What is Pneumonia?
Pneumonia is a serious inflammatory condition affecting the lung parenchyma, characterized by alveolar edema and congestion. This inflammation significantly impairs gas exchange within the lungs. Typically triggered by bacterial or viral infections, pneumonia spreads through respiratory droplets or direct contact. Notably, pneumonia ranks as the sixth leading cause of mortality in the United States, underscoring its significant public health impact.
For individuals with healthy lungs and robust immune systems prior to the onset of infection, the prognosis for pneumonia is generally favorable. However, it poses a greater threat to high-risk populations. These vulnerable groups include very young children, older adults, smokers, individuals experiencing prolonged bed rest, those malnourished, hospitalized patients, immunocompromised individuals, and those exposed to Methicillin-resistant Staphylococcus aureus (MRSA).
For an in-depth understanding of the pathophysiology, medical treatments, and surgical management of pneumonia, please refer to our comprehensive Pneumonia nursing study guide, a valuable resource within our broader collection of nursing notes.
Pneumonia is clinically categorized into several types, each defined by its origin and causative agents:
| Type of Pneumonia | Description | Common Causes |
|---|---|---|
| Community-Acquired Pneumonia (CAP) | Defined as pneumonia acquired in community settings or within the first 48 hours of hospital admission. It is most prevalent in individuals under 60 years of age without co-existing health conditions and those over 60 years with comorbidities. Older adults demonstrate a particularly high incidence of CAP. | Predominantly caused by Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae, as well as viruses including respiratory syncytial virus and adenovirus, and fungal pathogens. |
| Health Care–Associated Pneumonia (HCAP) | Pneumonia that develops in patients residing in long-term care facilities or outpatient settings. HCAP is often caused by multidrug-resistant (MDR) pathogens, necessitating prompt and targeted antibiotic therapy. | Frequently attributed to MDR bacteria such as Pseudomonas aeruginosa and MRSA. |
| Hospital-Acquired Pneumonia (HAP) | Diagnosed when pneumonia arises 48 hours or more after hospital admission. HAP carries a high mortality rate due to virulent and resistant organisms. It is commonly seen in patients with chronic illnesses, those requiring prolonged hospitalization, or individuals using medical devices like respiratory equipment. | Commonly caused by Enterobacter species, Escherichia coli, Klebsiella species, Proteus species, Staphylococcus aureus (including MRSA), and Pseudomonas aeruginosa. |
| Ventilator-Associated Pneumonia (VAP) | A subtype of HAP, VAP occurs in patients who have been on mechanical ventilation for at least 48 hours. The risk of VAP increases with the duration of mechanical ventilation. | Early-onset VAP is typically caused by antibiotic-sensitive bacteria, while late-onset VAP is often associated with MDR bacteria. |
| Pneumonia in Immunocompromised Host | This type of pneumonia is more common in individuals with compromised immune systems, such as those on immunosuppressants, undergoing chemotherapy, or living with AIDS. It is characterized by higher morbidity and mortality rates. | Frequently caused by Pneumocystis jiroveci, various fungi, Mycobacterium tuberculosis, and gram-negative bacilli including Klebsiella, Escherichia coli, and Pseudomonas. |
| Aspiration Pneumonia | Results from the inhalation of foreign materials, such as bacteria or gastric contents, into the lungs. The causative pathogens can vary depending on the nature of the aspirated substance and can occur in both community and hospital environments. | Commonly caused by anaerobic bacteria, Staphylococcus aureus, Streptococcus species, and gram-negative bacilli such as Escherichia coli and Klebsiella. |
Nursing Care Plans and Management
Effective nursing care plans and management for patients with pneumonia initiate with a comprehensive assessment. This includes gathering the patient’s medical history, conducting respiratory assessments every four hours, performing thorough physical examinations, and analyzing Arterial Blood Gas (ABG) measurements. Supportive nursing interventions are critical and include oxygen therapy, airway suctioning, encouraging coughing and deep breathing exercises, ensuring adequate hydration, and in severe cases, initiating mechanical ventilation. Further detailed nursing interventions are discussed in relation to specific nursing diagnoses in the following sections.
Nursing Problem Priorities
The primary nursing priorities in the care of patients with pneumonia are centered on:
- Enhancing and maintaining airway patency to ensure effective breathing.
- Improving activity tolerance to support the patient’s strength and recovery.
- Maintaining optimal fluid volume to prevent dehydration and support physiological functions.
- Implementing preventative measures to minimize potential complications associated with pneumonia.
Nursing Assessment
Key indicators of pneumonia include symptoms such as coughing, sputum production, pleuritic chest pain, shaking chills, rapid and shallow breathing, fever, and shortness of breath. If pneumonia is not promptly and effectively treated, it can lead to serious complications including hypoxemia, respiratory failure, pleural effusion, empyema, lung abscess, and bacteremia. Initially, patients may present with a dry, irritating cough producing minimal mucoid sputum. Additional early symptoms can include sternal soreness, fever or chills, night sweats, headache, and a general feeling of malaise. As the infection progresses, patients may develop increasing shortness of breath, noticeable abnormal breathing sounds such as inspiratory stridor and expiratory wheezing, and begin to produce purulent sputum. In severe instances, blood-streaked secretions may be observed due to irritation of the airway mucosa.
Perform a thorough assessment to identify both subjective and objective data:
- Observe for changes in respiratory rate and depth.
- Note any abnormal breath sounds such as rhonchi, bronchial lung sounds, or egophony.
- Assess for the use of accessory muscles during breathing.
- Evaluate for dyspnea and tachypnea.
- Characterize the cough (effective or ineffective) and sputum production (presence, absence, and characteristics).
- Check for cyanosis.
- Identify areas with decreased breath sounds over affected lung regions.
- Determine cough effectiveness.
- Assess sputum for purulence.
- Measure oxygen saturation to detect hypoxemia.
- Review chest X-ray reports for infiltrates.
- Measure reduced vital capacity.
Investigate factors related to the etiology of pneumonia:
- Assess for alterations in the patient’s oxygen/carbon dioxide (O2/CO2) ratio and hypoxia.
- Evaluate for decreased lung expansion and fluid accumulation in alveoli.
- Consider inflammatory processes, including tracheal and bronchial inflammation, edema formation, and increased sputum production.
- Assess for pleuritic pain and changes in the alveolar-capillary membrane.
- Evaluate altered oxygen-carrying capacity of blood and oxygen release at the cellular level.
- Determine if there is altered oxygen delivery and hypoventilation.
