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

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

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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.


Pneumonia is a lung infection that causes the air sacs in one or both lungs to become inflamed. Cough with phlegm or pus, fever, chills, and trouble breathing can occur when the air sacs fill with fluid or pus (purulent material). Pneumonia can be caused by various species, including bacteria, viruses, and fungus.

The severity of pneumonia can range from minor to life-threatening. Infants and young children, persons over the age of 65, and people with health problems or compromised immune systems are the most vulnerable.

Signs and Symptoms of Pneumonia

The following are some of the signs and symptoms of bacterial pneumonia:

  1. Lips and fingernails are a bluish tint.
  2. Delirium, or a confused mental state, is common in the elderly.
  3. Mucus that is green, yellow, or red when coughed
  4. Fever
  5. Sweating profusely
  6. Appetite loss.
  7. Low energy and excessive exhaustion
  8. Breathing quickly.
  9. The heart beats quickly.
  10. Chills shivering
  11. Sharp or stinging chest pain that gets worse when you cough or breathe deeply
  12. Shortness of breath that worsens as you go more active

The early signs of viral pneumonia are similar to those of bacterial pneumonia, and they can include:

  • Headache
  • Shortness of breath is getting worse.
  • Muscle ache
  • Weakness
  • Coughing has gotten worse.

Causes of Pneumonia

Pneumonia has more than 30 different causes, which are categorised according to the cause. The following are the most common types of pneumonia:

Bacterial pneumonia. A variety of bacteria brings on this type. Streptococcus pneumoniae bacteria is the most frequent. It usually happens when the body is weakened in some way, such as by disease, inadequate nutrition, advanced age, or decreased immunity, allowing germs to enter the lungs. Bacterial pneumonia can afflict people of all ages. Still, those who abuse alcohol, smoke cigarettes, are disabled, have recently had surgery, have a respiratory ailment or viral infection, or have a weaker immune system are at higher risk.

Viral pneumonia. This type of pneumonia is caused by various viruses, including the flu (influenza), and accounts for roughly one-third of all instances of pneumonia. You may be more susceptible to bacterial pneumonia if you have viral pneumonia.

Mycoplasma pneumonia. Atypical pneumonia is a form of pneumonia with slightly distinct symptoms and physical characteristics. Mycoplasma pneumoniae is the bacteria that causes it. It creates moderate, widespread pneumonia that affects people of all ages.

Other types of pneumonia. Other infections, such as fungi, can cause other pneumonia that are less prevalent.

Risk factors of Pneumonia

  1. Using a cigarette
  2. A respiratory viral infection that occurred recently (common cold, laryngitis, influenza)
  3. Stroke, dementia, Parkinson’s disease, or other neurological diseases can make swallowing difficult.
  4. Chronic obstructive pulmonary disease (COPD) (COPD, bronchiectasis, cystic fibrosis)
  5. Cerebral palsy is a condition that affects the brain.
  6. Other significant ailments include heart disease, cirrhosis of the liver, and diabetes mellitus.
  7. Being a resident of a nursing home
  8. Consciousness impairment (loss of brain function due to dementia, stroke, or other neurologic conditions)
  9. Trauma or recent surgery
  10. An issue with the immune system.

Diagnosis of Pneumonia

Diagnosis is normally made primarily based totally on your latest fitness records (including surgery, a cold, or journey exposures) and the volume of the illness. Your healthcare company might also diagnose pneumonia clearly on an intensive record and bodily examination based on those factors.

 The following exams can be used to verify the diagnosis:

 Chest X-ray – This check takes photographs of inner tissues, bones, and organs, including the lungs.

Blood exams – This check can be used to look at whether or not contamination is a gift and if contamination has unfolded to the bloodstream (blood cultures). Arterial blood fuel online trying out assessments the quantity of oxygen in your bloodstream.

Sputum culture– This check is carried out at the cloth coughed up from the lungs and into the mouth. It’s regularly used to look if there’s contamination inside the lungs.

Pulse oximetry – An oximeter is a small device that measures the quantity of oxygen inside the blood. A small sensor is taped or clipped onto a finger. A small purple mild may be visible inside the sensor when the device is on. The check is painless, and the purple mild does now no longer get hot.

