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Tuesday, March 15, 2011

NCP Nursing Care Plans for Croup

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NCP Nursing Care Plans for Croup. A severe inflammation and obstruction of the upper airway, croup can occur as acute laryngotracheobronchitis, laryngitis, and acute spasmodic laryngitis. It must always be distinguished from epiglottitis. Croup is a childhood disease affecting boys more commonly than girls typically between age 3 months and 3 years that usually occurs during the winter.
Croup usually occurs in the winter as acute laryngotracheobronchitis, laryngitis, or acute spasmodic laryngitis. It must be distinguished from epiglottiditis. Usually mild and self-limiting, acute laryngotracheobronchitis appears mostly in children ages 3 months to 3 years. Acute spasmodic laryngitis affects children between ages 1 and 3, particularly those with allergies and a family history of croup. Overall, up to 15% of patients have a family history of croup. Recovery is usually complete.

Causes for Croup
Parainfluenza viruses, adenoviruses, respiratory syncytial virus, influenza viruses, measles viruses, and bacteria (pertussis and diphtheria)

Complications for Croup
Airway obstruction, respiratory failure, and dehydration are complications of croup. Latent complications are ear infection and pneumonia.

Nursing Assessment Nursing Care Plans for Croup
Recent upper respiratory tract infection preceding croup.
• inspection, you may observe the use of accessory muscles with nasal flaring during breathing. You typically hear the child's sharp, barklike cough and hoarse or muffled vocal sounds. As croup progresses, the patient may display further upper airway obstruction with severely compromised ventilation. (See How croup affects the upper airways.)
• Auscultation may disclose inspiratory stridor and diminished breath sounds. These signs and symptoms may last for only a few hours, or they may persist for 1 to 2 days.
• In laryngotracheobronchitis, the patient may complain of fever and breathing problems that occur more often at night. Typically, the child becomes frightened because he can't breathe out (because inflammation causes edema in the bronchi and bronchioles).

Nursing diagnosis Nursing Care Plans for Croup

Nursing outcomes Nursing Care Plans for Croup

  • Patient and family will verbalize strategies to reduce anxiety.
  • Patient and family will demonstrate an understanding of what has been taught.
  • Patient and family will Verbalize understanding of condition/disease process and treatment
  • Patient and family will use available support systems to assist with coping.
  • Family Coping: Family actions to manage stressors that tax family resources
  • Patient and family will verbalize fears and concerns.
  • The patient's temperature will be within normal range.
  • The patient will maintain adequate ventilation and oxygenation.
  • The patient will maintain a patent airway.

Nursing Interventions Nursing Care Plans for Croup

  • Anxiety Control: Personal actions to eliminate or reduce feelings of apprehension and tension from an unidentifiable source
  • Coping: Actions to manage stressors that tax an individual’s resources
  • Teaching: Individual Planning, implementation, and evaluation of a teaching program designed to address a patient’s particular needs
  • Learning Facilitation: Promoting the ability to process and comprehend information
  • Learning Readiness Enhancement: Improving the ability and willingness to receive information
  • Family Therapy: Assisting family members to move their family toward a more productive way of living
  • Family Support: Promotion of family values, interests, and goals
  • Family Involvement Promotion: Facilitating family participation in the emotional and physical care of the patient
  • Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles
  • Temperature Regulation: Attaining and/or maintaining body temperature within a normal range
  • Fever Treatment: Management of a patient with hyperpyrexia caused by nonenvironmental factors
  • Malignant Hyperthermia Precautions: Prevention or reduction of hypermetabolic response to pharmacological agents used during surgery
  • Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange
  • Oxygen Therapy: Administration of oxygen and monitoring of its effectiveness
  • Airway Management: Facilitation of patency of air passages
  • Cough Enhancement: Promotion of deep inhalation by the patient with subsequent generation of high intrathoracic pressures and compression of underlying lung parenchyma for the forceful expulsion of air

Patient teaching discharge and home health guidance for patient with Croup

  • If the patient is hospitalized, advise the parents that he may be placed in a cool-mist tent to provide high humidity.
  • Explain that the hospitalized child may require hydration with I.V. fluids if he can't be hydrated orally.
  • Warn parents that ear infections and pneumonia may complicate croup.
  • Urge the parents to seek immediate medical attention if the patient has an earache, productive cough, high fever, or increased shortness of breath.


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