- Check for mucus accumulation in airways.
Nursing Diagnosis
Nursing diagnoses for pneumonia are formulated based on a comprehensive assessment and the nurse’s clinical judgment, tailored to meet each patient’s unique health condition. While the application of nursing diagnoses may vary across different healthcare settings, the nurse’s expertise is crucial in shaping the care plan to effectively prioritize and address patient needs. Based on thorough assessment data, common nursing diagnoses for pneumonia include:
- Ineffective Airway Clearance related to excessive secretions and decreased energy/fatigue.
- Impaired Gas Exchange related to alveolar-capillary membrane changes and fluid accumulation within the alveoli.
- Ineffective Breathing Pattern related to pain and decreased lung expansion.
- Hyperthermia related to the infectious process.
- Fluid Volume Deficit related to increased respiratory rate and fever.
- Activity Intolerance related to hypoxemia and insufficient oxygenation for activities of daily living.
- Acute Pain related to inflammation and frequent coughing.
- Imbalanced Nutrition: Less Than Body Requirements related to decreased appetite and increased metabolic demands.
- Risk for Infection spread to others, related to contagious nature of the infectious agent.
- Deficient Knowledge related to lack of exposure to information about pneumonia, its management, and prevention.
Nursing Goals
The goals and expected outcomes for patients diagnosed with pneumonia are designed to facilitate recovery and improve respiratory function. These may include:
- The patient will achieve improved ventilation and oxygenation of tissues, evidenced by maintaining ABGs within acceptable limits and absence of respiratory distress symptoms within 48 hours.
- The patient will maintain optimal gas exchange, demonstrated by stable ABG levels and oxygen saturation consistently above 92% within 24 hours.
- The patient will actively engage in interventions to enhance oxygenation, such as deep breathing exercises and adherence to prescribed oxygen therapy, within the next 24 hours.
- The patient will identify and demonstrate at least three effective behaviors to improve airway clearance, such as effective coughing techniques and the use of an incentive spirometer, within 48 hours.
- The patient will maintain a patent airway, indicated by clear breath sounds and absence of dyspnea or cyanosis, through effective secretion clearance within 24 hours.
Nursing Interventions and Rationales
Therapeutic nursing interventions and actions for patients with pneumonia are crucial for managing symptoms and promoting recovery. These interventions are focused on addressing impaired airway clearance, gas exchange, breathing patterns, and other related issues.
1. Managing Impaired Airway Clearance
For patients experiencing impaired airway clearance due to excessive secretions and ineffective coughing, nursing interventions are aimed at facilitating the removal of secretions and improving cough effectiveness. These strategies include promoting hydration, utilizing humidification, encouraging both voluntary and reflex coughing, and instructing patients in effective directed coughing techniques. Lung expansion maneuvers and external pressure assistance may also be employed to further enhance airway clearance.
Nursing Diagnosis
Ineffective Airway Clearance related to excessive secretions and decreased energy/fatigue.
Expected Outcomes
- The patient will achieve and maintain patent airway clearance, as evidenced by effective coughing, reduced sputum production, clear lung sounds upon auscultation, and sustained oxygen saturation levels at 90% or higher.
- The patient will demonstrate effective airway clearance and maintain stable respiratory status without recurrence of pneumonia symptoms throughout the recovery process.
Nursing Interventions and Rationales:
1. Assess the rate, rhythm, and depth of respiration, chest movement, and use of accessory muscles.
Rationale: Tachypnea, shallow respirations, and asymmetric chest movement are common in pneumonia due to chest wall discomfort and lung fluid, which are compensatory mechanisms to manage airway obstruction. Altered breathing patterns and the use of accessory muscles indicate the body’s attempt to increase chest excursion and facilitate more effective breathing.
2. Assess cough effectiveness and productivity.
Rationale: Coughing is the primary mechanism for clearing secretions. Pneumonia often leads to thick, tenacious secretions, making effective removal critical to prevent impaired gas exchange and delayed recovery. Encourage fluid intake of 2 to 3 liters per day, if not contraindicated, to help thin and loosen these secretions.
3. Auscultate lung fields, noting areas of decreased or absent airflow and adventitious breath sounds (crackles, wheezes).
Rationale: Decreased airflow indicates areas of fluid consolidation. Bronchial breath sounds may also be present in these consolidated areas. Crackles, rhonchi, and wheezes heard during inspiration and expiration are due to fluid accumulation, thick secretions, and airway spasms or obstruction.
4. Observe sputum color, viscosity, and odor; report any changes.
Rationale: Changes in sputum characteristics can indicate infection progression or secondary infections. Discolored, tenacious, or malodorous sputum may increase airway resistance and necessitate further intervention.
5. Assess the patient’s hydration status.
Rationale: Inadequate hydration leads to thickened secretions, hindering airway clearance. Maintaining optimal hydration is essential for thinning secretions and facilitating their expectoration.
6. Elevate the head of the bed and change position frequently.
Rationale: Elevating the head of the bed and frequent repositioning lowers the diaphragm, promoting chest expansion, aeration of lung segments, and mobilization and expectoration of secretions.
7. Suction as indicated for frequent coughing, adventitious breath sounds, or desaturation related to airway secretions.
Rationale: Suctioning stimulates coughing and mechanically clears the airway in patients unable to effectively cough due to weakness or decreased consciousness. Note: Suctioning can exacerbate hypoxemia; pre-oxygenate, and oxygenate during and post-suctioning.
8. Maintain adequate hydration by encouraging fluid intake to at least 3000 mL/day unless contraindicated (e.g., heart failure). Offer warm fluids rather than cold.
Rationale: Fluids, especially warm liquids, aid in mobilizing and expectorating secretions. Adequate hydration maintains moisture and enhances ciliary action to remove secretions and reduce viscosity, making secretions easier to cough out.
9. Utilize humidified oxygen or a bedside humidifier.
Rationale: Increased humidity reduces the viscosity of secretions. Ensure humidifiers are cleaned regularly to prevent bacterial growth. Humidification aids in loosening secretions and improving ventilation by delivering warm, humidified air to the tracheobronchial tree, liquefying secretions and alleviating tracheobronchial irritation.
10. Monitor serial chest X-rays, ABGs, and pulse oximetry readings.
Rationale: These diagnostic tools help track the progress and effectiveness of treatment for pneumonia. They can indicate the extent of pneumonia and guide necessary adjustments in therapy. Oxygen saturation should be maintained at 90% or greater. Imbalances in PaCO2 and PaO2 may indicate respiratory fatigue.
11. Assist with and monitor the effects of nebulizer treatments and other respiratory physiotherapy such as incentive spirometry, Intermittent Positive Pressure Breathing (IPPB), percussion, and postural drainage. Perform treatments between meals and limit fluids when appropriate.
Rationale:
- Nebulizers humidify the airway, thinning secretions and facilitating liquefaction and expectoration.
- Postural drainage may be less effective in interstitial pneumonias or those causing alveolar exudate or destruction.
- Incentive spirometry encourages deep breathing and helps prevent atelectasis.
- Chest percussion loosens and mobilizes secretions in smaller airways that are difficult to clear by coughing or suctioning alone.
- Coordinating treatments with meal times and limiting fluids around treatment times reduces the risk of vomiting during coughing and expectoration.
12. Assist with bronchoscopy and thoracentesis, if indicated.
Rationale: Bronchoscopy may be needed to remove secretions or foreign bodies directly from the airway, while thoracentesis may be necessary to drain pleural effusions that can complicate pneumonia and impair breathing.
13. Anticipate the potential need for supplemental oxygen or intubation if the patient’s condition deteriorates.
Rationale: These interventions address hypoxemia and improve oxygenation. Intubation may be required for deep suctioning and to provide enhanced oxygen support. Administer and adjust oxygen therapy as per medical guidelines, monitoring effectiveness through clinical signs, patient comfort, and pulse oximetry or arterial blood gas analysis to ensure adequate oxygenation.
2. Managing Impaired Gas Exchange
Effective management of impaired gas exchange is paramount in pneumonia care to ensure adequate oxygenation and ventilation. This section outlines nursing diagnoses, goals, and essential interventions focused on enhancing respiratory function and optimizing gas exchange.
Nursing Diagnosis
Impaired Gas Exchange related to alveolar-capillary membrane changes and fluid accumulation within the alveoli.
Expected Outcomes
- The patient will demonstrate improved gas exchange, evidenced by specific measurable indicators such as maintaining oxygen saturation levels at or above 95%, reduced or absent cyanosis, and ability to perform deep breathing exercises comfortably.
- The patient will maintain stable oxygenation and respiratory function, as demonstrated by clear Arterial Blood Gas (ABG) results within normal limits, absence of cyanosis, regular respiratory rate and depth between 12-20 breaths per minute, and the ability to engage in daily activities without significant dyspnea.
Nursing Interventions and Rationales:
1. Assess respirations: note quality, rate, rhythm, depth, use of accessory muscles, ease, and position assumed for easy breathing.
Rationale: These assessments help determine the extent of lung involvement and the patient’s respiratory effort. Rapid, shallow breathing and hypoventilation directly impair gas exchange. Hypoxia manifests through increased breathing effort and altered breathing patterns, while tripod positioning is indicative of significant dyspnea.
2. Observe the color of skin, mucous membranes, and nail beds, noting the presence of peripheral cyanosis (nail beds) or central cyanosis (circumoral).
Rationale: Cyanosis indicates impaired oxygenation. Peripheral cyanosis in nail beds may result from vasoconstriction or fever response, while central cyanosis in earlobes, mucous membranes, and around the mouth (“warm membranes”) is a more direct sign of systemic hypoxemia.
3. Assess mental status, restlessness, and changes in the level of consciousness.
Rationale: Changes in mental status such as restlessness, irritation, confusion, and somnolence can be early indicators of hypoxemia and reduced cerebral oxygenation. These changes necessitate immediate investigation, including pulse oximetry, particularly in older adults.
4. Assess anxiety level and encourage verbalization of feelings and concerns.
Rationale: Anxiety is a common psychological and physiological response to hypoxia. Reducing anxiety through reassurance and creating a secure environment can decrease oxygen demand and mitigate adverse physiological responses.
5. Monitor heart rate and rhythm, and blood pressure.
Rationale: Tachycardia is often present due to fever and/or dehydration, or as a response to hypoxemia. Initial hypoxia and hypercapnia can elevate BP and HR. As hypoxia worsens, BP may decrease while HR remains rapid, potentially with dysrhythmias.
6. Monitor body temperature, as indicated. Assist with comfort measures to reduce fever and chills, such as adjusting bedcovers, ensuring a comfortable room temperature, and providing tepid or cool water sponge baths.
Rationale: High fever, common in bacterial pneumonia and influenza, significantly increases metabolic demands and oxygen consumption, thereby affecting cellular oxygenation. Managing fever is crucial to reduce these demands.
7. Observe for deterioration in condition, noting hypotension, copious amounts of bloody sputum, pallor, cyanosis, change in LOC, severe dyspnea, and restlessness.
Rationale: These signs can indicate severe complications such as shock and pulmonary edema, which are leading causes of mortality in pneumonia and require immediate medical intervention.
8. Monitor ABGs and pulse oximetry.
Rationale: Continuous monitoring of ABGs and pulse oximetry is essential to track disease progression and adjust pulmonary therapy. Pulse oximetry effectively detects changes in oxygenation, aiming for O2 saturation of 90% or greater.
9. Enforce bed rest and plan activity and rest periods to minimize energy expenditure. Encourage relaxation techniques and diversional activities.
Rationale: Bed rest prevents over exhaustion and reduces oxygen demands, supporting infection resolution. Relaxation techniques conserve energy for effective breathing and coughing.
10. Elevate the head of the bed and encourage frequent position changes, deep breathing, and effective coughing.
Rationale: These measures maximize chest expansion, mobilize secretions, and enhance overall ventilation, improving gas exchange.
11. Administer oxygen therapy via appropriate devices: nasal cannula, mask, Venturi mask.
Rationale: The primary goal of oxygen therapy is to maintain PaO2 above 60 mmHg. Oxygen should be administered using a method that provides adequate delivery and is well-tolerated by the patient. Caution: Oxygen should be administered judiciously to patients with chronic lung diseases.
3. Promoting Effective Breathing Pattern and Breathing Exercises
Nursing Diagnosis
Ineffective Breathing Pattern related to pain and decreased lung expansion.
Expected Outcomes
The patient will demonstrate a more effective breathing pattern, as evidenced by a respiratory rate within normal limits (12-20 breaths per minute), regular and unlabored respirations, and improved depth of breathing, allowing for adequate ventilation and oxygenation.
Nursing Interventions and Rationales:
Teach and encourage regular deep-breathing exercises, incentive spirometer use, and diaphragmatic breathing for maximum lung expansion and effective coughing.
