Bronchitis: 9 Nursing Care Plans

Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. Bronchitis can be divided into two categories, acute and chronic, each of which has two distinct etiologies, pathologies, and therapies.

Acute bronchitis is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated (coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis, whereas bacteria account for fewer than 10%.

Chronic bronchitis, a type of chronic obstructive pulmonary disease, is characterized by the presence of a productive cough that lasts for three months or more per year for at least two years. Chronic bronchitis most often develops due to recurrent injury to the airways caused by inhaled irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants.

9 Nursing Diagnosis For Bronchitis

1. Ineffective airway clearance
related to: increased production of secretions.

2. Acute pain
related to: the inflammation of the pleura.

3. Impaired gas exchange
related to: airway obstruction by secretions, spasm of the bronchus.

Nursing Diagnosis : Impaired Gas Exchange

Goal: Demonstrate improved ventilation and adequate oxygenation of tissues with blood gas analysis in the normal range and free of symptoms of respiratory distress.

Nursing Interventions - Impaired Gas Exchange related to Bronchitis:

a. Assess the frequency, depth of breathing. Note the use of accessory muscles, mouth breathing, inability to speak / talk.
R / useful in the evaluation of the degree of respiratory distress and / or chronic disease process.

b. Elevate head of bed, help patients to choose a position that is easy to breathe. Encourage deep breath or breathing lips slowly as needed / individual tolerance.
R / oxygen delivery can be improved by a high seating position and breathing exercises to reduce airway collapse, dyspnea, and breath work.

c. Provide appropriate bronchodilator required. Can be administered orally, IV, rectal, or inhaled. Give oral bronchodilators or IV at the time interspersed with the action nebulizer, metered dose inhalers to extend the effectiveness of the drug. Observation of side effects: tachycardia, dysrhythmias, CNS excitation, nausea and vomiting.
R / Bronchodilators dilate the airway and helps fight the bronchial mucosal edema and muscular spasm. Because side effects can occur in this action, carefully adjusted doses for each patient, according to tolerance and clinical response.

d. Evaluate the effectiveness of the actions nebulizer, metered dose inhalers. Assess decrease shortness of breath, wheezing or crackles drop, looseness secretion, decreased anxiety. Make sure that the action is given before meals to prevent nausea and to reduce the fatigue that accompanies feeding activity.
R / Combining medication with a nebulizer aerosolized bronchodilator commonly used to control bronchoconstriction. Providing appropriate actions will reduce its effectiveness. Aerolisation ease bronchial clearance, help control the inflammatory process, and improve the function of ventilation.

e. Instruct and encourage the patient on diaphragmatic breathing and effective coughing.
R / techniques improve ventilation by opening the airway and clearing the airway of sputum. Improvement of gas exchange.

f. Provide supplemental oxygen in accordance with the indications of blood gas analysis results and patient tolerance.
R / can fix / prevent worsening hypoxia.

4. Ineffective breathing pattern
related to: bronchoconstriction, mucus.

5. Imbalanced Nutrition, Less Than Body Requirements
related to: dyspnoea, anorexia, nausea, vomiting.

6. Risk for infection
related to: the settlement of secretions, chronic disease processes.

7. Activity intolerance
related to: insufficiency of ventilation and oxygenation.

8. Anxiety
related to: changes in health status.

9. Knowledge Deficit
related to: the lack of information about the disease process and treatment at home.

Sample Nursing Care Plan

Nursing Care Plan on Bronchitis

Bronchitis: 9 Nursing Care Plans

Chronic Obstructive Pulmonary Disease (Bronchitis) Nursing Care Plans

Bronchitis Care Plan

Nursingcrib.com Nursing Care Plan - Bronchitis

1. Ineffective airway clearance: Bronchitis Nursing Care Plans

1. Ineffective airway clearance
related to: increased production of secretions.

As evidenced by:[Check those that apply]

Major: (Must be present)	(_) Ineffective cough. (_) Inability to remove airway secretions.
Minor: (May be present)	(_) Abnormal breath sounds. (_) Abnormal respiratory rate, rythm, depth.

