Author: Dr. Prince

Nursing Care Plans For Chronic Heart Failure – Best Nursing Care Plans (2022)

This article discusses Nursing Care Plans For Chronic Heart Failure plus its causes, symptoms, preventions, treatments and interventions.

Permalink: https://customnursingassignments.com/nursing-care-plans-for-chronic-heart-failure

customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us.(Nursing Care Plans For Chronic Heart Failure)

Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Introduction

Heart failure — sometimes known as congestive heart failure — occurs when the heart muscle doesn’t pump blood as well as it should. When this happens, blood often backs up, and fluid can build up in the lungs, causing shortness of breath.

Heart failure doesn’t mean the heart has stopped working. Rather, it means that the heart works less efficiently than normal. Due to various possible causes, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart can’t pump enough oxygen and nutrients to meet the body’s needs.

The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. The kidneys may respond by causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested. Congestive heart failure is the term used to describe the condition.

Causes of Heart Failure

Heart failure is caused by many conditions that damage the heart muscle, including:

Coronary artery disease. Coronary artery disease (CAD), an artery disease that supplies blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.

Heart attack. A heart attack happens when a coronary artery becomes suddenly blocked, stopping blood flow to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that doesn’t work the way it should.

Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as infections or alcohol or drug abuse.

Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can happen when several diseases or conditions are present at once.

Symptoms of Heart Failure

You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include:

Congested lungs. Fluid backup in the lungs can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.

Fluid and water retention. Less blood to your kidneys causes fluid and water retention, resulting in swollen ankles, legs, abdomen (called edema), and weight gain. Symptoms may cause an increased need to urinate during the night. Bloating in your stomach may cause a loss of appetite or nausea.

Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.

Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a rapid or irregular heartbeat.

Types of Heart Failure

Systolic dysfunction (or systolic heart failure) happens when the heart muscle doesn’t contract with enough force, so less oxygen-rich blood is pumped throughout the body.

Diastolic dysfunction (or diastolic heart failure) happens when the heart contracts normally, but the ventricles don’t relax properly or are stiff, and less blood enters the heart during normal filling.

A calculation done during an echocardiogram called the ejection fraction (EF) is used to measure how well your heart pumps with each beat to help determine if systolic or diastolic dysfunction is present. Your doctor can discuss which condition you have.

Diagnosis of Heart Failure

A doctor will ask many questions about the symptoms and medical history. A doctor may also order tests to determine the cause and severity of the heart failure. These include:

Blood tests. Blood tests are used to evaluate kidney and thyroid function as well as to check cholesterol levels and the presence of anemia. Anemia is a blood condition that happens when there is not enough hemoglobin (the substance in red blood cells that enables the blood to transport oxygen through the body) in your blood.

B-type natriuretic peptide (BNP) blood test. BNP is a substance secreted from the heart in response to blood pressure changes that happen when heart failure develops or worsens. BNP blood levels increase when heart failure symptoms worsen and decrease when the heart failure condition is stable. The BNP level in a person with heart failure — even someone whose condition is stable — may be higher than in a person with normal heart function. BNP levels do not necessarily correlate with the severity of heart failure.

Chest X-ray. A chest X-ray shows the size of your heart and whether there is fluid build-up around the heart and lungs.

Echocardiogram. This ultrasound test shows the heart’s movement, structure, and function.

Ejection fraction (EF) is used to measure how well your heart pumps with each beat to determine if systolic dysfunction or heart failure with preserved left ventricular function is present. Your doctor can discuss which condition you have.

Electrocardiogram (EKG or ECG). An EKG records the electrical impulses traveling through the heart.

Cardiac catheterization. This invasive procedure helps determine whether coronary artery disease is a cause of congestive heart failure.

Stress Test. Noninvasive stress tests provide information about the likelihood of coronary artery disease.

Other tests may be ordered, depending on the condition.

Treatment for Heart Failure

There are more treatment options available for heart failure than ever before. Tight control over your medications and lifestyle, coupled with careful monitoring, are the first steps. As the condition progresses, doctors specializing in the treatment of heart failure can offer more advanced treatment options.

The goals of treating heart failure are to keep it from getting worse (lowering the risk of death and the need for hospitalization), ease symptoms, and improve quality of life.

Some common types of medicines used to treat it are:

ACE inhibitors (angiotensin-converting enzyme inhibitors)
Aldosterone antagonists
ARBs (angiotensin II receptor blockers)
ARNIs (angiotensin receptor-neprilysin inhibitors)
Beta-blockers
Blood vessel dilators
Digoxin
Calcium channel blockers
Diuretics
Heart pump medications
Potassium or magnesium
Selective sinus node inhibitors
Soluble guanylate cyclase (sGC) stimulator

Stages of Chronic Heart Failure (CHF)

Stage A

People with stage A CHF do not yet have dysfunction of the pumping activity of the heart but have a high risk of developing CHF due to related conditions, such as chronic high blood pressure, diabetes, and coronary artery disease.

Stage A Symptoms

A person usually has no symptoms of CHF at this stage but may experience symptoms of their chronic conditions, including:

Shortness of breath
Difficulty breathing
Swelling in the hands, feet, and ankles

Stage B

Structural heart disease develops at this stage, such as reduced heart pumping function, which can lead to an enlarged left ventricle. It can also result from a previous heart attack.

Stage B Symptoms

Most people at stage B still do not show symptoms of CHF.

Stage C

People at this stage will show symptoms of CHF linked to underlying structural heart disease, including fatigue or breathlessness. These symptoms usually occur due to problems with the squeezing function of the left ventricle or the pumping chamber of the heart.

Stage C CHF also includes people who no longer show symptoms but are currently undergoing treatment for previous symptoms, such as those who spent time in the hospital with heart failure exacerbation.

Stage C Symptoms

Common symptoms include:

Fatigue
Breathlessness
Difficulty breathing

Stage D

People will have advanced structural heart disease at stage D and display significant symptoms, even when they are at rest.

Stage D Symptoms

Symptoms may include:

Shortness of breath
Difficulty breathing
Swelling of legs, arms, hands, and ankles
Fatigue
Nausea
Rapid heartbeat
Weight gain
Lightheadedness
Persistent cough

As you continue, customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Nursing Care Plans For Chronic Heart Failure)

**Nursing Care Plans For Chronic Heart Failure**

Prevention of Chronic Heart Failure (CHF)

Symptoms of CHF range from mild to severe but may get worse over time if not managed medically.

Lifestyle strategies can reduce the risk of developing CHF and can also slow its progress.

To prevent or slow the progression of CHF, people should take the following steps:

Maintain a healthy body weight: Excess body weight can place strain on the heart and increase the risk of more damage to the heart.

Exercise regularly: The AHA recommends getting 150 minutes of moderate-intensity exercise every week. Individuals with heart failure should talk to their doctors about getting an individualized exercise “prescription.”

Manage stress: Meditation, therapy, and relaxation techniques can help a person manage stress, which can have adverse effects on the heart.