Rationale: These techniques are crucial for enhancing oxygenation, preventing atelectasis, and promoting secretion mobilization. Regular practice helps maintain lung expansion and airway clearance. Effective directed coughing involves proper positioning, deep inspiration, glottic closure, contraction of expiratory muscles, sudden glottic opening, and forceful exhalation, which is vital for clearing secretions and improving airway patency.
Demonstrate and assist with splinting the chest during coughing in an upright position.
Rationale: Splinting minimizes chest discomfort during coughing, and an upright position facilitates deeper, more effective coughs, thus improving airway clearance.
Monitor and assess respiratory rate, depth, and use of accessory muscles every 4 hours; auscultate breath sounds and observe for retractions or nasal flaring.
Rationale: Regular monitoring allows for early detection of altered breathing patterns or abnormal sounds, which are indicators of respiratory compromise or muscle fatigue. Early detection is essential for timely intervention.
Monitor ABG levels and observe breathing patterns for signs of dysfunction or abnormality.
Rationale: Monitoring ABG levels and breathing patterns ensures that respiratory dysfunction is promptly detected, providing essential data for assessing oxygenation and ventilation status, and guiding necessary adjustments in treatment.
Encourage sustained deep breaths and controlled breathing techniques (e.g., slow inhalation, holding end-inspiration, passive exhalation) and teach the patient to yawn.
Rationale: These techniques promote deep inspiration, which increases oxygenation and helps prevent air trapping and tachypnea, improving overall breathing efficiency.
Ambulate the patient as tolerated and provide assistance with ADLs, ensuring frequent rest periods.
Rationale: Ambulation helps mobilize secretions, while scheduled rest periods between activities prevent overexertion and conserve energy, supporting respiratory function and recovery.
Teach and assist the patient with proper deep-breathing exercises.
Rationale: Deep breathing maximizes lung expansion, improves ventilation of smaller airways, and enhances the effectiveness of coughing, all of which are vital for improving breathing patterns in patients with pneumonia.
4. Administering Medications and Pharmacological Support
Administer prescribed antibiotics as ordered.
Rationale: Antibiotic therapy is the cornerstone of pneumonia treatment, especially for bacterial pneumonia. The selection of antibiotics is based on culture and sensitivity results whenever possible. In community-acquired pneumonia (CAP), where the causative organism is often unidentified initially, antibiotic choice follows established guidelines considering local resistance patterns, prevalent pathogens, patient risk factors, treatment setting, and antibiotic availability and cost.
| Medication Type | Function/Action | Example Drug Names |
|---|---|---|
| Mucolytics | Function to increase or liquefy respiratory secretions, making them easier to expectorate. | – Acetylcysteine (Mucomyst)– Dornase alfa (Pulmozyme) |
| Expectorants | Designed to enhance productive cough, clearing airways by liquefying lower respiratory tract secretions and reducing their viscosity. | – Guaifenesin (Mucinex, Robitussin) |
| Bronchodilators | These medications facilitate easier respiration by dilating the airways, reducing bronchospasm and improving airflow. | – Albuterol (Ventolin, ProAir)– Salmeterol (Serevent)– Ipratropium (Atrovent)– Theophylline |
| Analgesics | Prescribed to alleviate discomfort and improve cough effort, but should be used cautiously as they can depress respiratory drive and cough reflex. | – Acetaminophen (Tylenol)– Ibuprofen (Advil, Motrin) |
Administer prescribed antibiotics based on culture and sensitivity results.
Rationale: Targeted antibiotic therapy ensures that the patient receives the most effective treatment for the specific causative organism, enhancing treatment outcomes and minimizing the development of antibiotic resistance.
Monitor patient’s response to antibiotic therapy, assessing clinical stability (temperature, heart rate, respiratory rate, blood pressure, oxygen saturation).
Rationale: Regular monitoring helps in assessing treatment effectiveness and identifying any complications early. Clinical stability indicators guide adjustments in therapy and ensure timely intervention if needed.
Educate the patient and family on the importance of completing the full course of antibiotics.
Rationale: Completing the full course of antibiotics is crucial for eradicating the infection completely, preventing recurrence of pneumonia, and reducing the risk of antibiotic resistance.
Assess the patient’s readiness to transition from IV to oral antibiotics once they are hemodynamically stable and clinically improving.
Rationale: Transitioning to oral antibiotics, when appropriate, facilitates quicker discharge planning, reduces hospital stay, and is more convenient and less invasive for the patient while maintaining effective treatment.
5. Initiating Measures for Infection Control & Management
Implementing rigorous infection control measures is crucial for patients with pneumonia to minimize the risk of secondary infections and prevent the spread of the primary infection. This section highlights key nursing interventions focused on infection prevention and management.
Nursing Diagnosis
Risk for Infection spread to others, related to contagious nature of the infectious agent.
Expected Outcomes
The patient will remain free from secondary infections and will understand and adhere to infection control measures to prevent the spread of pneumonia to others.
Nursing Interventions and Rationales:
Monitor vital signs closely, especially at the initiation of therapy, and note that potentially fatal complications such as hypotension and shock may develop during this period. Instruct the patient on proper disposal of secretions, whether expectorating or swallowing, and to report any changes in color, amount, or odor of secretions.
Rationale: Close monitoring of vital signs is crucial for early detection of complications. Proper disposal of sputum is important for infection control, and changes in sputum characteristics can indicate progress in recovery or development of secondary infections.
Assess the patient’s immunization status.
Rationale: Vaccination against pneumococcal pneumonia and influenza is a key preventive measure. Assessing immunization status helps identify the need for vaccination to reduce the risk of future infections.
Demonstrate and encourage good hand washing techniques.
Rationale: Handwashing is the most effective method to prevent the spread of infection. Effective hand hygiene by healthcare providers, patients, and visitors is essential in reducing transmission.
Change patient position frequently and ensure good pulmonary hygiene.
Rationale: Frequent position changes promote expectoration and help clear infection. Pulmonary hygiene, including techniques to clear secretions and prevent atelectasis, is vital for recovery. For patients unable to cough effectively, chest physiotherapy and tracheal suctioning may be necessary.
Institute isolation precautions as appropriate for the type of pneumonia. Separate patients at high risk from infected patients. Limit visitors as indicated.
Rationale: Isolation precautions depend on the infectious agent and patient’s condition to prevent nosocomial spread. Immunocompromised patients are particularly vulnerable to nosocomial pneumonia, necessitating careful room assignments in semi-private settings and visitor limitations to minimize exposure.
