Pneumonia, an inflammatory condition affecting one or both lungs, is commonly triggered by bacteria, viruses, or fungi. While pneumonia typically poses a minimal threat to healthy individuals and often doesn’t necessitate hospitalization, it can become severe for vulnerable populations. These include the very young, the elderly, those with weakened immune systems, or individuals with pre-existing respiratory conditions. In these higher-risk groups, pneumonia may require hospital admission and intensive medical intervention.
Hospital-acquired pneumonia (HAP), emerging 48 hours post-hospitalization, is frequently linked to antibiotic-resistant pathogens. Healthcare-associated pneumonia (HCAP) develops in patients within other healthcare settings like nursing homes. Ventilator-associated pneumonia (VAP) is a significant concern for intensive care unit patients requiring mechanical ventilation. These critically ill individuals face a substantial mortality rate, ranging from 25% to 50%.
Community-acquired pneumonia (CAP), in contrast, arises outside of hospital or healthcare facility environments. It’s often spread through respiratory droplets expelled during coughing or sneezing, which are then inhaled by others. Transmission can also occur by touching contaminated surfaces and subsequently touching the nose or mouth.
In this article, we will delve into the essential nursing diagnoses for patients with pneumonia, providing a comprehensive guide for healthcare professionals.
The Nursing Process and Pneumonia Care
Pneumonia is a prevalent infection encountered by nurses across various healthcare settings. A nurse’s proficiency in monitoring for disease progression, recognizing complications, and understanding treatment rationales is crucial for effective patient care. Nurses are also pivotal in pneumonia prevention through patient education. Individuals with compromised immunity due to conditions like COPD, HIV, or autoimmune disorders need education on their heightened risk and preventive strategies. Smoking significantly elevates pneumonia risk and should be strongly discouraged. Nurses are responsible for assessing and promoting pneumonia vaccination for eligible individuals, contributing significantly to public health.
Comprehensive Nursing Assessment for Pneumonia
The cornerstone of nursing care is a thorough nursing assessment, encompassing the collection of physical, psychosocial, emotional, and diagnostic data. This section focuses on both subjective and objective data collection pertinent to pneumonia.
Reviewing Health History for Pneumonia Risk Factors
1. Evaluate General Symptoms: Pneumonia symptoms are diverse, influenced by the causative agent, patient age, and overall health status. Common symptoms include:
- Productive cough with sputum ranging from yellowish to greenish
- Elevated body temperature (fever)
- Profuse sweating episodes
- Shivering chills
- Dyspnea (shortness of breath)
- Tachypnea (rapid breathing)
- Pleuritic chest pain, exacerbated by breathing or coughing
- Fatigue and generalized weakness
- Anorexia (loss of appetite)
- Nausea and vomiting, particularly in pediatric patients
- Confusion or altered mental status, especially in older adults
2. Identify Risk Groups: Certain populations exhibit a higher susceptibility to pneumonia:
- Adults aged 65 years and older
- Infants and young children, particularly those under two years of age
- Individuals with compromised immune function
3. Investigate Potential Exposure Sources: Understanding potential sources of exposure is crucial for identifying specific types of pneumonia. For instance, Legionnaires’ disease is a pneumonia form linked to contaminated water systems. Fungal pneumonias can arise from soil exposure. Inquire about:
- Recent travel history, identifying potential geographic exposures.
- Occupation and living environment (e.g., military barracks, correctional facilities, nursing homes) to assess congregate living risks.
- Environmental exposures, including air pollution and industrial fumes.
- Animal contact, particularly with birds, which can transmit certain bacteria to humans.
4. Determine Aspiration Risk: Patients prone to aspiration are at increased risk for developing aspiration pneumonia. Risk factors for aspiration include:
- Alcohol abuse and substance use disorders
- Altered mental status due to various conditions
- Pre-existing anatomical abnormalities affecting swallowing
- Dysphagia (difficulty swallowing) from neurological or structural issues
- Gastroesophageal reflux disease (GERD) increasing reflux into the airway
- Seizure disorders potentially leading to aspiration during or post-seizure
5. Detailed Medical History Review: A comprehensive review of pre-existing medical conditions is vital, as several conditions elevate pneumonia risk:
- Asthma and other reactive airway diseases
- Chronic Obstructive Pulmonary Disease (COPD)
- Cystic fibrosis, predisposing to lung infections
- Respiratory Syncytial Virus (RSV) infection history
- Diabetes mellitus
- Heart failure and other cardiac conditions
- Sickle cell disease
- Current or past smoking habits
- Immunocompromised states from disease or medications
6. Medication Review: Antibiotic resistance is a growing concern. Methicillin-resistant Staphylococcus aureus (MRSA) and other resistant bacteria are frequent causes of HAP and HCAP. Document current and recent antibiotic use.
7. Surgical History: Postoperative pneumonia is a significant complication following surgical procedures. Risk factors for postoperative pneumonia include advanced age, pre-existing COPD, emergency surgeries, prolonged mechanical ventilation, low serum albumin levels, and prolonged bed rest.
Physical Examination in Pneumonia Assessment
1. Vital Sign Monitoring: Closely monitor vital signs for deviations:
- Tachypnea (respiratory rate exceeding 20 breaths per minute)
- Tachycardia (heart rate above 100 beats per minute)
- Fever (body temperature of 100.4°F (38°C) or higher)
Note: Immunocompromised patients may not always present with a fever, despite active infection.
2. Respiratory Status Evaluation: Auscultation, palpation, and percussion are essential for assessing respiratory function:
- Palpation: Increased tactile fremitus indicates lung consolidation.
- Percussion: Dullness to percussion suggests fluid or consolidation in the lung tissue.
- Auscultation: Assess for adventitious breath sounds such as decreased breath sounds, rales (crackles), rhonchi, or wheezes.
3. Systemic Signs and Symptoms: Pneumonia often manifests beyond respiratory symptoms, including:
- Chills and rigors
- Lethargy and reduced activity levels
- Anorexia (loss of appetite)
- Myalgia (muscle aches and pains)
- Altered mental status or confusion
- General weakness
- Dehydration, potentially indicated by diarrhea, vomiting, or headache
4. Sputum Characteristics: Sputum examination can provide clues about the etiology of pneumonia:
- Purulent or blood-tinged sputum is more indicative of bacterial pneumonia.
- Watery or mucopurulent sputum is more commonly associated with viral pneumonia.
5. Gag Reflex Assessment: Assessing the gag reflex is critical, especially in patients at risk for aspiration. Elicit the gag reflex by gently stimulating the posterior tongue with a cotton swab or tongue depressor.
Diagnostic Procedures for Pneumonia
1. Blood Tests: Blood analyses provide valuable insights into infection severity, inflammation, and potential complications. Common blood tests include:
- Complete Blood Count (CBC) with differential to assess white blood cell count and types.
- Coagulation studies to evaluate clotting function.
- Serum electrolytes panel to assess electrolyte balance.
- Renal function panel to evaluate kidney function.
- Liver function panel to assess liver health.
- Serum lactate level as an indicator of tissue hypoxia.
- C-reactive protein (CRP) and Procalcitonin levels as inflammatory markers, particularly for bacterial infections.
2. Blood and Sputum Cultures: Obtain blood and sputum cultures (if possible) before initiating antibiotic therapy to identify the causative pathogen and guide targeted treatment.
3. Blood Gas Analysis: Arterial blood gas (ABG) analysis assesses the degree of respiratory compromise, gas exchange efficiency, and acid-base balance in the blood.
4. Lower Respiratory Secretion Sampling: In cases like ventilator-associated pneumonia (VAP), obtaining lower respiratory tract secretions is essential. Bronchoscopy with bronchoalveolar lavage or protected specimen brushing is often used to acquire these samples for Gram stain and culture to guide antibiotic selection.
5. Imaging Studies: Chest radiography (chest X-ray) is the standard imaging modality for diagnosing pneumonia. It helps identify:
- Pulmonary infiltrates, indicating lung tissue consolidation.
- Pleural effusion, fluid accumulation in the pleural space.
- Parapneumonic effusions, pleural effusions associated with pneumonia.
Alt text: Chest X-ray image revealing lung opacities indicative of pneumonia, a common respiratory infection requiring nursing diagnosis.
Essential Nursing Interventions for Pneumonia Management
Nursing interventions and comprehensive care are vital for a patient’s recovery from pneumonia. The following section outlines key nursing interventions.
Managing Pneumonia Infection
1. Pneumonia Type Identification: Differentiating between CAP, VAP, and HAP is crucial as treatment strategies vary based on pneumonia type and severity. Consider factors such as:
- Appropriateness of outpatient treatment versus hospitalization.
- Need for intensive care unit (ICU) admission for severe cases.