Eat a heart-healthy diet: Daily food intake should be low in trans fats, rich in whole grains, and low in sodium and cholesterol. Experts often recommend that people with heart failure limit their sodium intake to 2,000 milligrams (mg) daily. However, individuals should check with their doctor to determine their sodium and fluid intake.

Monitor blood pressure regularly: A doctor can do this at regular check-ups. However, doctors also recommend people use home blood pressure monitors or sphygmomanometers.

Vaccinations: Be sure to stay on top of vaccinations for influenza and pneumococcal pneumonia.

Nursing Care Plans For Chronic Heart Failure Based on Nursing Diagnosis

Nursing Care Plan 1: Diagnosis: Decreased Cardiac Output related to increased preload and afterload and impaired contractility

Evidenced by an irregular heartbeat, heart rate of 128, dyspnea upon exertion, and fatigue.

Desired outcome

The patient will be able to maintain adequate cardiac output.

Interventions	Rationales
Assess the patient’s vital signs and characteristics of the heartbeat at least every 4 hours. Assess breath sounds via auscultation. Observe for decreasing peripheral tissue perfusion signs such as slow capillary refill, facial pallor, cyanosis, and cool, clammy skin.	To assist in creating an accurate diagnosis and monitoring medical treatment effectiveness. Breath sounds of crackles/rales are important signs of heart failure. The presence of signs of decreasing peripheral tissue perfusion indicates deterioration of the patient’s status which requires immediate referral to the physician.
Administer the cardiac medications and diuretics as prescribed.	To alleviate the symptoms of heart failure and to treat the underlying condition.
Administer supplemental oxygen as prescribed. Discontinue if SpO2 level is above the target range or as ordered by the physician.	To increase the oxygen level and achieve a SpO2 value of at least 94%.
Educate patients on stress management, deep breathing exercises, and relaxation techniques.	Stress causes a persistent increase in cortisol levels, which has been linked to people with cardiac issues. Chronic stress may also cause an increase in adrenaline levels, which tend to increase the heart rate, respiratory rate, and blood sugar levels.

Nursing Care Plans For Chronic Heart Failure

Nursing Care Plan 2: Diagnosis – Activity intolerance related to an imbalance between oxygen supply and demand

Evidenced by fatigue, overwhelming lack of energy, verbalization of tiredness, generalized weakness, and shortness of breath upon exertion

Desired Outcome

The patient will demonstrate active participation is necessary and desired activities and demonstrate an increase in activity levels.

Interventions	Rationales
Assess the patient’s activities of daily living and actual and perceived limitations to physical activity. Ask for any form of exercise that he/she used to do or wants to try.	To create a baseline of activity levels and mental status related to fatigue and activity intolerance.
Encourage progressive activity through self-care and exercise as tolerated. Explain the need to reduce sedentary activities such as watching television and using social media for long periods. Alternate periods of physical activity with rest and sleep.	To gradually increase the patient’s tolerance to physical activity.
Teach deep breathing exercises and relaxation techniques. Provide adequate ventilation in the room.	To allow the patient to relax while at rest and to facilitate effective stress management. To allow enough oxygenation in the room.
Refer the patient to the physiotherapy / occupational therapy team as required.	To provide more specialized care for the patient in terms of helping him/her build confidence in increasing daily physical activity.

Nursing Care Plans For Chronic Heart Failure

Nursing Care Plan 3: Diagnosis: Excess Fluid Volume related to decreased cardiac output and increased glomerular filtration rate (GFR)

Evidenced by S3 heart sound, the blood pressure level of 190/85, orthopnea, pitting edema of the ankles, and weight gain

Desired Outcome

The patient will demonstrate a balanced input and output and stabilized fluid volume.

Interventions	Rationales
Assess vital signs and auscultate lungs to find any crackles or wheezes.	Heart failure, especially left-sided, may lead to pulmonary congestion, as evidenced by crackles or wheezes upon auscultation of the lungs.
Commence a fluid balance chart, monitoring the input and output of the patient.	To monitor patient’s fluid volume accurately and effectiveness of actions to monitor the progress of excess fluid volume.
Restrict fluid intake as instructed by the physician.	To reduce fluid volume and manage edema.
Weigh the patient on a daily basis.	Diuretics are needed to manage heart failure but may put the patient at risk for sudden fluid loss, which is reflected through his/her weight. Monitor patient’s serum electrolytes and renal function to the physician as needed.

Nursing Care Plans For Chronic Heart Failure

Nursing Care Plan 4: Diagnosis – Acute Pain related to decreased myocardial blood flow

Evidenced by a pain score of 10 out of 10, verbalization of pressure-like/ squeezing chest pain (angina), guarding sign on the chest, the blood pressure level of 180/90, respiratory rate of 29 cpm, and restlessness.

Desired Outcome

The patient will demonstrate pain relief as evidenced by a 0 out of 10, stable vital signs, and an absence of restlessness.

Interventions	Rationale
Administer prescribed medications that alleviate the symptoms of acute chest pain (angina).	Aspirin may be given to reduce the ability of the blood to clot so that the blood flows easier through the narrowed arteries. Nitrates may be given to relax the blood vessels. Other medications that help treat angina include anti-cholesterol drugs (e.g., statins), beta-blockers, calcium channel blockers, and Ranolazine.
Assess the patient’s vital signs and characteristics of pain at least 30 minutes after administration of medication.	To monitor the effectiveness of medical treatment for the relief of angina. The time of monitoring of vital signs may depend on the peak time of the drug administered.
Elevate the head of the bed if the patient is short of breath. Administer supplemental oxygen as prescribed. Discontinue if SpO2 level is above the target range or as ordered by the physician.	To increase the oxygen level and achieve a SpO2 value of at least 94%.
Place the patient on complete bed rest during angina attacks. Educate patients on stress management, deep breathing exercises, and relaxation techniques.	Stress causes a persistent increase in cortisol levels, which has been linked to people with cardiac issues. The effects of stress are likely to increase myocardial workload.

Nursing Care Plans For Chronic Heart Failure

Nursing Care Plan 5: Diagnosis – Deficient Knowledge related to a new diagnosis of Congestive Heart Failure

Evidenced by the patient’s verbalization of “I want to know more about my new diagnosis and care.”

Desired Outcome

At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of congestive heart failure and its management.

Interventions	Rationales
Assess the patient’s readiness to learn, misconceptions, and blocks to learning (e.g., denial of diagnosis or poor lifestyle habits)	To address the patient’s cognition and mental status towards the new CHF diagnosis and help the patient overcome blocks to learning.
Explain what CHF is its types (specifically whether the CHF of the patient is left-sided, right-sided, or biventricular). Avoid using medical jargon and explain in layman’s terms.	To provide information on CHF and its pathophysiology in the simplest way possible.
Educate the patient about lifestyle changes that can help manage CHF. Create a plan for Activities of Daily Living (ADLs) with the patient that involve smoking cessation, increase in physical activity, dietary changes, blood pressure control, stress management, and diabetes management (if the patient has diabetes).	Smoking, a sedentary lifestyle, poor dietary choices, poor blood pressure control, chronic stress, and unmanaged diabetes are linked to CHF.
Inform the patient of the details about the prescribed medications (e.g., drug class, use, benefits, side effects, and risks) to treat heart failure. Ask the patient to repeat or demonstrate the self-administration details to you.	To inform the patient of each prescribed drug and to ensure that the patient fully understands the purpose, possible side effects, adverse events, and self-administration details.
Refer the patient to a dietitian and physiotherapist.	To enable the patient to receive more information in managing diet and physical activity from specific healthcare team members.