Chest CT test. This imaging technique uses a mixture of X-rays and computer technology to provide sharp, distinctive horizontal or axial photographs (regularly referred to as slices) of the body. A CT test suggests distinctive photographs of any part of the body, including the bones, muscles, fat, and organs. CT scans are greater distinctive than ordinary X-rays.

Bronchoscopy – This is a direct examination of the bronchi (the primary airlines of the lungs) by using a bendy tube (referred to as a bronchoscope). It enables to assess and diagnose lung problems, check blockages, and take out tissue and fluid testing samples.

Pleural fluid culture -In this check, a pattern of a fluid pattern is taken from the pleural space. This is the gap between the lungs and chest wall. A long, skinny needle is placed via the pores and skin among the ribs and into the pleural space. Fluid is pulled right into a syringe connected to the needle. It is despatched to the lab in which it’s examined to discover which microorganism is inflicting pneumonia.

Complications of Pneumonia

Although most patients with pneumonia react favourably to therapy, pneumonia can be extremely dangerous and even fatal.

If you’re an older adult, a very small child, have a weaker immune system or have a significant medical disease like diabetes or cirrhosis, you’re more likely to experience difficulties. Among the potential complications are:

Acute respiratory distress syndrome (ARDS) is a condition in which the body (ARDS). This is the most serious type of respiratory failure.

Abscesses in the lungs. These are pus-filled pockets that develop inside or around the lungs. They may need to be surgically drained.

Failure of the lungs. This necessitates the use of a ventilator or breathing equipment.

Sepsis. This is the point at which the pathogen enters the bloodstream. It has the potential to cause organ failure.

Treatment for pneumonia

The sort of pneumonia you have will determine your treatment options. Pneumonia is usually treated at home, but severe cases may require hospitalisation. Bacterial pneumonia is treated with antibiotics. Antibiotics can also help with mycoplasma pneumonia and other rare situations. The majority of viral pneumonia have no specific treatment. They typically improve on their own.

Other treatments could include proper nutrition, increased hydration intake, rest, oxygen therapy, pain medication, fever control, and possibly cough drugs if the cough is severe.

Prevention of Pneumonia

To help prevent pneumonia, do the following steps:

Get a vaccine. Some kinds of pneumonia and the flu can be prevented with vaccines. Make an appointment with your doctor to obtain these shots. Immunisation requirements have changed over time, so check with your doctor about your vaccination status, even if you recall receiving a pneumonia vaccine earlier.

Ascertain that your children are immunised. Children under the age of 2 and children aged 2 to 5 years who are at high risk of pneumococcal disease should receive a separate pneumonia vaccine. Vaccination is also recommended for children who attend a group child care centre. According to doctors, children above the age of six months should also get flu vaccines.

Maintain a healthy level of hygiene. Wash your hands frequently or use an alcohol-based hand sanitiser to protect yourself from respiratory infections that can lead to pneumonia.

Please don’t smoke. The natural defences of your lungs against respiratory infections are harmed by smoking.

Maintain a healthy immune system. Get plenty of rest, exercise regularly, and eat a nutritious diet.

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Nursing care plans for pneumonia
Nursing Care Plans for Pneumonia

Nursing Care Plans for Pneumonia Based on the Diagnosis

Nursing Diagnosis for Pneumonia

  1. Ineffective Airway Clearance
  2. Impaired Gas Exchange
  3. Ineffective Breathing Pattern

Nursing Care Plan 1: Ineffective Airway Clearance

A common NANDA-I nursing diagnostic for pneumonia nursing care plans is ineffective airway clearance. Excessive secretions and ineffective or nonproductive coughing are associated with this diagnosis. Inflammation and excessive secretions make maintaining a patent airway challenging in pneumonia.

Desired Outcomes

To clear the airway, the patient will identify and show activities.

As indicated by preserving a patent airway and properly clearing secretions, the patient will display/maintain a patent airway with breath sounds clearing; absence of dyspnea and cyanosis.

Nursing Assessment and Rationales

1. Examine your breathing rate, rhythm, and depth, as well as your chest movement and auxiliary muscle use.

Because of the discomfort of moving the chest wall and fluid in the lung as a compensatory response to airway blockage, tachypnea, short respiration, and asymmetric chest movement are common. Breathing patterns may be altered in conjunction with auxiliary muscles to promote chest excursion and facilitate successful breathing.

2. Assess cough effectiveness and productivity

Coughing is the most efficient method of secretion removal. Pneumonia sufferers may have thick, sticky secretions.

3. Examine the lungs, noting areas of reduced or absent airflow, as well as unusual breath, sounds such as crackles and wheezes.

In regions where there is a buildup of fluid, airflow is reduced. These consolidated areas can also produce bronchial breath sounds. Fluid accumulation, thick secretions, and airway spasms and blockage cause crackles, rhonchi, and wheezes on inspiration and expiration.

4. Examine the colour, viscosity, and odour of the sputum. Changes should be reported.

Changes in the properties of sputum could suggest an infection. Discoloured, sticky, or odorous sputum may worsen airway resistance, necessitating further treatment.

5. Determine the patient’s hydration level.

Inadequate hydration and thickening of secretions obstruct airway clearance.

Nursing Interventions and Rationales

The ineffective airway clearance nursing procedures and activities for pneumonia and their rationales or scientific justifications are discussed in this section.

  1. Raise the head of the bed and shift positions often.

The diaphragm would be lowered, allowing for chest expansion, aeration of lung segments, mobilisation, and secretory expectoration.

  • Instruct and support the patient in deep-breathing exercises. Demonstrate correct chest splinting and successful coughing while standing upright. Encourage the patient to do so regularly.
  • Deep breathing exercises boost cough productivity by allowing maximum expansion of the lungs and smaller airways.
  • Coughing is a reflex and a natural self-cleaning process that helps the cilia keep the airways open and clear. It is the most effective method for removing most secretions.
  • Splinting relieves chest discomfort, and standing upright encourages a deeper, more powerful cough, which is more effective.
  • Suction as needed: frequent coughing, unusual breath sounds, and desaturation from airway secretions.

Stimulates cough or clears the airway manually in a patient who cannot do so due to an inefficient cough or a reduced degree of consciousness. Suctioning can induce increased hypoxemia, so make sure you get plenty of oxygen before, during, and after you suction.

  • If necessary, assist with bronchoscopy and thoracentesis.
  1. Bronchoscopy is used to remove mucous plugs, drain purulent secretions, and gather lavage samples for culture and sensitivity testing.
  2. Thoracentesis is performed to drain pleural effusions and avoid atelectasis.
  • If the patient’s health worsens, anticipate the need for supplemental oxygen or intubation.

To correct the hypoxemia, these measures are required. Intubation is required for deep suctioning and provides a source of oxygenation supplementation.

  • Unless contraindicated, maintain appropriate hydration by forcing fluids to at least 3000 mL per day (e.g., heart failure). Warm fluids are preferred over cold fluids.

Fluids, particularly warm drinks, help mobilise and expectorate secretions. Fluids aid in hydration, improve ciliary activity to eliminate secretions and decrease secretion viscosity. Coughing up thinner secretions is easy.

  • Assist with and monitor the effects of nebuliser therapy and another respiratory physiotherapy, such as incentive spirometers, IPPB, percussion, and postural drainage. Treatments should be done in between meals, and fluid intake should be limited as necessary.
  1. Nebulisers thin secretions by humidifying the airway and facilitating liquefaction and expectoration.
  1. Postural drainage may not be as efficient in interstitial pneumonia or those involving alveolar exudate or destruction.
  2. Incentive spirometry can avoid atelectasis by improving deep breathing.
  3. Chest percussion loosens and mobilises secretions that cannot be eliminated by coughing or suctioning in narrower airways.
  4. The likelihood of vomiting with coughing and expectorations is reduced when therapies and oral intake are coordinated.

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Nursing care plans for pneumonia
Nursing Care Plans for Pneumonia

Nursing Care Plan 2: Impaired Gas exchange

Desired Outcomes

ABGs will show increased ventilation and oxygenation of tissues within the patient’s tolerable range and the lack of respiratory distress signs.

The patient’s gas exchange will be maintained at an ideal level.

The patient will take part in activities that will improve oxygenation.

Nursing Assessment and Rationales

  1. Evaluate breathing: take note of the quality, pace, rhythm, depth, usage of accessory muscles, ease, and adopted position for easy breathing.

As patients alter their breathing patterns to support effective gas exchange, symptoms of respiratory distress are dependent on/indicative of the degree of lung involvement and underlying general health state. Gas exchange is directly influenced by rapid, shallow breathing patterns and hypoventilation. Signs of increased respiratory effort are linked to hypoxia. The use of a tripod indicates significant dyspnea.

  • Look at the colour of your skin, mucous membranes, and nail beds to see if you have peripheral cyanosis (nail beds) or central cyanosis (skin, mucous membranes, and nail beds) (circumoral).

Peripheral tissues become cyanotic as oxygenation and perfusion are compromised. Cyanosis of the nail beds may indicate vasoconstriction or the body’s reaction to a fever or chills; however, cyanosis of the earlobes, mucous membranes, and skin around the mouth (“warm membranes”) indicates systemic hypoxemia.

  • Evaluate mental health, restlessness, and changes in consciousness.

Hypoxemia and reduced brain oxygenation can cause restlessness, irritability, disorientation, and drowsiness, which need further treatment. In older persons, check pulse oximetry readings if their mental status changes.

  • Keep an eye on your body temperature as directed. Assist with fever and chill relief by adding or removing bedcovers, maintaining a comfortable room temperature, and taking a tepid or cool water sponge bath.

Fever (which is frequent in bacterial pneumonia and influenza) raises metabolic demands and oxygen consumption and alters cellular oxygenation.

  • Keep an eye out for signs of worsening, such as hypotension, bloody sputum, pallor, cyanosis, LOC changes, severe dyspnea, and restlessness.

The most prevalent causes of death in pneumonia are shock and pulmonary oedema, both of which require prompt medical attention.

  • Check ABGs and pulse oximetry.

It monitors the progression of the disease and allows for changes in pulmonary therapy. Changes in oxygenation are detected by pulse oximetry. O2 saturation levels should be at least 90%.

  • Evaluate your anxiety level and encourage you to verbally express your feelings and concerns.

Anxiety is a symptom of psychological distress and physiological responses to hypoxia. The psychological component can be reduced by providing reassurance and increasing a sense of security, lowering oxygen consumption and unpleasant physiological responses.

  • Keep an eye on your heart rate and rhythm, as well as your blood pressure.

Tachycardia is commonly caused by fever and dehydration, but it can also respond to hypoxia—initial hypoxia and hypercapnia raise blood pressure and heart rate. With dysrhythmias, BP may drop as hypoxia becomes more severe, whereas HR tends to be fast.

Nursing Interventions and Rationales

  1. Maintain bed rest by carefully scheduling activity and rest hours to save energy. Encourage the use of relaxation techniques and activities that provide a change of pace.

It minimises overexertion and lowers oxygen needs, making infection resolution easier. Relaxation techniques help you save energy to focus on breathing and coughing more effectively.

  • Encourage frequent position changes, deep breathing, and productive coughing by elevating the head of the bed.

These techniques encourage maximum chest expansion, secretion mobilisation, and improved ventilation.

  • Use nasal prongs, a mask, or a Venturi mask to administer oxygen therapy.

The goal of oxygen treatment is to keep PaO2 levels above 60 mmHg. Oxygen is provided using a mechanism that ensures proper delivery while staying within the patient’s tolerance. Note: Oxygen should be provided with caution to patients with underlying chronic lung disorders.

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Nursing care plans for pneumonia
Nursing Care Plans for Pneumonia

Nursing Care Plan 3: Ineffective Breathing Pattern

The nursing diagnostic of Ineffective Breathing Pattern, in this case, is linked to compensatory tachypnea as a result of a failure to meet metabolic needs. Many pneumonia patients have this problem. Because of chest pain and elevated body warmth, damaged alveoli cannot adequately exchange oxygen and carbon dioxide, resulting in changes in breathing patterns.