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Maintain patent airway A.E.B.: Clear breath sounds or breath sounds consistent with own baseline. Respirations easy and un-labored. Normal resp. rate. (_) Other:		(_) Assess respiratory rate, depth, rythm, effort, and breath sounds q ___ hours. (_) Position: HOB elevated ___ degrees. (_) Promote optimum level of activity for best possible lung expansion: Ambulate q ___ for ___ min. Chair q ___ for ___ min. Turn/reposition q ___. (_) Suction q ___ hours (and prn) per: Nasal

2. Acute pain: Bronchitis Nursing Care Plans

2. Acute pain
related to: the inflammation of the pleura.

As evidenced by:[Check those that apply]

Major: (Must be present)	(_) Pt. reports or demonstrates discomfort.
Minor: (May be present)	(_) Autonomic response to acute pain: increased BP, P, R diaphoresis dilated pupils guarding facial mask of pain crying/moaning abdominal heaviness cutaneous irritation

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Experience relief of pain A.E.B. verbal reports of relief of pain less autonomic responses to pain (_) Other:		(_) Asses characteristics of pain: location, severity on a scale of 1-10, type, frequency, precipitating factors, relief factors. (_) Eliminate factors that precipitate pain: eg.:__________________ ________________________ (_) Offer analgesics q___ hrs prn (according to physician order).

3.Impaired gas exchange: Bronchitis Nursing care Plans

3. Impaired gas exchange
related to: airway obstruction by secretions, spasm of the bronchus.

Nursing Diagnosis : Impaired Gas Exchange

Goal: Demonstrate improved ventilation and adequate oxygenation of tissues with blood gas analysis in the normal range and free of symptoms of respiratory distress.

Nursing Interventions - Impaired Gas Exchange related to Bronchitis:

a. Assess the frequency, depth of breathing. Note the use of accessory muscles, mouth breathing, inability to speak / talk.
R / useful in the evaluation of the degree of respiratory distress and / or chronic disease process.

b. Elevate head of bed, help patients to choose a position that is easy to breathe. Encourage deep breath or breathing lips slowly as needed / individual tolerance.
R / oxygen delivery can be improved by a high seating position and breathing exercises to reduce airway collapse, dyspnea, and breath work.

c. Provide appropriate bronchodilator required. Can be administered orally, IV, rectal, or inhaled. Give oral bronchodilators or IV at the time interspersed with the action nebulizer, metered dose inhalers to extend the effectiveness of the drug. Observation of side effects: tachycardia, dysrhythmias, CNS excitation, nausea and vomiting.
R / Bronchodilators dilate the airway and helps fight the bronchial mucosal edema and muscular spasm. Because side effects can occur in this action, carefully adjusted doses for each patient, according to tolerance and clinical response.

d. Evaluate the effectiveness of the actions nebulizer, metered dose inhalers. Assess decrease shortness of breath, wheezing or crackles drop, looseness secretion, decreased anxiety. Make sure that the action is given before meals to prevent nausea and to reduce the fatigue that accompanies feeding activity.
R / Combining medication with a nebulizer aerosolized bronchodilator commonly used to control bronchoconstriction. Providing appropriate actions will reduce its effectiveness. Aerolisation ease bronchial clearance, help control the inflammatory process, and improve the function of ventilation.

e. Instruct and encourage the patient on diaphragmatic breathing and effective coughing.
R / techniques improve ventilation by opening the airway and clearing the airway of sputum. Improvement of gas exchange.

f. Provide supplemental oxygen in accordance with the indications of blood gas analysis results and patient tolerance.
R / can fix / prevent worsening hypoxia.

As evidenced by:[Check those that apply]

Major: (Must be present)

(_) Dyspnea on exertion.

Minor: (May be present)

(_) Tendency to assume a three-point position (bending forward while supporting self by placing one hand on each knee). (_) Pursed lip breathing with prolonged expiratory phase. (_) Increased anteroposterior chest diameter, if chronic. (_) Lethargy and fatigue. (_) Increased pulmonary vascular resistance (increased pulmonary artery/right ventricular pressure). (_) Decreased oxygen content, decreased oxygen saturation, increased PCO2. (_) Cyanosis.

4. Ineffective breathing pattern: Bronchitis Nursing Care Plans

4. Ineffective breathing pattern
related to: bronchoconstriction, mucus.

As evidenced by:[Check those that apply]

Major: (Must be present)	(_) Changes is respiratory rate or pattern from baseline. (_) Changes in pulse (rate, rythm).
Minor: (May be present)	(_) Orthopnea (_) Tachypnea (_) Hyperpnea (_) Splinted, guarded respirations.