Nursing Care Plans For Chronic Heart Failure

Related FAQs

1. What happens during chronic heart failure?

Heart failure occurs when the heart muscle doesn’t pump blood as well as it should. Blood often backs up and causes fluid to build up in the lungs (congest) and in the legs. The fluid buildup can cause shortness of breath and swelling of the legs and feet. Poor blood flow may cause the skin to appear blue (cyanotic).

2. Can you survive chronic heart failure?

Although there have been recent improvements in congestive heart failure treatment, researchers say the prognosis for people with the disease is still bleak, with about 50% having an average life expectancy of less than five years. For those with advanced forms of heart failure, nearly 90% die within one year.

3. What causes chronic heart failure?

Common causes of heart failure are coronary artery disease, high blood pressure and diabetes. It is more common in people who are 65 years old or older, African Americans, people who are overweight, and people who have had a heart attack. Men have a higher rate of heart failure than women.

4. What is the difference between heart failure and chronic heart failure?

Chronic heart failure is typically a long-term condition that gradually worsens over time. This is the feature that differentiates it from acute heart failure, which develops very suddenly. It cannot typically be cured, but symptoms can be managed effectively.

https://customnursingassignments.com/nursing-care-plans-for-bronchiolitis/

https://customnursingassignments.com/nursing-care-plans-for-cellulitis/

April 29, 2022

Nursing Care Plans for Cellulitis – Best Nursing Care Plans(2022)

This article discusses Nursing Care Plans for Cellulitis plus its causes, symptoms, preventions, treatments and interventions.

Permalink: https://customnursingassignments.com/nursing-care-plans-for-cellulitis

customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us.(Nursing Care Plans for Cellulitis)

Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Introduction

Cellulitis is a common bacterial skin condition that can be dangerous. The affected skin appears inflamed and red and is usually painful and warm to the touch.

Cellulitis mainly affects the lower legs, although it can also affect the face, arms, and other body parts. It happens when bacteria enter your body through a crack or break in your skin.

If left untreated, the infection can quickly spread to your lymph nodes and circulation, posing a serious health risk. It isn’t frequently passed on from one person to the next.

What is cellulitis?

Cellulitis is a painful skin ailment that affects many people. It may show as a discoloured, swollen area that is hot and painful to the touch at first. The swelling and discolouration can spread swiftly.

Cellulitis usually appears red or pink on light skin. It might seem dark brown, grey, or purple on dark skin. The infection most commonly affects the feet and lower legs, but it can affect any part of a person’s body or face.

Cellulitis normally affects the skin’s surface, but it can also harm its tissues. The infection has the potential to spread to lymph nodes and circulation. Cellulitis can become life-threatening if it is not treated.

Pathophysiology

Cellulitis is caused by skin breaks that are not properly covered or cleaned.

Weak defence – Cellulitis is most commonly associated with skin breaks such as puncture wounds, fissures, or lacerations.

Entry – Cellulitis is caused by organisms in the skin gaining access to the dermis and multiplying.

Inflammation – Swollen, red, and painful skin indicates infection, and a fever may accompany these symptoms.

Invasion – If left untreated, cellulitis can penetrate the skin’s inner layers, infiltrate the lymph nodes and bloodstream, and spread throughout the body.

Epidemiology & Statistics

The exact prevalence of cellulitis is unknown because it is not a reportable condition; however, it is a relatively common infection that affects all races and ethnicities.

Individuals above the age of 45 are more likely to get cellulitis.
The cellulitis has a prevalence rate of 24.6 occurrences per 1000 people.
Cellulitis was found in 37.3 % of patients in a comprehensive epidemiologic investigation of skin, soft tissue, joint, and bone infections.
Skin and soft tissue infections occur in 32.1 to 48.1 visits per 1000 people.
The number of abscess and cellulitis visits per 1000 people increased from 17.3 to 32.5.
In a general hospital in the United Kingdom, cellulitis accounted for about 3% of emergency medical consultations.

Causes

Weak immune system. Bacteria can quickly infect a person with a weakened immune system.
Breaks in the skin. Breaks in the skin caused by eczema and athlete’s foot, for example, allow germs to enter and produce cellulitis.
Intravenous drug use. The insertion site is also a breach in the skin where pathogens could enter via.
Diabetes. Patients with diabetes have a slower wound healing rate, and wounds exposed to microorganisms may get infected for an extended period of time.
Skin ulcers
Chronic skin conditions
Nail infections

Risk factors

A combination of factors causes cellulitis:

Injury – Bacteria can enter through any wound, fracture, burn, or scrape.

Weakened immune system – Diabetes, leukaemia, and HIV/AIDS impair your immune system, making you more susceptible to infections. Some drugs can also weaken your immune system.

Skin conditions – Eczema, athlete’s foot, and shingles can all produce skin cracks, which allow bacteria to enter the body.

Chronic swelling of your arms or legs – This disease can occur due to surgery.

History of cellulitis – If you’ve had cellulitis previously, you’re more likely to get it again.

Obesity – Cellulitis is more likely to develop if you are overweight or obese.

Signs and Symptoms of Cellulitis

Cellulitis signs and symptoms are usually visible and noticeable on the skin tissues.

Tenderness at the injury site -The site of developing cellulitis causes pain.

Skin inflammation is a condition in which the skin becomes inflamed. Inflammation occurs as the infection progresses into the inner layer of the skin.

A rash or a sore on the skin that spreads swiftly – The skin produces rashes over the affected area due to pathogen invasion.

The skin has a tight, shiny aspect – Because of the swelling, the skin expands and appears taut and glossy.

Abscess filled with pus – Pus and an abscess form as the infection progresses.

Fever – As the body battles the illness, a fever develops.

erythema/ red streaks

Warm/hot to touch

Oedema (fluid)

Pain/tenderness

Blisters (bullae)

More serious cellulitis symptoms include:

Shaking
Chills
Feeling ill
Fatigue
Dizziness
Lightheadedness
Muscle aches
Warm skin
Sweating

Cellulitis can spread into other parts of your body if left untreated. If it does spread, you may develop some of the following symptoms:

Drowsiness
Lethargy
Blisters
Red or dark brown streaks on the skin

Complications of Cellulitis

1. Blood infection – Severe cellulitis may cause toxins to spill into the bloodstream, causing sepsis.

2. Osteomyelitis – Osteomyelitis or bone infection can occur if cellulitis is advanced enough that it penetrates the bone structures underneath.