Encourage adequate rest balanced with moderate activity. Promote adequate nutritional intake.
Rationale: Rest and proper nutrition facilitate the body’s healing process and enhance natural resistance to infection.
Monitor the effectiveness of antimicrobial therapy.
Rationale: Signs of clinical improvement, such as reduced fever and improved respiratory symptoms, should typically appear within 24–48 hours of initiating effective antimicrobial therapy. Lack of improvement or worsening condition requires reassessment.
Investigate sudden changes in condition, such as increasing chest pain, new heart sounds, altered sensorium, recurring fever, or changes in sputum characteristics.
Rationale: Delayed recovery or worsening symptoms may indicate antibiotic resistance or secondary infection, necessitating prompt investigation and potential modification of treatment.
Prepare for and assist with diagnostic studies as indicated.
Rationale: Fiberoptic bronchoscopy (FOB) may be indicated in patients who do not respond to antimicrobial therapy within 1–3 days to further investigate the diagnosis and guide therapy, particularly in complicated or unresponsive cases.
6. Managing Acute Pain and Promoting Comfort
Effective management of acute pain is crucial for pneumonia patients to enhance comfort, facilitate effective breathing, and improve overall recovery. This section outlines nursing interventions focused on pain relief and promoting comfort.
Nursing Diagnosis
Acute Pain related to inflammation and frequent coughing.
Expected Outcomes
The patient will report a manageable level of pain, using a pain scale, and demonstrate effective pain management strategies that allow for rest, effective coughing, and participation in respiratory therapies.
Nursing Interventions and Rationales:
Assess pain characteristics: note if it is sharp, constant, or stabbing. Investigate changes in pain character, location, or intensity. Assess and document patient reports of pain associated with breathing or coughing.
Rationale: Chest pain is a common symptom of pneumonia but can also indicate complications such as pericarditis or endocarditis. Comprehensive pain assessment is essential to differentiate pneumonia-related pain from pain indicative of complications. (See also: Acute Pain Nursing Care Plan and Management)
Monitor vital signs regularly.
Rationale: Changes in heart rate or blood pressure may indicate pain, especially when other causes for vital sign changes have been ruled out. Pain can physiologically manifest through changes in vital signs.
Provide non-pharmacologic comfort measures: back rubs, position changes, quiet music, massage. Encourage relaxation and/or breathing exercises.
Rationale: Non-pharmacologic measures, combined with gentle touch, can alleviate discomfort and enhance the effectiveness of analgesics. Patient involvement in pain management promotes independence and enhances well-being.
Offer frequent oral hygiene.
Rationale: Mouth breathing and oxygen therapy can dry and irritate mucous membranes, increasing discomfort. Regular oral care helps maintain moisture, reduces irritation, and promotes comfort.
Instruct and assist the patient in chest splinting techniques during coughing episodes.
Rationale: Splinting the chest minimizes discomfort during coughing, making coughing more effective and less painful, thereby aiding in secretion clearance.
Administer antitussives as needed but avoid suppressing productive coughs. Use moderate analgesics for pleuritic pain relief, as indicated.
Rationale: Antitussives can help manage nonproductive coughing, while moderate analgesics alleviate pleuritic pain. It is crucial to use antitussives judiciously to avoid suppressing productive coughs needed to clear secretions.
Administer analgesics as prescribed. Encourage the patient to take analgesics before discomfort becomes severe.
Rationale: Timely administration of pain relief medications provides better pain control, allowing for more effective deep breathing and coughing, and preventing exacerbation of pain.
7. Promoting Rest and Improving Tolerance to Activity
Nurses play a key role in promoting rest and helping patients with pneumonia improve their activity tolerance. This involves advising patients to avoid overexertion and to adopt comfortable positions that support rest and breathing, such as the semi-Fowler’s position. Encouraging frequent position changes is also important for optimizing lung function. For outpatients, moderate activity is recommended during the initial treatment phase.
Nursing Diagnosis
Activity Intolerance related to hypoxemia and insufficient oxygenation for activities of daily living.
Expected Outcomes
The patient will demonstrate improved activity tolerance, evidenced by performing daily activities with reduced dyspnea, fatigue, and without significant changes in vital signs, and will participate in a progressive activity plan as tolerated.
Nursing Interventions and Rationales:
Assess the patient’s baseline level of function and activity tolerance.
Rationale: Establishing a baseline is essential for planning appropriate interventions and monitoring the patient’s progress in regaining activity tolerance.
Use a standardized tool such as the Functional Independence Measure (FIM) to assess baseline function and activity tolerance.
Rationale: Standardized tools like FIM provide a quantifiable baseline of function and activity tolerance, aiding in tailored intervention planning and progress tracking.
Monitor the patient’s response to activity, noting reports of dyspnea, increased weakness, fatigue, and changes in vital signs during and after activities.
Rationale: Monitoring activity response helps identify limitations and the need to adjust the care plan to accommodate the patient’s changing activity tolerance levels.
Provide a quiet environment and limit visitors during the acute phase as indicated.
Rationale: Reducing environmental stimuli conserves energy and promotes rest, which is crucial during the acute phase of pneumonia to facilitate recovery.
Assist with self-care activities as necessary, gradually increasing activity levels during the recovery phase.
Rationale: Assisting with self-care promotes independence and prevents deconditioning. Gradual increase in activity builds endurance and improves overall activity tolerance.
Explain the importance of rest in the treatment plan and the necessity of balancing rest and activity.
Rationale: During the acute phase, bed rest reduces metabolic demands and conserves energy for healing. Balancing rest with gradual activity progression is key to recovery. Educating patients about the importance of rest and activity balance is vital for adherence to the treatment plan.
Pace activity for patients with reduced activity tolerance.
Rationale: Pacing activities helps prevent overexertion and fatigue, especially in patients with compromised respiratory function. Effective coughing, though necessary, can be exhausting for these patients.
Assist patient to assume a comfortable position for rest and sleep.
Rationale: Comfortable positioning, such as elevating the head of the bed or using pillows for support in a chair or leaning forward on an overbed table, can significantly improve rest and sleep quality by easing breathing effort and reducing discomfort.
8. Maintaining Normal Body Thermoregulation
Nursing Diagnosis
Hyperthermia related to the infectious process.
Expected Outcome
- The patient will maintain a core body temperature within the normal range (e.g., ≤ 37.5°C or ≤ 99.5°F) throughout the treatment period.
- The patient will demonstrate effective thermoregulation, evidenced by stable vital signs, adequate hydration status, normal fluid intake and output, and absence of fever-related complications.
