Nursing Diagnosis for Pneumonia

Pneumonia is an inflammatory condition of the lung - primarily affects the microscopic air sacs known as alveoli. This condition is usually caused by a viral or bacterial infection and more rarely other microorganisms, certain medications, and other conditions such as autoimmune diseases.

Pneumonia is mainly caused by infection from bacteria or viruses and rare caused by fungi and parasites. Although there are more than 100 strains of infectious agents have been identified, but only a few are responsible for the majority of cases. Infection with the virus and bacteria can appear up to as much as 45% of infections in children and 15% of infections in adults. Etiological agent could not be isolated in about half the cases despite careful testing has been done.

Typical symptoms include cough, chest pain, fever, and difficulty breathing. Diagnostic tools include x-rays and making culture of sputum. Vaccines to prevent certain types of pneumonia is now available. Treatment options depend on the underlying cause. Allegations of bacterial pneumonia is treated with antibiotics. If severe pneumonia, the patient is usually referred to the hospital.

Patients with infectious pneumonia, usually suffer from productive cough, fever with chills shaking, difficulty breathing, chest pain sharp or stabbing during a deep breath, and increased respiration rate. In the elderly, confusion become the most important sign. Signs and symptoms specifically in children under five are fever, cough, and rapid or difficult breathing.

Fever is not very specific, because these are common symptoms arise in a variety of diseases, and may not appear in patients with severe disease or malnutrition. In addition, symptoms of cough often do not appear in children aged less than 2 months. The signs and symptoms are more severe include: blue skin, thirst decreases, convulsions, persistent vomiting, extreme temperatures, or a decreased level of consciousness.

Nursing Interventions for Pneumonia
  1. Monitor vital signs.
    R/: Changes in heart rate or blood pressure (BP) may indicate that client is experiencing pain, especially when other reasons for changes in vital signs have been ruled out.
  2. Determine pain characteristics, such as sharp, constant, and stabbing. Investigate changes in character, location, and intensity of pain.
    R/: Chest pain, usually present to some degree with pneumonia, may also herald the onset of complications of pneumonia, such as pericarditis and endocarditis.
  3. Instruct and assist client in chest-splinting techniques during coughing episodes.
    R/: Aids in control of chest discomfort while enhancing effectiveness of cough effort.
  4. Provide comfort measures, such as back rubs, change of position, and quiet music or conversation. Encourage use of relaxation and breathing exercises.
    R/: Nonanalgesic measures administered with a gentle touch can lessen discomfort and augment therapeutic effects of analgesics. Client involvement in pain control measures promotes independence and enhances sense of well-being.
  5. Offer frequent oral hygiene.
    R/: Mouth breathing and oxygen therapy can irritate and dry out mucous membranes, potentiating general discomfort.