3. Lymphangitis – This is an inflammation of the lymph nodes and vessels and is correlated with sepsis.

4. Endocarditis – This is an inflammation of the heart and its tissues.

5. Meningitis – It is the inflammation of the meninges, the brain’s outer covering. Opportunistic infection from cellulitis can affect the brain as toxins circulate the body through the infected blood.

6. Septic shock – Untreated cellulitis precipitates an inadequately controlled infection that will cause undue stress to the organs, thereby causing systemic effects, such as multi-organ failure.

7. Gangrene – Tissue death and necrosis will occur if the cellulitis is left untreated or if treatment is ineffective.

Prevention

If your cellulitis recurs, your doctor may recommend preventive antibiotics. To help prevent cellulitis and other infections, take these precautions when you have a skin wound:

Wash your wound daily with soap and water. Do this gently as part of your normal bathing.
Apply a protective cream or ointment. An over-the-counter ointment (Vaseline, Polysporin, others) provides adequate protection for most surface wounds.
Cover your wound with a bandage. Change bandages at least daily.
Watch for signs of infection. Redness, pain and drainage all signal possible infection and the need for medical evaluation.

People with diabetes and those with poor circulation need to take extra precautions to prevent skin injury. Good skincare measures include the following:

Inspect your feet daily. Regularly check your feet for signs of injury so you can catch infections early.
Moisturize your skin regularly. Lubricating your skin helps prevent cracking and peeling. Do not apply moisturizer to open sores.
Trim your fingernails and toenails carefully. Take care not to injure the surrounding skin.
Protect your hands and feet. Wear appropriate footwear and gloves.
Promptly treat infections on the skin’s surface (superficial), such as athlete’s foot. Superficial skin infections can easily spread from person to person. Don’t wait to start treatment.

Diagnosis of Cellulitis

For most cases, no further evaluation is required for uncomplicated cellulitis that meet the following criteria:

Limited area of involvement
Minimal pain in the area
Absence of systemic signs (e.g. Fever, altered mental status, hypotension)
Absence of risk factors for other serious conditions (e.g. Extremes of age, immunocompromised status)

For moderate or severe forms of cellulitis, further workup is necessary, and they include:

1. Laboratory studies

2. Blood cultures — to detect the specific organism causing the cellulitis

3. CBC — basic laboratory test to determine blood count levels for proper management

4. Creatinine — to assess baseline kidney function and guide for antibiotic dosing

5. Bicarbonate, creatine phosphokinase — to assess for latent muscle injuries caused by infection

6. C-reactive protein (CRP) — laboratory marker for inflammation

7. Imaging studies

8. Ultrasound — to detect hidden sources of infection (occult abscess) and lead to proper management. (e.g. Ultrasound-guided pus aspiration for deep infections)

9. CT imaging or MRI — if necrotizing fascitis is a concern, doing this imaging procedure will aid in visualizing the extent of damage the infection has caused

Treatment for Cellulitis

The treatment approach of cellulitis involves either or both medical management and surgical intervention:

Medical management. Treatment of cellulitis involves using a variety or combination of antibiotics.

For mild cases, cellulitis can be treated on an outpatient basis with prescriptions for oral 1st class penicillin. Macrolides may be used as alternatives for patients with Penicillin allergies. Fluoroquinolones may be used but are only warranted for gram-negative organisms to avoid resistance.

For severe forms of cellulitis, intravenous administrations of higher class of antibiotics are given. 3rd class penicillin is the drug of choice for severe sepsis. However, IV lincosamides and IV Glycopeptides may be given for patients allergic to penicillin.

The main goal of antibiotic use for severe forms is to cover for all possible causative pathogens (gram-positive, gram-negative, anaerobic organisms) to prevent inadequate treatments. Patients with risk factors (immunocompromised state, diabetes) may necessitate in-patient IV antibiotics to address the infection properly and to monitor their hemodynamic stability already impeded by their latent conditions.

Surgical Management

Incision and drainage. This is used for simple cellulitis with the presence of pus or abscess to the infected tissue. This treatment is followed by a course of antibiotics to treat the remaining infection otherwise not drained from the procedure.

Surgical resection. In severe forms of cellulitis, deep tissues like the muscle and bone may be infected and would require surgical removal of the necrotized and dead tissues.

Cellulitis and other conditions

Many conditions can present symptoms similar to cellulitis.

Cellulitis versus Venous Stasis

Venous stasis, or venous stasis dermatitis, is a condition commonly misdiagnosed as cellulitis.

This condition causes swelling, discolouration and can develop into skin ulcers. It results from poor circulation in the lower limbs and typically affects the lower legs and ankles.

Unlike cellulitis, this condition can affect both sides of the body and is not the result of bacterial infection. However, should you develop sores or ulcers due to venous stasis, your risk of a skin infection will increase.

Cellulitis versus Erysipelas

Erysipelas is another skin infection. Like cellulitis, it can start from open wounds, burns, or surgical cuts.

Most of the time, the infection is on the legs. Less often, it can appear on the face, arms, or trunk.

However, cellulitis affects deeper tissue, while erysipelas is often the result of strep bacteria and its effects are more superficial.

Other symptoms of erysipelas include:

Fever
headache
nausea
chills
weakness
ill feeling

Doctors treat erysipelas with antibiotics, most often penicillin or a similar drug.

Cellulitis versus Abscess

An abscess is a swollen pocket of pus underneath the skin. It forms when bacteria — often Staphylococcus — get into your body through a cut or other open wound.

Your immune system sends in white blood cells to fight off the bacteria when this happens. The attack can form a hole under your skin, filling with pus. The pus contains dead tissue, bacteria, and white blood cells.

Unlike cellulitis, an abscess looks like a lump under the skin. You may also have symptoms like a fever and chills.

Some abscesses shrink on their own without treatment. In other instances, you may require antibiotics, or a doctor may need to drain the abscess.

Cellulitis versus Dermatitis

Dermatitis is a general term for a swollen skin rash that covers many conditions. These include atopic dermatitis, or eczema, and contact dermatitis, an allergic reaction to an irritating substance.

Unlike cellulitis, most forms of dermatitis are the result of allergic reactions, not bacterial infections.

General dermatitis symptoms include:

Discoloured skin
Blisters that ooze or crust
Itching
Swelling
Scaling

Doctors treat dermatitis with cortisone creams and antihistamines to relieve the swelling and itching.

Cellulitis versus DVT

Deep vein thrombosis (DVT) is a blood clot in one of the deep veins, usually in the legs. You can get a DVT after you sit or lie in bed for a long period of time, such as on a long plane trip or after surgery.

Symptoms of DVT include:

Pain in the leg
Redness
Warmth

It’s important to get medical help if you have DVT. If the clot breaks free and travels to the lungs, it can cause a life-threatening condition called pulmonary embolism (PE).

Doctors treat DVT with blood thinners. These prevent the clot from getting bigger and stop you from getting new clots.

Nursing Care Plans for Cellulitis Based on Diagnosis

Nursing Care Plan Based on Impaired Skin Integrity Diagnosis

Nursing Diagnosis: Impaired Skin Integrity related to skin infection secondary to cellulitis, as evidenced by erythema, warmth and swelling of the affected leg.

Desired Outcome: The patient will re-establish healthy skin integrity by following a treatment regimen for cellulitis.

Intervention	Rationale
Assess the patient’s skin on their whole body.	To determine the severity of cellulitis and any affected areas that require special attention or wound care.
Administer antibiotics as prescribed. Ensure that the patient finishes the course of antibiotics prescribed by the physician.	Cellulitis is generally treated through the use of antibiotic therapy. •For mild cases, cellulitis can be treated on an outpatient basis with prescriptions for oral 1st class penicillin. Macrolides may be used as alternatives for patients with Penicillin allergies. Fluoroquinolones may be used but are only warranted for gram-negative organisms to avoid resistance. •For severe forms of cellulitis, intravenous administrations of higher class of antibiotics are given. 3rd class penicillin is the drug of choice for severe sepsis. However, IV lincosamides and IV Glycopeptides may be given for patients allergic to penicillin. Even if the symptoms have already improved and healing is evident, it is still important to finish the course of antibiotic therapy to prevent recurrence of infection and antibiotic resistance.
Apply corticosteroids over the affected skin as prescribed by the physician. Application is usually done twice a day and is done thinly over the inflamed skin. It is applied for a maximum of 14 days.	Topical corticosteroids promote the reduction of skin inflammation in the affected area. Mild cellulitis may benefit from over-the-counter topical corticosteroid preparations, but severe cellulitis requires prescription ones.
Prevent the use of occlusive dressing over the affected site.	Occlusive dressing potentiates the systemic absorption of the corticosteroid cream or ointment.
Prepare the patient for surgery as indicated.	Incision and drainage. This is used for simple cellulitis with the presence of pus or abscess to the infected tissue. This treatment is followed by a course of antibiotics to treat the remaining infection otherwise not drained from the procedure—surgical resection. In severe forms of cellulitis, deep tissues like the muscle and bone may be infected and would require surgical removal of the necrotized and dead tissues.
Educate the patient and caregiver about proper skin hygiene through washing the skin with soap and water.	It is important to maintain the cleanliness of the affected areas by washing with mild soap and water.

Nursing Care Based on Risk for Infection

Nursing Diagnosis: Risk for Infection.

Desired Outcome: The patient will prevent the spread of infection to the rest of the body by following a treatment regimen for cellulitis.

Intervention	Rationale
Assess the patient’s skin on their whole body.	To determine the severity of cellulitis and any affected areas that require special attention or wound care.
Administer antibiotics as prescribed. Ensure that the patient finishes the course of antibiotics prescribed by the physician.	Even if the symptoms have already improved and healing is evident, it is still important to finish the course of antibiotic therapy to prevent recurrence of infection and antibiotic resistance.
Educate the patient and caregiver about proper skin hygiene by washing it with soap and water.	It is important to maintain the cleanliness of the affected areas by washing with mild soap and water.
Trim the patient’s fingernails and ensure frequent hand hygiene. Advise the patient and caregiver to prevent scratching the affected areas.	Long fingernails tend to harbour more bacteria.
Using a skin marker, mark the edges of the cellulitic area and observe for its shrinkage or spread.	This method can help determine whether the antibiotics are effective or if there is a need to change the antibiotic used.

Summary

Cellulitis is a common skin infection that causes inflammation, skin discolouration, and pain. Complications are but can be severe. It can affect the surface or deep tissue, and if left untreated, it can lead to catastrophic complications, including amputation of a limb. Cellulitis is more common in people with diabetes, cancer, or immunocompromised. Nursing care plans will focus on effective pain management, antibiotics, and skin integrity evaluation.

Most people fully recover from cellulitis after 7 to 10 days on antibiotics. If left untreated, cellulitis can lead to gangrene and septic shock and may require surgery to treat severe cases.

Related FAQs

1. What is the main cause of cellulitis?

Cellulitis is usually caused when bacteria enter a wound or area where there is no skin. The most common bacteria that cause cellulitis include: Group A ß – hemolytic streptococcus (Strep) Streptococcus pneumoniae (Strep)

2. What does cellulitis look like in the beginning?

In general, cellulitis appears as a red, swollen, and painful area of skin that is warm and tender to the touch. The skin may look pitted, like the peel of an orange, or blisters may appear on the affected skin. Some people may also develop fever and chills.

3. What is the fastest way to get rid of cellulitis?

Treatment for cellulitis, which is an infection of the skin and tissues, includes antibiotics and addressing any underlying condition that led to the infection. Home remedies can also help cellulitis go away faster, such as keeping the area dry, using antibiotic ointments, rest, and elevating the affected leg or arm.

4. Is cellulitis caused by poor hygiene?

Most commonly, it occurs in areas that may have been damaged or are inflamed for other reasons, such as inflamed injuries, contaminated cuts, or areas with poor skin hygiene. Bad circulation from poor vein function or peripheral arterial disease is a common cause of cellulitis.

https://customnursingassignments.com/nursing-care-plans-for-bronchiolitis/

https://customnursingassignments.com/nursing-care-plans-for-bowel-obstruction/

April 29, 2022

Nursing Care Plans for Bronchiolitis – Best Nursing Care Plans(2022)

This article discusses Nursing Care Plans for Bronchiolitis plus its causes, symptoms, preventions, treatments and interventions.

Permalink: https://customnursingassignments.com/nursing-care-plans-for-bronchiolitis

customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us.(Nursing Care Plans for Bronchiolitis)

Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Introduction

Bronchiolitis is a common lung infection in young children and infants. It causes inflammation and congestion in the lung’s small airways (bronchioles). A virus almost always causes bronchiolitis. Typically, the peak time for bronchiolitis is during the winter months.

Bronchiolitis starts out with symptoms similar to those of a common cold but then progresses to coughing, wheezing and sometimes difficulty breathing. Symptoms of bronchiolitis can last for several days to weeks.

Symptoms of Bronchiolitis

For the first few days, the signs and symptoms of bronchiolitis are similar to those of a cold:

Runny nose
Stuffy nose
Cough
A slight fever (not always present)

After this, there may be a week or more of difficulty breathing or a whistling noise when the child breathes out (wheezing).

Causes of Bronchiolitis

Bronchiolitis occurs when a virus infects the bronchioles, which are the smallest airways in the lungs. The infection makes the bronchioles swell and become inflamed. Mucus collects in these airways, making it difficult for air to flow freely in and out of the lungs.

Most cases of bronchiolitis are caused by the respiratory syncytial virus (RSV). RSV is a common virus that infects just about every child by 2 years of age. Outbreaks of RSV infection occur every winter, and individuals can be reinfected, as the previous infection does not appear to cause lasting immunity. Bronchiolitis also can be caused by other viruses, including those that cause the flu or the common cold.

The viruses that cause bronchiolitis are easily spread. A person can contract them through droplets in the air when someone who is sick coughs, sneezes or talks. A person can also get them by touching shared objects — such as utensils, towels or toys — and then touching the eyes, nose or mouth.