2. Antibiotic Therapy Administration: Antibiotics are the cornerstone of bacterial pneumonia treatment. Initiate empiric antibiotic therapy promptly as per established guidelines. Tailor antibiotic selection once the specific pathogen is identified from culture results.
3. Oxygen Therapy: Administer supplemental oxygen as needed to address hypoxemia and dyspnea, maintaining adequate oxygen saturation levels.
4. Fluid Resuscitation: Volume depletion is common in pneumonia patients. Intravenous fluid therapy may be required, particularly for hypotensive patients. Exercise caution when administering IV fluids to patients with pre-existing heart disease or kidney failure to prevent fluid overload.
5. Pharmacological Management: Administer prescribed medications, which may include:
- Corticosteroids to reduce inflammation in certain cases.
- Analgesics and antipyretics such as aspirin, NSAIDs, or acetaminophen for pain and fever management.
- Cough suppressants and/or expectorants to manage cough and aid in secretion mobilization.
6. Respiratory Therapy Collaboration: Collaborate closely with respiratory therapists for interventions such as breathing treatments, chest physiotherapy, oxygen administration, and ventilatory support.
7. Secretion Mobilization Techniques: Implement strategies to help loosen and expel respiratory secretions, including:
- Diaphragmatic breathing exercises.
- Deep breathing and controlled coughing exercises.
- Use of incentive spirometry or flutter valves to improve lung expansion and airway clearance.
- Early ambulation, promoting lung function and secretion movement.
8. Humidity and Hydration: Encourage increased fluid intake, especially warm liquids, to promote hydration and thin secretions. Recommend using humidifiers or steamy showers/baths to moisten airways and ease breathing.
Pneumonia Prevention Strategies
1. Smoking Cessation: Emphasize the detrimental effects of smoking on lung health and its strong association with increased pneumonia risk. Advise patients to avoid both active and secondhand smoke exposure.
2. Vaccination Promotion: Advocate for pneumonia vaccination, especially for adults over 65 and younger individuals at increased risk. Promote other recommended vaccinations such as influenza, COVID-19, and RSV vaccines, as these respiratory infections can predispose to pneumonia.
3. Exposure Risk Reduction: Educate patients on infection control measures:
- Emphasize proper handwashing techniques and the use of alcohol-based hand sanitizers.
- Advise avoiding close contact with individuals who are ill.
- Recommend mask use in crowded settings or during travel, especially during respiratory illness seasons.
- Promote immune system strengthening through a balanced diet, regular exercise, and adequate sleep.
4. Aspiration Precautions: For patients at risk of aspiration, implement specific measures:
- Encourage small bites and slow eating.
- Minimize distractions during meal times.
- Allow ample time for thorough chewing and swallowing.
- Ensure upright positioning (90 degrees) during meals and for at least 30 minutes post-meal.
- Monitor for food or pill pocketing in the mouth.
- Observe for choking or gagging during eating.
- Consider modified diets, such as thickened liquids or pureed foods, as recommended by speech therapy.
- Request speech therapy evaluation for patients with swallowing difficulties.
Strategies to Minimize Ventilator-Acquired Pneumonia (VAP) Risk
1. Oral Hygiene: Provide meticulous and frequent oral care for ventilated patients to reduce bacterial colonization in the oral cavity.
2. Suctioning Protocols: Implement regular suctioning, including subglottic suctioning, to remove pooled secretions from the oropharynx and prevent aspiration.
3. Patient Positioning: Maintain the head of the bed elevated at a 30 to 45-degree angle to minimize reflux and aspiration risk, thus reducing VAP incidence.
4. Early Ambulation: When clinically appropriate, facilitate early ambulation or mobilization (sitting at the bedside, chair positioning, marching in place) to promote lung expansion and reduce VAP risk.
Alt text: Nurse instructing elderly patient on deep breathing exercises, crucial for pneumonia recovery and improved lung function, highlighting expert nursing care.
Nursing Care Plans for Pneumonia: Addressing Key Diagnoses
Once nursing diagnoses are established for a pneumonia patient, nursing care plans are essential for prioritizing assessments and interventions to achieve short-term and long-term care goals. Common nursing diagnoses and associated care plan examples for pneumonia are detailed below.
Nursing Diagnosis: Impaired Gas Exchange
Impaired gas exchange is intrinsically linked to ineffective airway clearance in pneumonia. The accumulation of pus and mucus in the alveoli directly impedes gas exchange and oxygenation processes.
