Definition

Bronchopneumonia or bronchial pneumonia is the acute inflammation of the walls of

the bronchioles. It is a type of pneumonia characterized by multiple foci of isolated, acute
consolidation, affecting one or more pulmonary lobules.
Pneumonia is the inflammation of the lung caused by bacteria in which the air sacs
become filled with inflammatory cells and the lung becomes solid. The symptoms include
those of any infection (fever, malaise, headache, etc.,) together with cough and chest
pain.
Statistics
It is estimated that, worldwide, some 4 million children under five years of age, die each
year from acute respiratory infection (AI) with the most of these deaths caused by
pneumonia in developing countries.
In !"#", when the program for $ontrol Acute espiratory Infections ($AI) of the
%hilippines was launched, the death toll from pneumonia among children under the age of
five years was &',(((. The latest statistics (&(()) disclosed that almost )( out of !(((
children under five children suffer from pneumonia and five in every !!,((( die from the
disease. The *epartment of +ealth believes that if health wor,ers used a standard method
of detecting and managing AIs specially pneumonia, infant deaths could be cut by
half, saving '(,((( lives a year. %neumonia can be categorized by type of infiltrate- lobar
pneumonia and bronchopneumonia.
Nursing Care Plans
Ineffective Airway Clearance
.*/- Ineffective airway clearance r0t accumulation of tracheobronchial secretions
1ucus is produced at all times by the membranes lining the air passages. 2hen the
membranes are irritated or inflamed, e/cess mucus is produced and it will retain in
tracheobronchial tree. The inflammation and increased in secretions bloc, the airways
ma,ing it difficult for the person to maintain a patent airway. In order to e/pel e/cessive
secretions, cough refle/ will be stimulated. An increased in will also be e/pected as a
compensatory mechanism of the body due to obstructed airways.
Assessment %lanning .ursing Interventions ationale
3/pected
4utcome
estlessnes
s with
nasal
flaring
2ith rales
5+4T
T31-After
674 hours of
.I, pt.s
54 will be
!. 1onitor and
record vital
signs
&. Assess
patients
!. To obtain
baseline data
&. To ,now the
patients
general
5+4T
T31-After
674 hours of
.I, pt. shall
have
on both
lung fields
warm,
flushed
s,in
minimal
colorless
nasal
secretions
tachypnea
A38
9'6bp
m
*48
tachycardia
irritability
chest
indrawing
cough
cyanosis
noisy
breathing
pallor
changes in
and
rhythm
ris, for
infection
orthopnea
tachypnea
able to
demonstrate
improve
airway
clearance
A38
reduction of
congestion
with breath
sounds clear
and
improve:4
.; T31-
After &76
days of .I,
pt. will be
able to
establish and
maintain
airway
patency.
condition.
6. 3levate head
of bed and
encourage
fre<uent
position
changes.
4. =eep bac, dry
and loosen
clothing
'. Auscultate
breath sounds
and assess air
movement
). 1onitor child
for feeding
intolerance
and
abdominal
distention
>. Instruct the
54 to provide
an increased
fluid inta,e
for the child
#. Instruct the
54 to provide
". ade<uate rest
periods for the
child
!(. ;ive
e/pectorants
and
bronchodilato
rs as ordered.
!!. Administer
o/ygen
therapy and
other
medications
as ordered.
condition
6. To promote
ma/imal
inspiration,
enhance
e/pectoratio
n of
secretions in
order to
improve
ventilation
4. To promote
comfort and
ade<uate
ventilation
'. To ascertain
status and to
note progress
). To avoid
compromisin
g the airway
>. To help
li<uefy the
secretions
#. est will
prevent
fatigue and
decrease
o/ygen
demands for
metabolic
demands
". To further
mobilize
secretions
!(. To clear
airway when
secretions
are bloc,ing
the airway
!!. indicated to
increase
o/ygen
saturation.
demonstrated
improve
airway
clearance
A38
reduction of
congestion
with breath
sounds clear
and
improve
:4.;
T31-
After &76 days
of .I, pt. shall
have
established
and
maintained
airway
patency.
Impaired Gas Excange
.*/- Impaired gas e/change related to inflammation of airways and accumulation of
sputum affecting 4& and $4& transport
The e/change in o/ygenation and carbon dio/ide gases is impeded due to the obstruction
caused by the accumulation of bronchial secretions in the alveoli. 4/ygen cannot diffuse
easily.
Assessment %lanning
.ursing
Interventions
ationale
3/pected
4utcome
estlessnes
s
with nasal
flaring
2ith rales
on both
lung fields
1etabolic
acidosis
$ircum7
oral
cyanosis
*48
tachypnea
5+4T
T31-After
) hours of
.I, pt will be
able to
demonstrate
improvement
in gas
e/change
A38 a
decrease in
respiratory
rate to
normal:4.
; T31-
After !7&
days of .I,
pt will be
able to
demonstrate
improved
ventilation
and ade<uate
o/ygenation
of tissues
A38
absence of
symptoms of
respiratory
distress.