Nursing Interventions and Rationales:
Monitor the patient’s HR, BP, and especially tympanic or rectal temperature every 4 hours.
Rationale: Heart rate and blood pressure typically increase as hyperthermia progresses. Tympanic or rectal temperature measurements provide a more accurate assessment of core body temperature compared to oral or axillary methods.
Determine the patient’s age and weight.
Rationale: Extremes of age or weight can increase the risk of impaired thermoregulation. Infants, young children, and older adults, as well as underweight or obese individuals, may have a reduced ability to control body temperature.
Monitor fluid intake and urine output. If the patient is unconscious, central venous or pulmonary artery pressure should be measured to monitor fluid status.
Rationale: Fever can lead to significant fluid loss and dehydration. Monitoring fluid balance is crucial. In unconscious patients, more invasive monitoring like central venous or pulmonary artery pressure may be necessary to accurately assess fluid status and guide fluid resuscitation.
Review serum electrolytes, especially serum sodium.
Rationale: Electrolyte imbalances, particularly sodium losses, can occur with profuse sweating associated with fever and hyperthermia. Monitoring and correcting electrolyte imbalances is important for patient stability.
Adjust and monitor environmental factors like room temperature and bed linens as indicated.
Rationale: Adjusting room temperature and bed linens can help regulate the patient’s temperature. Cooling the room and using lighter bed linens can promote heat loss and help reduce fever.
Eliminate excess clothing and covers. Encourage patient to dress in lightweight clothing and maintain a comfortable room temperature.
Rationale: Exposing skin to room air and wearing lightweight clothing facilitates heat loss through evaporation and convection, promoting cooling and enhancing patient comfort.
Administer antipyretic medications as prescribed.
Rationale: Antipyretic medications, such as acetaminophen or ibuprofen, lower body temperature by blocking the synthesis of prostaglandins in the hypothalamus, the body’s temperature control center.
Prepare for oxygen therapy in extreme hyperthermia cases.
Rationale: Hyperthermia increases metabolic oxygen demand. In severe cases, supplemental oxygen may be needed to meet the increased oxygen requirements of body tissues and prevent hypoxemia.
Encourage the patient to drink plenty of fluids to prevent dehydration.
Rationale: Adequate hydration is crucial for effective thermoregulation. Fever increases metabolic rate and fluid loss, leading to dehydration. Maintaining fluid intake helps prevent dehydration and supports the body’s ability to regulate temperature.
Provide tepid sponge baths as necessary.
Rationale: Tepid sponge baths can help reduce fever through evaporative cooling, lowering the patient’s temperature and improving comfort. Water should be tepid, not cold, to avoid causing shivering, which can paradoxically increase body temperature.
9. Promoting Optimal Nutrition & Fluid Balance
Patients with pneumonia often experience an increased respiratory rate and fever, both of which can lead to significant fluid loss and dehydration. Promoting optimal nutrition and maintaining fluid balance are critical components of pneumonia care. It is generally recommended to encourage increased fluid intake (at least 2 liters per day), unless contraindicated, while carefully monitoring hydration status, especially in patients with conditions like heart failure.
Nursing Diagnosis
Fluid Volume Deficit related to increased respiratory rate and fever.
Expected Outcomes
- The patient will maintain adequate hydration, as evidenced by balanced intake and output, urine output of at least 30 mL/hour, moist mucous membranes, and stable vital signs within normal limits.
- The patient will demonstrate improved appetite and increased oral intake, consuming at least 75% of meals provided, to meet nutritional needs and support recovery.
Nursing Interventions and Rationales:
Assess vital sign changes: increasing temperature, prolonged fever, orthostatic hypotension, tachycardia.
Rationale: Elevated temperature and prolonged fever increase metabolic rate and fluid loss through evaporation. Orthostatic hypotension and tachycardia are indicators of systemic fluid deficit and potential dehydration.
Assess skin turgor and moisture of mucous membranes.
Rationale: Skin turgor and mucous membrane moisture are indirect indicators of hydration status. Dry mucous membranes and poor skin turgor suggest dehydration, although oral mucous membranes may be dry due to mouth breathing and supplemental oxygen.
Investigate reports of nausea and vomiting.
Rationale: Nausea and vomiting can significantly reduce oral intake, contributing to fluid and nutritional deficits. Identifying and managing these symptoms is crucial for maintaining hydration and nutrition.
Monitor intake and output (I&O), noting color and character of urine. Calculate fluid balance. Be aware of insensible losses. Weigh patient as indicated.
Rationale: Accurate I&O monitoring provides essential data on fluid balance and helps determine fluid replacement needs. Urine color and character indicate hydration level. Daily weights help assess overall fluid status changes, with insensible losses (e.g., through respiration and sweating) also contributing to fluid deficit.
Encourage fluids to at least 3000 mL/day or as individually appropriate.
Rationale: Adequate fluid intake meets basic fluid needs, reduces dehydration risk, thins respiratory secretions, and promotes expectoration, facilitating airway clearance and overall recovery.
Administer medications as indicated: antipyretics, antiemetics.
Rationale: Antipyretics reduce fever, thereby reducing fluid losses associated with hyperthermia. Antiemetics help control nausea and vomiting, improving oral intake and reducing fluid loss.
Provide supplemental IV fluids as necessary.
Rationale: In cases of reduced oral intake and/or excessive fluid loss, parenteral IV fluids may be necessary to correct fluid deficits and maintain hydration, especially in severely dehydrated patients.
Identify factors contributing to nausea or vomiting: copious sputum, aerosol treatments, severe dyspnea, pain.
Rationale: Identifying the underlying causes of nausea and vomiting helps in selecting appropriate interventions to alleviate these symptoms and improve patient comfort and oral intake.
Provide a covered container for sputum and remove it frequently. Assist with and encourage oral hygiene after emesis, aerosol and postural drainage treatments, and before meals.
Rationale: Removing sputum containers frequently and ensuring good oral hygiene eliminates unpleasant sights, tastes, and smells from the patient’s environment, reducing nausea and improving appetite.
Schedule respiratory treatments at least 1 hour before meals.
Rationale: Scheduling respiratory treatments before meals minimizes the likelihood of treatment-induced nausea interfering with meal consumption and nutritional intake.
Maintain adequate nutrition to offset hypermetabolic state secondary to infection. Request a high-calorie, high-protein diet of soft, easy-to-eat foods from dietary services.