Nursing Diagnosis: Impaired Gas Exchange
Related Factors:
- Inflammatory processes within the lungs
- Presence of fluid and mucus in the alveoli
- Hypoventilation leading to insufficient oxygen delivery
Evidenced By:
- Dyspnea (shortness of breath)
- Hypoxemia (low blood oxygen levels)
- Confusion and altered mental status
- Restlessness and anxiety
- Lethargy and fatigue
- Abnormal breathing patterns (tachypnea, bradypnea, shallow breathing)
Expected Outcomes:
- Patient will demonstrate improved oxygenation, as evidenced by arterial blood gas (ABG) values within normal limits for their baseline.
- Patient will actively participate in interventions to promote ventilation and oxygenation.
Nursing Assessments:
1. Lung Sounds and Vital Signs Assessment: Regularly assess breath sounds, respiratory rate and depth, SpO2 levels, blood pressure, heart rate, and capillary refill to monitor for indicators of hypoxia and perfusion changes.
2. Mental Status Evaluation: Monitor for changes in mental status. Hypoxia can impair brain perfusion, leading to decreased level of consciousness, restlessness, agitation, and lethargy.
3. ABGs and Oxygen Saturation Monitoring: Continuously monitor SpO2 via pulse oximetry. Obtain and analyze ABGs to directly measure blood oxygen and carbon dioxide levels. Decreasing SpO2 and abnormal ABG values signify hypoxia and inadequate gas exchange.
Nursing Interventions:
1. Promote Rest and Activity Management: Balance activity and rest. Pneumonia patients may have limited activity tolerance due to dyspnea and fatigue. Encourage rest in a calm environment, minimizing interruptions. Space out activities like bathing and therapy sessions to reduce oxygen demand.
2. Judicious Use of Respiratory Depressants: Administer narcotics and sedatives with caution. These medications can further depress the respiratory system. Closely monitor respiratory status in patients receiving these medications for pain control or anxiety.
3. Oxygen Administration: Administer supplemental oxygen as prescribed to support oxygenation and maintain target SpO2 levels. Oxygen delivery methods will depend on the patient’s needs and severity of hypoxemia.
Nursing Diagnosis: Impaired Spontaneous Ventilation
Severe pneumonia cases can progress to respiratory failure, compromising the patient’s ability to breathe independently.
Nursing Diagnosis: Impaired Spontaneous Ventilation
Related Factors:
- Underlying respiratory conditions (COPD, asthma)
- Sepsis and systemic infection
- Respiratory muscle fatigue and weakness
Evidenced By:
- Dyspnea and increased work of breathing
- Cyanosis (bluish discoloration of skin and mucous membranes)
- Tachycardia (rapid heart rate)
- Restlessness and anxiety
- Hypoxia (low oxygen levels)
- Accessory muscle use during breathing
- Nasal flaring
- Abnormal arterial blood gas (ABG) values
Expected Outcomes:
- Patient will maintain arterial blood gas (ABG) values within acceptable parameters for their clinical condition.
- Patient will be free from signs of respiratory distress, such as cyanosis, restlessness, and hypoxia.
- Patient will maintain a patent airway.
Nursing Assessments:
1. Respiratory Distress Monitoring: Continuously assess for signs of worsening respiratory distress. Increased dyspnea, tachypnea, retractions, accessory muscle use, and cyanosis require immediate nursing intervention.
2. Arterial Blood Gas (ABG) Analysis: Regularly monitor ABG results. ABG analysis is crucial for detecting changes in oxygenation and acid-base balance, enabling proactive interventions before respiratory failure develops.
3. Identify Complicating Factors: Determine the presence of any co-existing conditions that may complicate respiratory status. Chronic conditions like COPD, asthma, heart failure, and cirrhosis can significantly impact breathing ability and may necessitate advanced respiratory support.
Nursing Interventions:
1. Discuss Advanced Respiratory Support: Prepare the patient and family for potential escalation of respiratory support. Discuss the process of noninvasive and invasive ventilation to reduce anxiety and ensure informed decision-making.
2. Noninvasive Positive Pressure Ventilation (NPPV) Consideration: Consider NPPV, such as BiPAP, as an initial intervention. NPPV provides ventilatory support noninvasively and carries a lower risk of ventilator-associated pneumonia (VAP) compared to intubation and mechanical ventilation.