Risk Factors of Bronchiolitis

Bronchiolitis typically affects children under the age of 2 years. Infants younger than 3 months of age are at the greatest risk of getting bronchiolitis because their lungs and immune systems aren’t yet fully developed.

Other factors that are linked with an increased risk of bronchiolitis in infants and with more-severe cases include:

Premature birth
Underlying heart or lung condition
Depressed immune system
Exposure to tobacco smoke
Never having been breast-fed (breast-fed babies receive immune benefits from the mother)
Contact with multiple children, such as in a child care setting
Spending time in crowded environments
Having siblings who attend school or get child care services and bring home the infection

Complications of Bronchiolitis

Complications of severe bronchiolitis may include:

Blue lips or skin (cyanosis), caused by lack of oxygen
Pauses in breathing (apnea), which is most likely to occur in premature babies and in babies within the first two months of life
Dehydration
Low oxygen levels and respiratory failure

If these occur, a child may need to be in the hospital. Severe respiratory failure may require that a tube be inserted into the windpipe (trachea) to help the child’s breathing until the infection has run its course.

If a baby was born prematurely, has a heart or lung condition, or has a depressed immune system, watch closely for beginning signs of bronchiolitis. The infection can quickly become severe. In such cases, a child will usually need hospitalization.

Prevention of Bronchiolitis

Because the viruses that cause bronchiolitis spread from person to person, one of the best ways to prevent it is to wash hands frequently — especially before touching a baby when a person has a cold or other respiratory illness. Wearing a face mask at this time is appropriate.

If a child has bronchiolitis, keep him or her at home until the illness is past to avoid spreading it to others.

Other commonsense ways to help curb infection include:

Limit contact with people who have a fever or cold. If a child is a newborn, especially a premature newborn, avoid exposure to people with colds, especially in the first two months of life.
Clean and disinfect surfaces. Clean and disinfect surfaces and objects that people frequently touch, such as toys and doorknobs. This is especially important if a family member is sick.
Cover coughs and sneezes. Cover your mouth and nose with a tissue. Then throw away the tissue and wash your hands or use an alcohol-based hand sanitiser.
Use your own drinking glass. Don’t share glasses with others, especially if someone in your family is ill.
Wash hands often. Frequently wash your own hands and those of your child. Keep an alcohol-based hand sanitiser handy for yourself and your child when you’re away from home.
Breast-feed. Respiratory infections are significantly less common in breast-fed babies.

Diagnosis of Bronchiolitis

Doctor’s likely give a patient a physical exam. They may use a stethoscope to listen to their breathing and count the breaths per minute.

Doctors rarely order X-rays or blood tests for bronchiolitis. But if a child’s symptoms are severe or it’s unclear what’s causing them, they may get these tests:

Chest X-ray: This is done to look for possible signs of pneumonia.

Blood tests: Blood is taken to check the white blood cell count (these are cells that fight infection).

Pulse Oximetry: A sensor is taped to a child’s finger or toe to measure how much oxygen is in their blood.

Nasopharyngeal swab: a doctor will insert a swab into the nose to get a sample of mucus that will be tested for viruses.

Treatment of Bronchiolitis

There is no cure. It usually takes about 2 or 3 weeks for the infection to go away. Antibiotics and cold medicines are not effective in treating it.

Most children with bronchiolitis can be treated at home. There, you should watch to see if your child’s symptoms get worse or they have breathing problems.

A doctor may suggest these home treatments:

Give them plenty of liquids.
Use nose drops or sprays to help with a runny nose.
Use a bulb syringe, which is an at-home method to remove mucus from the nose.
Prop up their head with an extra pillow (but don’t do this if they are under a year old).

Nursing Diagnosis for Bronchiolitis

Ineffective Airway Clearance

Ineffective Breathing Pattern

Deficient Knowledge

Nursing Care Plans for Bronchiolitis Based on Diagnosis

Nursing Care Plan 1: Diagnosis – Deficient Knowledge

It may be related to a lack of information about the respiratory syncytial virus

Possibly evidenced by parents verbalize lack of understanding about RSV

Desired Outcomes

Parents will verbalize understanding of the condition, prevention methods, and treatment of RSV.

Nursing Interventions	Rationale
Assess existing knowledge of disease prevention, transmission, and treatment.	Provides a baseline for the type of information needed to prevent infection transmission to the child.
Teach that the virus is transmitted by direct and indirect contact via the nose and eyes and that hands should be kept away from these areas.	Explains that kissing and cuddling infant/small child and fomites that are on hard, smooth surfaces are sources of contact with the virus.
Teach parents about the signs and symptoms of respiratory distress and infection, including fever, dyspnea, tachypnea, and expectoration of yellow/green sputum.	Encourages parents to seek prompt medical attention as needed.
Teach of potential for spreading the virus to other family members and the need for segregation of infant/small child from others.	Explains that the virus is easily transmitted, with an incidence as high as half of the family members acquiring viral infections.
Suggest that plastic goggles may be worn when caring for an infant/small child.	Prevents the risk of contact with the virus via the eyes.
Teach good handwashing techniques for children and family members.	It prevents transmission by the hands, which are the main sources of contamination and carriers of organisms to the face area.
Encourage parents to provide good nutrition and hydration, emphasizing a high-calorie balanced diet and increased fluids (specify amounts).	Promotes liquification of secretions and replaces calories used to fight infection, thereby boosting the child’s own natural body defence.
Teach parents about the administration of medications prescribed.	Improves consistency of medication administration and the recognition of adverse side effects.
If hospitalized, adhere to infection control policies for clients with RSV.	Protects from exposure to secretions and transmission of the virus to other patients.
Encourage and teach parents to provide care for the hospitalized child at a comfortable level and within the constraints of necessary treatments. Teach parents about the prophylactic drugs (if ordered) of RespiGam or Synagis (specify). These drugs are given to high-risk infants only during the RSV season to prevent RSV infection of compromised infants. RespiGam is RSV immune globulin that is administered once a month during RSV season by IV infusion lasting several hours. The drug interferes with vaccine effectiveness. Synagis is a synthetic monoclonal antibody that is administered IM once a month during RSV season. The drug does not interfere with vaccines. It is very expensive.	Promotes parental identity and control; may lessen anxiety and stress.
Instruct parents regarding the drug Ribavirin if used during hospitalization: Side effects Type and purposes of isolation, including the use of masks, gloves, and/or gowns as applicable. Precautions utilized for parents, staff, and visitors, including information regarding potential risks of environmental exposure; advise pregnant women not to directly care for the child; decrease potential exposure by temporarily stopping the aerosols when tent/hood is opened and administer the drug in well-ventilated rooms (at least 6 air exchanges per hour) Strict handwashing before and after leaving the child’s room)	Promotes understanding which may lessen anxiety; prevents accidental exposures to the drug.
Teach family members about the appropriate disposal of soiled tissues and so forth.	Prevent the transmission of the disease.
Instruct parents on the importance of limiting the number of visitors and screening them for a recent illness.	Prevent transmission of the disease to others; prevent further complications in the child with RSV.