!. 1onitor
and record
vital signs
&. 4bserve
color of
s,in,
mucous
membranes
and nail
beds,
noting
presence of
peripheral
cyanosis.
6. 3levate
head of bed
and
encourage
fre<uent
position
changes.
4. =eep bac,
dry.
'. %romote
). ade<uate
rest periods
>. $hange
position < &
hrs.
#. =eep
environmen
t allergen
free
". 5uction
secretions
!. To obtain
baseline data
&. $yanosis of
nail beds may
represent
vasoconstrictio
n or the
bodys
response to
fever0 chills
6. To promote
ma/imal
inspiration,
enhance
e/pectoration
of secretions in
order to
improve
ventilation
4. To avoid
coughing
'. est will
prevent fatigue
and decrease
o/ygen
demands for
metabolic
demands
). To promote
drainage of
secretions
>. To reduce
irritant effects
on airways
#. To clear airway
5+4T
T31-%atient
shall
demonstrate
improvement
in gas
e/change
A38 a
decrease in
respiratory
rate to
normal:4.;
T31-%atient
shall
demonstrate
improved
ventilation
and ade<uate
o/ygenation
of tissues
A38 absence
of symptoms
of respiratory
distress.
%.
!(. Instruct 54
to increase
fluid inta,e
of the child
!!. Administer
o/ygen
therapy as
ordered.
when
secretions are
bloc,ing the
airway
". indicated to
increase
o/ygen
saturation
!(. To li<uefy
secretions
!!. 4& therapy is
indicated to
increase
o/ygen
saturation
!ypertermia
A person e/periences hyperthermia due to the inflammatory process wherein the body
tries to compensate and adapt to the dse. condition. As a defense mechanism, the body
produces host inflammatory cells causing fever. Interleu,in7! function as a pyrogens that
acts on the hypothalamus. !:7! act as a hormone where it is carried by the inflammation
site of production to the $.5, where it acts directly on the hypothalamic thermal control
center, thus elevating the thermal set point.
Assessment %lanning
.ursing
Interventions
ationale
3/pected
4utcome
Increas
e body
temp.
at
6>."?$
5,in is
warm
to
touch.
2ith
flushed
s,in.
Increas
e in

chills
lac, of
5hort7term-After 6
hours of nursing
interventions the
pts temperature
will be decrease to
normal limits
from 6>." to
6>.'?$:ong7term-
After 6 days of
nursing
interventions the
pt will be able to
maintain a temp.
within normal
range .
!. Assess
pts
condition
and
monitored
vital
signs.
&. %erform
tepid
sponge
bath
6. Instruct
the 54 to
provide
an
increase
fluid
inta,e for
!. To have
baseline
data.
&. To promote
heat loss by
evaporation
and
conduction.
6. To support
circulating
volume and
tissue
perfusion.
4. To promote
pts safety
and to
avoid
chills.
5hort7term-After 6
hours of nursing
interventions the
pts temperature
shall have
decreased to
normal limits from
6>." to
6>.'?$:ong7term-
After 6 days of
nursing
interventions the
pt shall be able to
maintain a temp.
within normal
range .
appetit
e
the child.
4. 1aintain
patent
airway
and
provide
blan,et
for the
child.
'. 1aintain
bed rest
and
ade<uate
rest
periods.
). As, 54 to
provide
high
caloric
diet for
the child
>. Administe
r
antipyreti
cs as
ordered.
'. To reduce
metabolic
demands0
4/ygen
consumptio
n.
). To meet
increase
metabolic
demands.
>. To lower
the
temperature
.
Distur"ed Sleeping Pattern
.*/- *isturbed 5leep %attern r0t difficulty of breathing
5leep is disrupted when a person e/periences unpleasant sensation arising from difficulty
of breathing and ineffective e/pectoration of mucus secretions in the airways.
Assessment %lanning
.ursing
Interventions
ationale
3/pected
4utcome
changes in
behavior
(irritability
)
restless
*48
nasal
flaring
The patient
5hort
Term-After 6
hours of
nursing
interventions
the 54 will be
able to
verbalize
understanding
!. 1onitor
vital signs
&. 3ncourage
54 to
increase
inta,e of
warm mil,
for the child
6. %rovide a
!. To have a
comparabl
e baseline
data7to
promote
drowsiness
&. To
promote
comfort
5hort
Term-After 6
hours of
nursing
interventions
the 54 shall
have verbalized
understanding
of sleep
may
manifest-
lac, of
interest in
food
weight loss
*48
tachypnea
of sleep
disturbance and
identify
interventions to
promote sleep
for the
child.:ong
Term-
After 6 days of
nursing
interventions,
54 will be able
to report
improvement in
sleep pattern of
the child.
