Common related factors:
- Lack of exposure
- Misinterpretation of information
- Altered recall
- Unfamiliarity with the disease process and/or transmission of disease
The common assessment cues that could serve as defining characteristics or part of your “as evidenced by” in your diagnostic statement.
- Requests for information
- Questions to health care team
- Statement of misconception
- Failure to improve/recurrence
- Confusion about treatment
- Inability to comply with treatment regimen, including appropriate isolation procedures
Common goals and expected outcomes for Deficient Knowledge nursing diagnosis:
- Patient and caregiver will verbalize understanding of condition, disease process, and prognosis.
- Patient and caregiver will verbalize understanding of therapeutic regimen.
- Patient will initiate necessary lifestyle changes.
- Patient will participate in treatment program.
Nursing Interventions and Rationale
|Determine patient’s understanding of pneumonia complications and its treatment regimen.||Provides a starting point in education.|
|Review normal lung function, pathology of condition.||Promotes understanding of current situation and importance of cooperating with treatment regimen.|
|Discuss debilitating aspects of disease, length of convalescence, and recovery expectations. Identify self-care and homemaker needs.||Information can enhance coping and help reduce anxiety and excessive concern. Respiratory symptoms may be slow to resolve, and fatigue and weakness can persist for an extended period. These factors may be associated with depression and the need for various forms of support and assistance.|
|Assess potential home care needs.||Therapeutic regimen will continue after hospital discharge and home care needs will depend on the availability of supportive people including the patient’s energy level and cognitive level.|
|Provide information in written and verbal form.||Fatigue and depression can affect ability to assimilate information and follow therapeutic regimen.|
|Reinforce importance of continuing effective coughing and deep-breathing exercises.||During initial 6–8 wk after discharge, patient is at greatest risk for recurrence of pneumonia.|
|Emphasize necessity for continuing antibiotic therapy for prescribed period.||Full-course antibiotic treatment is required to reduce the recurrence of pneumonia and promote a healthy immune system. Early discontinuation of antibiotics may result in failure to completely resolve infectious process and may cause recurrence or rebound pneumonia.|
|Review the importance of cessation of smoking.||Smoking destroys tracheobronchial ciliary action, irritates bronchial mucosa, and inhibits alveolar macrophages, compromising body’s natural defense against infection.|
|Outline steps to enhance general health and well-being: balanced rest and activity, well-rounded diet, avoidance of crowds during cold/flu season and persons with URIs.||Increases natural defense, limits exposure to pathogens.|
|Stress importance of continuing medical follow-up and obtaining vaccinations as appropriate.||May prevent recurrence of pneumonia and/or related complications.|
|Identify signs and symptoms requiring notification of health care provider: increasing dyspnea, chest pain, prolonged fatigue, weight loss, fever, chills, persistence of productive cough, changes in mentation.||Prompt evaluation and timely intervention may prevent complications.|
|Instruct patient to avoid using antibiotics indiscriminately during minor viral infections.||This may results in upper airway colonization with antibiotic-resistant bacteria. If the patient then develops pneumonia, the organisms producing the pneumonia may require treatment with more toxic antibiotics.|
|Encourage Pneumovax and annual flu shots for high-risk patients.||To help prevent occurrence of the disease.|
You may also like the following posts and care plans:
- Nursing Care Plan: The Ultimate Guide and Database – the ultimate database of nursing care plans for different diseases and conditions! Get the complete list!
- Nursing Diagnosis: The Complete Guide and List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
Related Nursing Care Plans
Related nursing diagnoses you can use to craft another pneumonia nursing care plans.
- Impaired Dentition. May be related to dietary habits, poor oral hygiene, chronic vomiting, possibly evidenced by erosion of tooth enamel, multiple carries, abraded teeth.
- Impaired oral mucous membrane. Maybe related to breathing through the mouth, malnutrition or vitamin deficiency, poor oral hygiene, chronic vomiting, possibly evidenced by sore, inflamed buccal mucosa, swollen salivary glands, ulcerations, and reports of sore mouth and/or throat.
References and Sources
Recommended journals, books, and other interesting materials to help you learn more about Pneumonia Nursing Care Plans:
- Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
- Dempsey, C. L. (1995). Nursing Home‐Acquired Pneumonia: Outcomes from a Clinical Process Improvement Program. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 15(1P2), 33S-38S. [Link]
- Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse‘s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
- Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
- Head, B. J., Scherb, C. A., Reed, D., Conley, D. M., Weinberg, B., Kozel, M., … & Moorhead, S. (2011). Nursing diagnoses, interventions, and patient outcomes for hospitalized older adults with pneumonia. Research in gerontological nursing, 4(2), 95-105. [Link]
- Yoshino, A., Ebihara, T., Ebihara, S., Fuji, H., & Sasaki, H. (2001). Daily oral care and risk factors for pneumonia among elderly nursing home patients. Jama, 286(18), 2235-2236. [Link]
Originally published January 10, 2010.