**Nursing Care Plans for Bronchiolitis**

Nursing Care Plan 2: Diagnosis – Ineffective Airway Clearance

It may be related to

Tracheobronchial obstruction, secretions, infection

Possibly evidenced by:

Diminished or absent breath sounds
Crackles, wheezes, rhonchi
Paroxysmal, nonproductive, and harsh, hacking cough
Change in rate and depth of respiration
Dyspnea and shallow respiratory excursion
Hyperresonance
Increased mucus and nasal discharge
Tachypnea
Fever

Desired Outcomes

The child will demonstrate effective coughing and clear breath sounds; is free of cyanosis and dyspnea.

Nursing Interventions	Rationale
Assess airway for patency.	Maintaining a patent airway is always the first priority, especially in cases like trauma, acute neurological decompensation, or cardiac arrest.
Assess respirations. Note quality, rate, pattern, depth, flaring of nostrils, dyspnea on exertion, evidence of splinting, use of accessory muscles, and position for breathing.	A change in the usual respiration may mean respiratory compromise. An increase in respiratory rate and rhythm may be a compensatory response to airway obstruction.
Assess breath sounds by auscultation.	Abnormal breath sounds can be heard as fluid and mucus accumulate. This may indicate airway is obstructed.
Assess cough (moist, dry, hacking, paroxysmal, brassy, or croupy): onset, duration, frequency, if it occurs at night, during the day, or during activity; mucus production: when produced, amount, colour (clear, yellow, green), consistency (thick, tenacious, frothy); ability to expectorate or if swallowing secretions, stuffy nose or nasal drainage.	Coughing is a mechanism for clearing secretions. An ineffective cough compromises airway clearance and prevents mucus from being expelled. Respiratory muscle fatigue, severe bronchospasm, or thick and tenacious secretions are possible causes of ineffective cough.
Provide for rest periods by organizing procedures and care and disturbing infant/child as little as possible in acute stages of illness.	Prevents unnecessary energy expenditure resulting in fatigue.
Elevate the head of the bed at least 30° for the child and hold infant and young child in the lap or in an upright position with the head-on shoulder; an older child may sit up and rest head on a pillow on an overbed table.	Upright position limits abdominal contents from pushing upward and inhibiting lung expansion. This position promotes better lung expansion and improved air exchange.
Encourage fluid intake at frequent intervals over 24-h time periods, specify amounts.	Fluids help minimize mucosal drying and maximize ciliary action to move secretions.
Reposition on sides q 2h; position child in proper body alignment.	Prevents accumulation and pooling of secretions.
Assist in performing deep breathing and coughing exercises in a child when in a relaxed position for postural drainage unless procedures are contraindicated; use incentive spirometer in an older child, blowing up a balloon, blowing bubbles, blowing a pinwheel or blowing cotton balls across the table in a younger child.	Vibration loosens and dislodges secretions, and gravity drains the airways and lung segments through Promotes deeper breathing by enlarging the tracheobronchial tree and initiating cough reflex to remove secretions.
Teach parents and possibly older children (specify) administration of medications via a proper route with name and action of each drug: dosage; why given; frequency; time of day or night; side effects to report; how to administer in food—crushed, chewable, by measured dropper, or other recommended form; and method (nose drops, inhaler).	Ensures compliance with correct drug dosage and other considerations for administrations for desired results and what to do if side effects occur.

Nursing Care Plan 3: Diagnosis – Ineffective Breathing Pattern

It may be related to:

Increased work of breathing
Inflammatory process
Tracheobronchial obstruction

Possibly evidenced by:

Cough
Nasal flaring
Dyspnea
Tachypnea
Shallow respiratory excursion
Suprasternal and subcostal retractions
Abnormal arterial blood gases (ABGs)

Desired Outcomes

The child will maintain an effective breathing pattern, as evidenced by relaxed breathing at a normal rate and depth and absence of dyspnea.

Nursing Interventions	Rationale
Assess respiratory status, a minimum of every 2–4 hours or more often, as indicated for a decreasing respiratory rate and apnea episodes.	Changes in breathing patterns may occur quickly as the child’s energy reserves are depleted. Assessment and monitoring baseline reveal rate and quality of air exchange. Frequent assessment and monitoring provide objective evidence of changes in the quality of respiratory effort, enabling prompt and effective intervention.
Assess chest configuration by palpation; auscultate for breath sounds that indicate a movement restriction (absent or diminished, crackles or rhonchi).	This is to detect decreased or adventitious breath sounds.
Note for changes in the level of consciousness.	Restlessness, confusion, and/or irritability can be early indicators of insufficient oxygen to the brain.
Assess pulse rate and oxygen saturation using pulse oximetry.	Pulse oximetry is a helpful tool to detect alterations in oxygenation initially; but, for CO2 levels, end-tidal CO2 monitoring or arterial blood gases (ABGs) would require obtaining.
Monitor arterial blood gases.	Monitors oxygenation and ventilation status.
Position the head of the bed up or place the child in a position of comfort on the parent’s lap if crying or struggling in a crib or bed.	The position facilitates improved aeration and promotes a decrease in anxiety (especially in toddlers) and energy expenditure.
Encourage frequent rest periods and teach the patient to pace activity.	Extra activity can worsen shortness of breath. Ensure the patient rests between strenuous activities.
Assist and demonstrate proper deep breathing exercises.	Promotes deep inspiration, which increases oxygenation and prevents atelectasis.
Maintain a clear airway by encouraging the patient to mobilize their own secretions with successful coughing.	Facilitates adequate clearance of secretions.
Provide humidified oxygen via face mask, hood, or tent.	Humidified oxygen loosens secretions, helps maintain oxygenation status and ease respiratory distress.

References

ncbi.gov
scholar.google.com

Related FAQs

1. What is the difference between bronchitis and bronchiolitis?

Both can be caused by a virus. Both affect the airways in the lungs, but bronchitis affects the larger airways (the bronchi).Bronchiolitis affects the smaller airways (bronchioles). Bronchitis usually affects older children and adults, while bronchiolitis is more common in younger children.

2. What is the best treatment for bronchiolitis?

Relieving symptoms — There is no treatment that can get rid of bronchiolitis, so treatment is aimed at relieving symptoms until the infection resolves. Treatment at home usually includes making sure the child drinks enough and using saline nose drops (or bulb suctioning for infants) to keep the nose clear.

3. Can bronchiolitis turn into pneumonia?

Bronchitis and pneumonia are two lung infections with similar symptoms. In some cases, bronchitis can turn into pneumonia. This occurs when an infection spreads from the airways to the air sacs in the lungs. It is also possible for a person with bronchitis to develop a separate pneumonia infection.

4. How do you get rid of bronchiolitis in adults?

There’s currently no cure for the scarring of bronchiolitis obliterans. Treatment options include: Corticosteroids can help clear the lungs of mucus, reduce inflammation, and open up the airways. You may need oxygen treatments and immunosuppressant medications to regulate your immune system.

https://customnursingassignments.com/nursing-care-plans-for-bowel-obstruction/

https://customnursingassignments.com/nursing-care-plans-for-bipolar-disorder/

April 29, 2022

Nursing Care Plans for Bowel Obstruction Based on Diagnosis – Best Nursing Care Plans(2022)

This article discusses Nursing Care Plans for Bowel Obstruction plus its causes, symptoms, preventions, treatments and interventions.

Permalink: https://customnursingassignments.com/nursing-care-plans-for-bowel-obstruction

customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us.(Nursing Care Plans for Bowel Obstruction)

Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Introduction

Bowel obstruction is a serious problem that happens when something blocks the bowels, either the large or small intestine. It’s also known as an intestinal obstruction. If the digestive system comes to a grinding halt, a person can’t have a bowel movement or pass gas. A person might also notice stomach pain and a swollen belly.

A common type of blockage is called fecal impaction. This is when a large, hard mass of poop gets stuck in the digestive tract and can’t get pushed out the usual way. But when the bowel is blocked by something other than hard stool, doctors call it a bowel obstruction.

Types of Bowel Obstruction

A bowel obstruction may be a partial blockage or a complete blockage. A person can also have what’s called pseudo-obstruction. This is when a person has symptoms of bowel obstruction, but nothing is physically blocking it. It can happen because of problems with the gastrointestinal muscles or with the nerves that control them.

Pseudo-obstruction

Intestinal pseudo-obstruction (paralytic ileus) can cause signs and symptoms of intestinal obstruction, but it doesn’t involve a physical blockage. In paralytic ileus, muscle or nerve problems disrupt the normal coordinated muscle contractions of the intestines, slowing or stopping the movement of food and fluid through the digestive system.

Paralytic ileus can affect any part of the intestine. Causes can include:

Abdominal or pelvic surgery
Infection
Certain medications that affect muscles and nerves, including antidepressants and opioids
Muscle and nerve disorders, such as Parkinson’s disease

Bowel Obstruction Symptoms

Signs of intestinal blockage will depend on how severe the obstruction is. But it almost always comes with belly pain, usually around your belly button and cramping. Other signs include:

Constipation
Can’t pass gas
Lack of appetite
Nausea or vomiting
A hard, swollen belly
Diarrhea (with a partial blockage)

Many people with bowel obstructions are older and may have other serious illnesses, so a bowel obstruction may be life-threatening.

Causes of Bowel Obstruction

The bowel could become blocked in several ways:

Part of the bowel may get twisted, which can close it off and keep anything from passing through.
It can get inflamed and swell up.
Part of the intestine can slide into another part like a telescope (intussusception).
Scar tissue or a hernia could make the bowel too narrow for anything to pass through.
A tumor or other type of growth inside the bowel could block it.
Damaged blood vessels leading to the bowel can cause some bowel tissue to die.
Inflammation, surgeries, or cancer can cause bowel obstruction in many cases. It’s more likely to happen in older people.

Risk Factors for Bowel Obstruction

Bowel obstructions can happen in your small or large intestine, but they’re more likely to be in the small intestine. A person might be at higher risk if they have:

Crohn’s disease
Diverticulitis
Hernia
Colon cancer
Stomach cancer
Ovarian cancer
Scar tissue from surgery
Radiation to the belly
Lung cancer, breast cancer, or melanoma that’s spread to the bowel

Bowel Obstruction Diagnosis

A doctor will ask about the patient’s medical history, including whether they have been constipated, if they have had cancer, and what new symptoms they have had. The doctor may also:

Do a physical exam to see if a patient has pain in the belly, if he/she can be able to pass gas, or if they can feel a lump in the belly
Order blood tests
Order urine tests
Order a CT scan or an X-ray to look for a blockage
Give a barium enema. They’ll put a special liquid that contains barium (a whitish-silver metal) into the rectum. It will spread into the bowels and show on an X-ray as a bright area. If there’s a blockage, the barium may show it.

Bowel Obstruction Treatment

A doctor may give medicine and fluids through a vein (intravenous or IV). They may also run a thin tube through the nose and into the stomach. This is called a nasogastric (NG) tube. It lets out fluids and gas to ease the symptoms.

Most partial blockages get better on their own. A doctor may give a special diet that’s easier on the intestines.

Enemas of air or fluid can help clear blockages by raising the pressure inside the bowels.

A mesh tube called a stent is a safe option for people who are too sick for surgery. A doctor puts it in the intestine to force the bowel open. Some people may not need anything more than a stent. Others may need surgery after they become stable.

Surgery is usually the best treatment for a totally blocked intestine when the bowel is damaged. A doctor can treat the cause of the obstruction or take out the blocked area and any damaged tissue.

If a patient has surgery, they may need a colostomy or ileostomy. After a doctor takes out the damaged part of the intestine, they sew the rest to an opening in the skin. The poop exits the body through this opening and goes into a disposable bag. In some cases, the intestines can be reattached after the patient gets better.

Nursing Care Plans for Bowel Obstruction Based on Diagnosis

Nursing Care Plan 1: Diagnosis – Acute Pain (Abdominal)

Acute pain related to bowel obstruction as evidenced by reports of cramping abdominal pain and restlessness

Desired Outcome

The patient will be able to have reduced pain levels of less than 3 to 4 on a rating scale of 0 to 10 with improved patient baseline vital signs and mood.

Nursing Interventions	Rationale
Anticipate occurrence by providing measures to relieve pain, especially before it becomes severe.	Anticipating occurrence and episodes of severe pain will provide continued relief to the patient. Timely pain assessment ensures that the patient has controlled pain levels and the continuity of daily living activities.
Provide cognitive-behavioral therapy of the patient’s pain through the following: Distraction such as watching TV, reading, etc. Eliciting the relaxation response such as directed meditation, deep breathing, etc. Guided imagery	Providing cognitive-behavioral therapy provides comfort by changing the patient’s perception of pain. Distraction techniques help with pain control by lessening the patient’s perception of pain. Increased stress levels are related to the increase in pain levels. Invoking the relaxation response may decrease the effects of stress on pain. Guided imagery such as using mental pictures or relaxing events will help the patient to be distracted from the pain.
Offer cutaneous stimulation or physical interventions through the following: Heat and cold applications Contralateral stimulation Transcutaneous Electrical Nerve Stimulation (TENS)	Cutaneous stimulation may provide temporary pain relief through tactile stimulation. Cold is effective in reducing pain by decreasing the release of pain-inducing chemicals, while heat is helpful by improving blood flow and reduction of pain impulses. This technique is used when touching the painful area and is done by stimulating the skin opposite the painful area. This method may be used to apply low-volt electricity over painful areas and thereby temporarily the pain pathways, thereby providing pain relief.
Provide pharmacologic pain treatment as indicated and ordered.	Adequate and timely administration of pain medications ensures continued and effective pain relief to the patient. Compliance with the prescribed treatment regimen ensures that effectivity levels are maintained to provide analgesia to the patient.
Perform nursing care at the peak levels of pain medications.	Careful scheduling of tasks during peaks of effectivity of pain medications ensures optimal client comfort and compliance to care.