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Demonstrate an effective respiratory rate, depth, and pattern A.E.B.: Color pink/ absence of cyanosis. Absence of diminished breath sounds. (_) Other:		(_) Assess color, respiratory rate, depth, effort, rythm and breath sounds q ___ hours. (_) Position to facilitate optimum breathing patterns: HOB elevated ___ degrees. Turn q ___ hours. (_) Cough and deep breath q ___ hours. (_) Increase activity as tolerated to promote maximum diaphragmatic excursion

5. Imbalanced Nutrition, Less Than Body Requirements

5. Imbalanced Nutrition, Less Than Body Requirements
related to: dyspnoea, anorexia, nausea, vomiting.

As evidenced by:[Check those that apply]

Major: (Must be present)	(_) Reported inadequate food intake less than recommended daily allowance with or without weight loss and/or actual or potential metabolic needs in excess of intake.
Minor: (May be present)	(_) Weight 10% to 20% or more below ideal for height and frame. (_) Tachycardia on minimal exercise and bradycardia at rest. (_) Muscle weakness and tenderness. (_) Mental irritability or confusion. (_) Decreased serumm albumin.

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Experience adeuqate nutrition through oral intake. (_) Experience an increase in the amount or type of nutrients ingested. (_) Gain weight. (_) Other:		(_) Assess and document patient's dietary history, patters of ingestion, intolerance to foods. (_) Assess patient likes and dislikes. Inform dietary. (_) Teach techniques to maintain adequate nutritional intake and stimulate appetite: administer/instruct pt. on good oral hygiene before and after feedings maintain pleasant environment for patient

6. Risk for infection: Bronchitis Nursing Care Plans

 Risk for infection
related to: the settlement of secretions, chronic disease processes.

As evidenced by:[Check those that apply]

Major: (Must be present)	(_) Altered production of leukocytes. (_) Altered immune response.
Minor: (May be present)	(_) Altered circulation. (_) Presence of favorable conditions for infection. (_) History of infection.

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Remain infection free A.E.B.: (_) Demonstrate complete recovery from infection A.E.B.: (_) Other:		(_) Assess temperature q ___ hrs. (_) Inspect and record signs of erythema, induration, foul smelling drainage, from or around wound, skin, invasive line, mouth/throat, or other site q ___ hrs. (_) Asses for cloudiness of urine q ___ hrs. (_) Report abnormal changes in WBC count and/or pathogenic growth on cultures.

7. Activity intolerance: Bronchitis Nursing Care Plans

 7. Activity intolerance
related to: insufficiency of ventilation and oxygenation.

As evidenced by:[Check those that apply]

Major: (Must be present)

(_) _____________________________________________________ ________________________________________________________ ________________________________________________________

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Identify factors that reduce activity tolerance. (_) Progress to highest level of mobility possible. Describe: (_) Exhibit a decrease in anoxic signs of increased activity. (eg: BP, pulse, resp.) (_) Other:		(_) Reduce or eliminate contributing factors by: Assess patient's schedule. Allow rest periods between all activities. Encourage person to note daily progress.

8. Anxiety: Bronchitis Nursing Care Plans

 Anxiety
related to: changes in health status.

As evidenced by:[Check those that apply]

Major: (Must be present)

[Physiological] (_) Elevated BP, P, R (_) Insomnia (_) Restlessnes (_) Dry mouth (_) Dilated pupils (_) Frequent urination (_) Diarrhea [Emotional] (_) Patient complains of apprehension, nervousness, tension [Cognitive] (_) Inability to concentrate (_) Orientation to past (_) Blocking of thoughts, hyperattentiveness

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Demonstrate a decrease in anxiety A.E.B.: A reduction in presenting physiological, emotional, and/or cognitive manifestations of anxiety. Verbalization of relief of anxiety. (_) Discuss/demonstrate effective coping mechanisms for dealing with anxiety. (_) Other:		(_) Assist patient to reduce present level of anxiety by: Provide reassurance and comfort. Stay with person. Don't make demands or request any decisions. Speak slowly and calmly. Attend to physical symptoms. Describe symptoms:

9. Knowledge Deficit: Bronchitis Nursing Care Plans

 Knowledge Deficit
related to: the lack of information about the disease process and treatment at home.

As evidenced by:[Check those that apply]

Major: (Must be present)	(_) Verbalizes a deficiency in knowledge or skill. (_) Requests information. (_) Expresses and inaccurate perception of health status. (_) Does not correctly perform a desired or prescribed health behaviour.
Minor: (May be present)	(_) Lack of integration of treatment plans into daily activities. (_) Exhibits or expresses psychological alteration, (anxiety, depression) resulting from misinformation or lack of information.

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Describe disease process, causes, factors contributing to symptoms. (_) Describe procedure(s) for disease or symptom control. (_) Identify needed alterations in lifestyle. (_) Other:		(_) Assess patient's readiness to learn by assessing emotional respose to illness: Acceptance Anger Anxiety Denial Depression Other: