NURSING CARE PLAN FOR A PERSON WITH CROUP

NURSING DIAGNOSIS
Ineffective airway clearance related to presence of thick, tenacious mucus as
evidenced by persistent barking (croupy) cough, thick secretions, diminished breath sounds,
with diffuse crackles and rhonchi, dyspnea, tachypnea, and tachycardia.
INFERENCE
Croup refers to a variety of conditions characterized by a harsh “barking”
(croupy) cough, inspiratory stridor, hoarseness, and marked respiratory retraction. The
condition usually affects infants and small children between 3 months and 3 years of age
and occurs during the cold weather.

The most common form of croup is laryngotracheobronchitis (LTB). It is caused by an

acute viral infection of the larynx, trachea, and bronchi resulting in the obstruction below
the level of the vocal cords. Spasmodic croup is croup of sudden onset, developing at night
and characterized by laryngeal obstruction at the level of the vocal cords caused by viral
infections or allergens. Both occur as a result of upper respiratory infection, edema, and
spasms that cause respiratory problems in varying degrees depending on the severity of
obstruction.

NURSING GOAL AND OBJECTIVE

At the end 1week of nursing intervention, the client will:

 Be able to maintain clear, open airways
 Be able to have normal breath sounds
 Have normal rate and depth of respiration
 Have the ability to effectively cough up secretions after treatments and deep
breaths.
NURSING INTERVENTION AND RATIONALE

NURSING INTERVENTION RATIONALE

Observe the sound of cough. Grunting is produced during expiration by a
premature glottic closure. It is an effort to
maintain or increase functional residual
capacity.
Assess the use of accessory muscles with As the trachea and larynx become inflamed
nasal flaring and swollen, a child with croup produces a
bark-like cough and hoarse or muffled vocal
sounds. When it progresses, the child may
manifest further upper airway obstruction
with severely compromised oxygenation.
Advise the patient’s significant others to To maintain adequate hydration can help
increase fluid intake and maintain loosen mucus in the oropharynx and
intravenous fluid as prescribed. prevent dehydration.
 Place the child elevated in a semi- To facilitates breathing and maximal lung
Fowler’s to high Fowler’s position; expansion by lowering the diaphragm.
Reposition the child frequently. Frequent reposition prevents pooling and
stasis of secretions.
Use a cool mist humidifier or allow a hot To cool mist and humidity soothe inflamed
shower to run for 10 minutes until the airways and decreases the viscosity of the
bathroom becomes humid and steamy, mucus thus helps in clearing the airway.
then let the child sit or stand in the
bathroom.
Perform chest physiotherapy as indicated. To promote expansion of the lungs,
strengthen respiratory muscles and
mobilization of secretions.

EVALUATION
After rendering nursing intervention, the client

 Have maintained clear, open airways

 Have normal breath sounds
 Have normal rate and depth of respiration
 Have the ability to effectively cough up secretions after treatments and deep
breaths.
Thus, the goal was totally met.