Rationale: Pneumonia and infection induce a hypermetabolic state, increasing nutritional needs. A high-calorie, high-protein diet helps replenish nutrients, support the immune system, and aid in recovery. Soft, easy-to-eat foods are better tolerated by patients who may experience fatigue and decreased appetite.
Evaluate the need for limiting milk products in patients with excessive mucus production.
Rationale: While it is a common belief that milk increases mucus production, scientific evidence is not conclusive. Limiting milk products should be individualized based on patient history and observed response, as only a subset of individuals might experience symptom improvement with dairy reduction, particularly those with conditions like asthma or existing inflammation.
Elevate the patient’s head and neck and verify tube position during NG tube feedings to prevent aspiration. Avoid administering large volumes at once, which can cause vomiting. Keep the patient’s head elevated for at least 30 minutes post-feeding. Regularly check for residual formula.
Rationale: For patients receiving NG tube feedings, proper positioning and feeding techniques are essential to prevent aspiration. Elevating the head, avoiding bolus feedings, and checking residuals help minimize the risk of vomiting and aspiration pneumonia.
Auscultate for bowel sounds and observe for abdominal distension.
Rationale: Diminished bowel sounds may indicate severe infection impacting gastrointestinal function. Abdominal distension can result from air swallowing or the effects of bacterial toxins on the GI tract, affecting digestion and nutrition absorption.
Provide small, frequent meals, including dry foods (toast, crackers) and/or foods that are appealing to the patient.
Rationale: Small, frequent meals are easier to tolerate for patients experiencing shortness of breath, fatigue, or decreased appetite. Including dry foods and patient-preferred items can encourage better oral intake and nutritional support during recovery.
Evaluate general nutritional state and obtain baseline weight.
Rationale: Assessing general nutritional status and baseline weight helps identify pre-existing malnutrition or nutritional risks, which can influence recovery and response to therapy. Conditions like COPD or alcoholism can predispose patients to nutritional deficits.
Monitor and record intake and output accurately, observe urine color, and watch for decreased urinary output.
Rationale: Accurate I&O monitoring is crucial for assessing fluid balance. Urinary output less than 30 mL for two consecutive hours is a key indicator of potential fluid volume deficit. Dark-colored urine reflects increased concentration and potential dehydration.
Weigh the patient daily at the same time, in the same clothes, and using the same scale; monitor for trends (weight changes of 1-1.5 kg/day).
Rationale: Consistent daily weights provide a reliable measure of fluid balance. Weight changes of 1-1.5 kg/day can indicate significant fluid volume deficit or excess, guiding fluid management strategies.
Assess skin turgor and mucous membranes for signs of dehydration.
Rationale: Assessing skin turgor and mucous membranes helps identify clinical signs of dehydration. Dry tongue and mucous membranes, along with longitudinal tongue furrows, are symptoms of deficient fluid volume.
Monitor and record vital signs.
Rationale: Vital sign changes associated with hypovolemia include increased temperature and heart rate, and decreased blood pressure. Monitoring vital signs is essential for detecting and managing fluid imbalances.
Encourage frequent oral hygiene.
Rationale: Oral hygiene helps moisten dry mucous membranes, alleviating discomfort and stimulating the sensation of thirst, encouraging increased fluid intake.
Advise patient to increase fluid intake to at least 2.5 L/day as appropriate.
Rationale: Increasing fluid intake is a key measure to maintain adequate hydration, especially in patients with pneumonia who are at risk for dehydration due to fever and increased respiratory rate.
Maintain intravenous fluid therapy as indicated.
Rationale: Parenteral fluid replacement via IV therapy is administered to prevent or treat shock and severe dehydration, ensuring adequate fluid volume when oral intake is insufficient.
Provide humidified oxygen therapy as indicated.
Rationale: Humidification during oxygen therapy lessens convective moisture losses, helping to maintain fluid balance and prevent dehydration, particularly in patients receiving oxygen.
10. Providing Patient Education & Health Teachings
Patient education is a cornerstone of pneumonia care, focusing on empowering patients and their families with knowledge about the condition, its management, and preventative strategies. Education includes understanding pneumonia causes, managing symptoms, recognizing concerning signs that require medical attention, and adopting lifestyle adjustments to promote recovery and prevent future occurrences. Hospitalized patients receive detailed instructions on their treatment regimen and the importance of adherence. Educational materials should be provided in clear, written formats and alternative formats as needed, with repeated explanations to accommodate the potential impact of symptoms on comprehension.
Nursing Diagnosis
Deficient Knowledge related to lack of exposure to information about pneumonia, its management, and prevention.
Expected Outcomes
- The patient will demonstrate improved understanding of their pneumonia and its treatment by accurately describing their medication regimen, including the purpose, dosage, and potential side effects of each medication.
- The patient will verbalize the importance of preventive measures, including receiving recommended vaccinations (e.g., pneumococcal and influenza vaccines), to reduce the risk of future respiratory infections.
Nursing Interventions and Rationales:
Determine the patient’s current understanding of pneumonia, its complications, and their prescribed treatment regimen.
Rationale: Assessing the patient’s baseline knowledge is the first step in patient education. It helps identify knowledge gaps, strengths, and weaknesses, allowing for tailored teaching strategies.
Review normal lung function and the pathology of pneumonia.
Rationale: Providing information about normal lung function and how pneumonia disrupts this function enhances patient understanding of their condition and the rationale behind the treatment plan, promoting cooperation and adherence.
Identify patient’s self-care and homemaker needs.
Rationale: Pneumonia and its recovery can impact a patient’s ability to perform self-care and manage household responsibilities. Assessing these needs helps in planning for support services and resources, reducing anxiety and concern.
Assess potential home care needs.
Rationale: As the therapeutic regimen continues post-hospital discharge, assessing home care needs is essential. This assessment considers the availability of support systems, patient energy levels, and cognitive function to ensure a smooth transition and continued recovery at home.
Provide information in both written and verbal formats.
Rationale: Providing information in multiple formats, including written materials and verbal explanations, accommodates different learning styles and enhances comprehension. Fatigue and illness-related cognitive impairment can affect information processing, making reinforcement through written materials particularly useful.
Reinforce the importance of continuing effective coughing and deep-breathing exercises at home.
Rationale: Continued coughing and deep-breathing exercises are crucial during the initial 6–8 weeks post-discharge when the risk of pneumonia recurrence is highest. Reinforcing these techniques ensures patients maintain airway clearance and lung function at home.
Emphasize the necessity of completing the prescribed antibiotic therapy for the entire duration.
Rationale: Completing the full course of antibiotic treatment is essential to eradicate the infection completely, prevent recurrence of pneumonia, and minimize the development of antibiotic resistance. Premature discontinuation can lead to treatment failure and relapse.
Review the importance of smoking cessation.
Rationale: Smoking significantly impairs tracheobronchial ciliary action, irritates bronchial mucosa, and inhibits alveolar macrophages, all of which compromise the body’s natural defenses against infection. Emphasizing smoking cessation is crucial for long-term respiratory health and preventing future infections.
Outline steps to enhance general health and well-being: balanced rest and activity, a well-rounded diet, and avoidance of crowds during cold/flu season and contact with individuals with Upper Respiratory Infections (URIs).
Rationale: Promoting healthy lifestyle practices enhances the body’s natural defenses and reduces exposure to pathogens. Balanced rest, proper nutrition, and avoiding exposure to infections are key strategies for preventing illness and promoting overall well-being.
Stress the importance of continuing medical follow-up and obtaining recommended vaccinations.
Rationale: Regular medical follow-up allows for monitoring of recovery and early detection of any complications or recurrence. Stressing the importance of pneumococcal and influenza vaccinations as appropriate preventive measures helps reduce the risk of future pneumonia and related complications.
Identify signs and symptoms that require immediate notification of a healthcare provider: increasing dyspnea, chest pain, prolonged fatigue, unexplained weight loss, fever, chills, persistent productive cough, changes in mental status.
Rationale: Educating patients about warning signs and when to seek prompt medical attention is crucial for timely intervention and prevention of complications. Early evaluation and treatment can significantly improve outcomes.
Instruct patients to avoid indiscriminate use of antibiotics for minor viral infections.
Rationale: Overuse of antibiotics, especially for viral infections, can lead to the development of antibiotic-resistant bacteria in the upper airways. If pneumonia develops subsequently, these resistant organisms may necessitate treatment with more toxic antibiotics.
Encourage Pneumovax and annual flu shots for high-risk patients.
Rationale: Pneumococcal vaccination (Pneumovax) and annual influenza vaccination are highly effective in reducing the incidence of pneumonia, hospitalizations, and mortality, particularly in older adults and high-risk groups. Staying updated with the CDC’s current vaccination recommendations ensures patients receive optimal protection against vaccine-preventable pneumonias.
11. Monitoring Potential Complications of Pneumonia
Pneumonia can lead to serious complications, especially in vulnerable populations such as older adults, those with delayed treatment, resistant infections, comorbidities, or compromised immune systems. Prompt and vigilant monitoring for these complications is essential for effective patient management.
Assess and monitor for signs of shock and respiratory failure.
Rationale: Pneumonia can precipitate severe complications like hypotension, septic shock, and respiratory failure, especially in older adults or those with risk factors. These complications are more likely with resistant organisms, comorbidities, or compromised immunity. Vigilant monitoring of vital signs, pulse oximetry, and hemodynamic parameters is critical for early detection of septic shock and respiratory failure, enabling timely interventions such as fluid resuscitation, medication administration, and potentially intubation and mechanical ventilation.
Assess and monitor for signs of pleural effusion and empyema.
Rationale: Pleural effusion, fluid accumulation in the pleural space, is a common complication of bacterial pneumonia. Parapneumonic effusions can progress to empyema, which involves thick, purulent fluid accumulation and localized infection. Early detection through chest auscultation and chest X-rays is important. Thoracentesis may be required for fluid analysis and drainage. Monitoring post-procedure for pneumothorax or effusion recurrence is crucial, and chest tube insertion may be necessary for empyema drainage, often followed by prolonged antibiotic therapy and sometimes surgical intervention.
Assess and monitor for signs of delirium, especially in older adults.
Rationale: Delirium and cognitive changes are unfavorable prognostic indicators in pneumonia, particularly in older adults. The Confusion Assessment Method (CAM) is a recommended screening tool. Factors such as hypoxemia, fever, dehydration, sleep deprivation, sepsis, and comorbidities can contribute to delirium. Nursing interventions should focus on identifying and addressing these underlying causes while prioritizing patient safety and managing delirium symptoms.
Recommended Resources
Explore these recommended nursing diagnosis and nursing care plan books and resources to further enhance your understanding and skills in pneumonia care.
Disclosure: The following are affiliate links from Amazon. If you purchase through these links, we may earn a small commission at no extra cost to you. For more details, please see our privacy policy.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
This handbook is highly recommended for its evidence-based approach to nursing interventions. It offers a user-friendly, three-step system to guide you through client assessment, nursing diagnosis, and care planning. It includes step-by-step instructions for implementing care and evaluating outcomes, helping to build diagnostic reasoning and critical thinking skills.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
This comprehensive resource includes over two hundred care plans reflecting the most current evidence-based guidelines. The 10th edition features new ICNP diagnoses, care plans addressing LGBTQ health issues, and expanded content on electrolytes and acid-base balance.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
A quick and essential reference tool for identifying correct diagnoses and planning efficient patient care. The 16th edition includes the latest nursing diagnoses and interventions, with an alphabetized listing covering over 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
This manual assists in planning, individualizing, and documenting care for over 800 diseases and disorders. It uniquely provides subjective and objective data for each diagnosis, sample clinical applications, prioritized actions/interventions with rationales, documentation sections, and much more.
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
This e-book features over 100 care plans covering medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health nursing. It emphasizes interprofessional “patient problems,” helping you to effectively communicate with patients and across disciplines.
See Also
Explore these other recommended resources from our site for further information on nursing care plans:
- Impaired Gas Exchange Nursing Care Plan
- Ineffective Airway Clearance Nursing Care Plan
- Infection Control Nursing Care Plan
Other nursing care plans related to respiratory system disorders:
- Asthma Nursing Care Plan
- COPD Nursing Care Plan
- Tuberculosis Nursing Care Plan
References and Sources
Explore these recommended journals, books, and materials to further enhance your understanding of pneumonia nursing care plans and nursing diagnosis:
- Vanoni, N. M., & Bauer, T. W. (2019). Pneumonia. In J. L. Jameson, D. L. Kasper, S. L. Hauser, A. S. Fauci, D. Longo, & J. Loscalzo (Eds.), Harrison’s principles of internal medicine (20th ed.). McGraw Hill.
- المبيض, محمد. (2024). التهاب الرئة. موقع الطبي. Retrieved from Altibbi: https://www.altibbi.com/مقالات-طبية/امراض-الجهاز-التنفسي/التهاب-الرئة
Originally published January 10, 2010.