Desired Outcomes

As shown by calm breathing at a normal rate and depth and the absence of dyspnea, the patient maintains an effective breathing pattern.

The patient’s respiration rate is within normal norms.

Nursing Assessment and Rationales

The following are nurse assessments for pneumonia nursing care plans that target inefficient breathing patterns.

  1. Measure and record your breathing rate and depth at least once every four hours.

Adults breathe at a pace of 10 to 20 breaths per minute on average. When there is a change in breathing patterns, it is critical to act quickly to recognise early indicators of respiratory compromise.

  • Determine ABG levels in accordance with facility policies.

This device keeps track of your oxygenation and ventilation levels.

  • Keep an eye on the patient’s breathing habits.

Breathing patterns that are unusual could indicate an underlying sickness or dysfunction. Cheyne-Stokes respiration is a symptom of bilateral brain damage or metabolic disorders in the deep cerebral or diencephalon. The failure of the respiratory centres in the pons and medulla is linked to apneusis and ataxic breathing.

  • Listen to your breath for at least four (4) hours.

This is to identify abnormal or diminished breath sounds.

  • Determine whether or not auxiliary muscle is being used.

As lung compliance declines, the amount of work required to breathe climbs dramatically.

  • Keep an eye out for diaphragmatic muscle weakness or tiredness (paradoxical motion).

The inward versus outward displacement of the belly during inspiration is symptomatic of respiratory muscle exhaustion and weakening.

Nursing Interventions and Rationales

  1. Align the patient’s body properly for the best breathing rhythm.

Sitting allows for the most lung excursion and chest expansion.

  •  Encourage long, deep breaths by doing the following:
  1. Demonstration: gradual inhalation, holding end inspiration for a few seconds, and quiet exhalation are all highlighted.
  2. Using a spirometer with an incentive
  3. Insisting on the patient yawning

Deep inspiration is encouraged by these procedures, which enhances oxygenation and prevent atelectasis. Controlled breathing techniques may also help tachypneic patients breathe more slowly. Air trapping is avoided by exhaling slowly.

  • Encourage diaphragmatic breathing in chronic illness patients.

This approach relaxes muscles while also increasing oxygen levels in the patient.

  • Encourage the patient to cough successfully to mobilise their own secretions and maintain a clear airway.

This allows for proper secretion clearance.

  • Teach the following to the patient:
  1. Breathing with a pursed-lip
  2. Breathing from the abdomen
  3. Using relaxing methods
  4. Taking Prescription Drugs (ensuring the accuracy of dose and frequency and monitoring adverse effects)
  5. Planning activities to avoid exhaustion and allow for rest times
  6. Ambulate the patient three times daily, as tolerated by the patient and as directed by the doctor.

Secretions that have clogged the airways can be broken up and moved by ambulation.

  • Encourage the patient to take regular breaks and teach them how to pace themselves.

Shortness of breath might be exacerbated by increased activity. Ensure that the patient gets plenty of rest in between heavy activity.

  • Encourage regular little meals.

This keeps the diaphragm from getting too crowded.

  • Make sure there’s a fan in the room.

Feelings of air hunger can be alleviated by moving air.

Related FAQs

1. What are nursing plan of pneumonia?

Nursing interventions for pneumonia and care plan goals for patients with pneumonia include measures to assist in effective coughing, maintain a patent airway, decreasing viscosity and tenaciousness of secretions, and assist in suctioning.

2. What are the 4 main parts of a nursing care plan?

Nursing care plan formats are usually categorized or organized into four columns: (1) nursing diagnoses, (2) desired outcomes and goals, (3) nursing interventions, and (4) evaluation.

3. What is interprofessional care for pneumonia?

Interprofessional care is a collaborative practice approach for a harmonious process of patient care. Teamwork produces better patient outcomes and efficient healthcare delivery. Managing pneumonia is challenging, especially COVID-19 pneumonia.

4. How do you position a patient with pneumonia?

Lateral decubitus positioning with “the good side down” can significantly improve oxygenation in many adult patients with unilateral parenchymal lung disease (e.g., lobar pneumonia). In the intensive care unit, continuous rotational therapy has been reported to reduce pulmonary complications.

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