<uiet
environment
for the
child7
instruct 54
to provide a
dim
environment
for the child
4. Advise 54
to provide
blan,et for
the child
'. Instruct 54
to elevate
+48
and
rela/ation
0sleep
periods for
the child
6. To
promote
comfort
for the
child
4. To avoid
chills and
to promote
comfort
'. To
ma/imize
lung
e/pansion
of the
child and
to decrease
*48
disturbance and
identified
interventions to
promote sleep
for the
child.:ong
Term-
After 6 days of
nursing
interventions,
the 54 shall
have reported
improvement in
sleep pattern
for the child
#is$ for Infection
.*/- is, for infection (spread) related to inade<uate secondary defenses(decrease
hemoglobin, hematocrit and immunosuppression
Immuno7suppression due to decrease in hemoglobin, leu,openia, and suppress
inflammatory response gives a greater opportunity for pathogenic bacteria to invade and
inoculate in a specific body part of a susceptible human body. Thus, leading to a further
damage or infection.
Assessment %lanning
.ursing
Interventions
ationale
3/pected
4utcome
ever of
6#.6?$
presence
of
adventitio
us sounds
in both
lung field.
productive
cough
5hort term-
After ) hours of
nursing
interventions
the patients
5.4 will
verbalize her
understanding
of individual
causative0ris,
!. 1onitor v0s
closely,
especially
during
initiation of
therapy.
&. Instruct the
5.4
concerning
about the
!. To ,now
potential
fatal
complicati
on that
may occur.
&. To
promote
safety
disposal of
5hort term- The
patients 5.4
shall have
verbalized her
understanding
of individual
causative0ris,
factors and
demonstrate
lifestyle
s,in pale
in color
restlessnes
s
activity
intoleranc
e
fever
cough and
colds
pallor
cyanosis
*48
tachypnea
tachycardi
a
factors and
demonstrate
lifestyle
changes to
prevent further
infection.:ong
term-
After !7& days
of nursing
interventions
the patient will
be free from
possible spread
of infection.
disposition
of
secretions
and report
changes in
color,
amount and
odor of
secretions.
6. 3ncourage
the 54 to
perform
good hand
washing
techni<ues.
4. 3ncourage
ade<uate
rest.
'. 5tress the
importance
of
increasing
the childs
nutritional
inta,e.
). 3ncourage
the mother
to ,eep an
eye to the
baby and
observe
anything
that the
baby is
putting in
his mouth.
>. As, 54 to
provide a
good
hygiene for
the child.
(bed bath)
#. As, 54 to
provide an
ade<uate
safe
secretions
and to
assess for
the
resolution
of
pneumonia
or
developme
nt of
secondary
infection.
6. To reduce
spread or
ac<uisition
of
infection.
4. To enhance
fast
recovery
and regain
strength.
'. A good
nutritional
inta,e can
strengthen
body
immune
defense.
). ). To
prevent
entry of
microbes.
>. To
eliminate
14
#. To prevent
;I
disturbance
". To avoid
chills and
to prevent
the child
from
having
changes to
prevent further
infection.:ong
term-
The patient
shall have been
free from
possible spread
of infection.
drin,ing
mil,0water
for the child
". As, 54 to
,eep the
child warm
and to
provide
blan,et
!(. Administer
antimicrobia
ls as
ordered.
fever
!(. To combat
microbial
pneumonia
s.
#is$ for Im"alanced Nutrition
.*/- is, for imbalanced nutrition, less than body re<uirement related to decrease
nutrient absorption
A disruption in the mucosal barrier causes gastric acid to come into contact with gastric
tissues and damage them causing irritation or inflammation. This leads to alteration of the
mucosal barrier impairing the absorption process with in the stomach and putting the
patient at high ris, for imbalance nutrition less than body re<uirements.
Assessment %lanning
.ursing
Interventions
ationale
3/pected
4utcome
pallor
lac, of
appetite
lac, of
interest to
food
offered
type of
food cannot
meet the
metabolic
demand of
the child
(powder
mil,, milo,
chips)
constipatio
n
diarrhea
5+4T
T31-After 6
hours of .ursing
Interventions,
the 54 will be
able to verbalize
understanding of
causative factors
when ,nown and
necessary
interventions for
the child.:4.;
T31-
After & days of
.ursing
Interventions,
the patient will
be able to
!. 1onitor
vital signs
&. Assess for
difficulty of
swallowing
and the
ability to
swallow
6. 3ncourage
family
members to
prepare
food of
patients
preferences
7 develop
meal plan
with the
!. To have
baseline
data
&. $an be
factors
that can
affect
ingestion
and
causative
of altered
nutrition
6. To
maintain
ade<uate
caloric
inta,e
4. To meet
the
5+4T
T31-The 54
shall have
verbalized
understanding
of causative
factors when
,nown and
necessary
interventions
for the child.
:4.; T31-
The client shall
have
demonstrated
behaviors,
lifestyle
weight loss
pallor
demonstrate
behaviors,
lifestyle changes
to regain and0or
maintain
appropriate
weight.
patient
4. As, the
mother to
@oin the
child
during meal
time
nutritiona
l needs of
the client
'. To
enhance
inta,e
changes to
regain and0or
maintain
appropriate
weight.