3. Repositioning and Mobilization: Reposition the patient frequently to optimize lung expansion and secretion mobilization. If not contraindicated, assist with ambulation. For immobile patients, utilize rotational beds to facilitate turning and prevent atelectasis and VAP.
4. VAP Prevention Protocols: Implement comprehensive VAP prevention strategies. Maintain head of bed elevation at 30-45 degrees, provide meticulous oral care, and perform suctioning to prevent aspiration and subsequent VAP.
Nursing Diagnosis: Ineffective Airway Clearance
Pneumonia often leads to increased sputum production, making it challenging for patients to effectively clear their airways.
Nursing Diagnosis: Ineffective Airway Clearance
Related Factors:
- Weak or ineffective cough reflex
- Presence of secretions in the bronchi and alveoli
- Excessive mucus production
- Underlying comorbidities such as COPD, asthma, and cystic fibrosis
Evidenced By:
- Shortness of breath and dyspnea
- Adventitious lung sounds (diminished, crackles, rhonchi)
- Ineffective or weak cough
- Sputum production (amount, color, consistency)
- Orthopnea (difficulty breathing when lying down)
- Changes in respiratory rate and rhythm (tachypnea, irregular breathing)
- Restlessness and anxiety
Expected Outcomes:
- Patient will maintain a patent airway, free from obstruction by secretions.
- Patient will demonstrate effective airway clearance techniques, such as coughing and deep breathing.
- Patient will exhibit improved airway clearance, evidenced by clear breath sounds and a regular, unlabored respiratory rate.
Nursing Assessments:
1. Respiratory Status Monitoring: Closely monitor respiratory rate, rhythm, depth, and effort. Subtle or sudden changes can occur. Promptly intervene if respiratory rate increases, breathing becomes labored, accessory muscles are used, or oxygen saturation levels decrease.
2. Cough Assessment: Evaluate the patient’s ability to cough and the effectiveness of their cough. Pneumonia-induced inflammation and increased sputum production necessitate an effective cough to maintain airway patency. Assess cough strength and frequency. Patients with weakness or impaired cough reflex are at higher risk for aspiration and airway obstruction.
3. Sputum Sample Collection: Obtain a sputum sample for culture and sensitivity testing. If the patient can expectorate sputum, instruct them to cough deeply and expectorate into a sterile container. If unable to expectorate, sputum can be obtained via suctioning.
Nursing Interventions:
1. Respiratory Devices and Techniques Assistance: Assist with and instruct patients on the use of respiratory devices and techniques. Flutter valves help mobilize secretions, and incentive spirometers promote lung expansion. Educate on proper use and encourage hourly use. Teach effective coughing and deep breathing exercises.
2. Suctioning Administration: Perform suctioning as needed to remove secretions and maintain airway patency. Patients with tracheostomies may require frequent suctioning. Teach patients with ineffective coughs how to self-suction if appropriate.
3. Nebulizer Treatments and Medications: Administer nebulizer treatments as prescribed. Nebulized bronchodilators and mucolytics can help loosen secretions and facilitate expectoration. Expectorants can thin mucus, making it easier to cough up.
4. Movement and Positioning Promotion: Encourage patient mobility and optimal positioning. Mobile patients should ambulate several times daily to mobilize secretions. For immobile patients, implement turning every 2 hours, assist to an upright position, or transfer to a chair to promote lung expansion and secretion clearance.
Nursing Diagnosis: Ineffective Breathing Pattern
Pneumonia, as a lung infection, can disrupt normal respiratory patterns, leading to ineffective ventilation.
Nursing Diagnosis: Ineffective Breathing Pattern
Related Factors:
- Increased sputum production and airway inflammation
- Pleuritic pain exacerbating breathing
- Fatigue and weakness
- Poor body positioning restricting lung expansion
- Chronic lung diseases contributing to breathing pattern alterations
Evidenced By:
- Changes in respiratory rate, depth, and rhythm (tachypnea, shallow breathing)
- Abnormal breath sounds (wheezing, crackles, rhonchi)
- Use of accessory muscles of respiration
- Dyspnea and shortness of breath
- Orthopnea
- Cyanosis
- Productive cough
Expected Outcomes:
- Patient will demonstrate effective respirations while in a comfortable position.
- Patient will maintain a regular and unlabored breathing pattern.
Nursing Assessments:
1. Respiratory Status Monitoring and Measurement: Assess respiratory rate, depth, and pattern regularly. Closely monitor for signs of increased work of breathing: accessory muscle use, nasal flaring, grunting, and orthopnea.
2. Lung Auscultation: Auscultate lung fields to identify abnormal breath sounds. Inflammation and mucus accumulation in the lungs can cause wheezing, crackles, or rhonchi, indicating an ineffective breathing pattern.
3. Pain Assessment with Breathing: Assess for pleuritic chest pain or pain associated with breathing and coughing. Pain can inhibit normal breathing patterns and lead to shallow, ineffective respirations.
Nursing Interventions:
1. Head of Bed Elevation and Ambulation: Elevate the head of the bed to promote optimal chest expansion. Encourage ambulation as tolerated to mobilize secretions and improve ventilation.
2. Oxygen Therapy Administration: Administer supplemental oxygen as indicated to address hypoxia and improve oxygenation. Titrate oxygen therapy based on prescribed orders or established guidelines and patient response.
3. Deep Breathing and Chest Splinting Encouragement: Teach and encourage deep, controlled breathing exercises to improve ventilation. For patients with pleuritic chest pain, instruct on splinting the chest with a pillow during coughing or deep breathing to minimize pain and promote effective respiratory effort.
4. Rest and Sleep Promotion: Promote adequate rest periods and uninterrupted sleep to reduce fatigue and improve respiratory muscle function. Encourage participation in activities of daily living (ADLs) as tolerated, but advise against overexertion. Limit nighttime interruptions to promote restorative sleep.
Nursing Diagnosis: Risk for Infection
While pneumonia is an infection itself, a “Risk for Infection” nursing diagnosis is relevant because untreated or poorly managed pneumonia can progress to secondary infections or sepsis.
Nursing Diagnosis: Risk for Infection
Related Factors:
- Inadequate primary defenses: compromised ciliary action, increased respiratory secretions
- Invasive procedures: suctioning, intubation, mechanical ventilation
- Presence of existing infection (primary pneumonia)
- Deterioration of condition leading to immobility, immunosuppression, and malnutrition
Evidenced By:
A “Risk for” diagnosis is not evidenced by current signs and symptoms, as the problem has not yet occurred. Interventions are preventative.
Expected Outcomes:
- Patient will not develop secondary infections or sepsis.
- Patient will demonstrate improvement in the primary infection, evidenced by vital signs and lab values returning to within normal limits.
Nursing Assessments:
1. Monitor for Sepsis Indicators: Closely monitor for signs of worsening infection and sepsis. Dropping blood pressure, hypothermia or hyperthermia, elevated heart rate, and tachypnea are early indicators of sepsis requiring immediate medical attention.
2. Laboratory Value Monitoring: Assess white blood cell count (WBC). An elevated WBC is expected in pneumonia but should trend downwards with effective treatment. A persistently rising WBC or significant changes may indicate secondary infection or sepsis. Monitor blood cultures if sepsis is suspected.
3. Identify Potential Infection Sources: Systematically assess for potential sources of secondary infection, particularly in hospitalized patients. Examine insertion sites of IV lines, urinary catheters, feeding tubes, suction tubing, and ventilation equipment for signs of infection. Remove unnecessary invasive lines as soon as clinically appropriate. Monitor surgical incisions and any skin breakdown for redness, warmth, drainage, or odor indicative of infection.
Nursing Interventions:
1. Antibiotic Administration and Monitoring: Administer prescribed antibiotics promptly and monitor for therapeutic effectiveness. If the patient’s condition worsens or laboratory values do not improve as expected, reassess antibiotic regimen and consider potential antibiotic resistance or secondary infection.
2. Hydration and Nutritional Support: Encourage adequate fluid intake and balanced nutrition. Hydration is crucial for preventing dehydration and supporting kidney function. Fluids help mobilize respiratory secretions. Proper nutrition supports immune function and overall homeostasis.
3. Infection Prevention Measures: Implement rigorous infection prevention practices. Emphasize and practice proper hand hygiene as the most effective way to prevent and control infection spread. Implement standard and transmission-based precautions as indicated. Limit visitors if necessary to minimize exposure to potential pathogens. Maintain aseptic technique during all invasive procedures.
4. Skin Integrity Promotion: Promote and maintain skin integrity. Intact skin is the body’s primary barrier against infection. Reposition immobile patients every 2 hours to prevent pressure ulcers and skin breakdown. Provide meticulous skin care, keeping skin clean and dry, especially in perineal areas and skin folds. Ensure prompt linen changes when soiled.
References
Original article’s references to be included here.
