Pediatric Diphtheria - 3 Nursing Diagnosis and Interventions

Nursing Diagnosis and Interventions for Pediatric Diphtheria


Nursing Diagnosis I : Body temperature imbalance: Hyperthermia related to the release of an exotoxin.

Goal: The client shows the body temperature within normal limits.

Outcomes:
  • Normal temperature (36.5 to 37.2 C)
  • Sweat out naturally.
Intervention:
1. Maintain room temperature.
R /: Can an exchange by convection temperature.

2. Give thin clothes that easily absorbs sweat.
R /: Helping the process of evaporation.

3. Give drink that much.
R /: Drinking a lot helps the drop in body temperature.

4. Collaborate with physicians for the provision of anti-pyretic.
R /: Reduce the heat in the center of the hypothalamus.


Nursing Diagnosis II : Imbalanced Nutrition: Less than Body Requirements related to pain swallow.

Goal:
  • Clients can demonstrate and maintain a normal weight.
  • Nutritional needs are met.

Outcomes:
  • The existence of interest and appetite.
  • Portions as needed.
  • Increased weight.

Intervention:
1. Monitor calorie intake and quality of food consumption.
R /: Knowing food intake.

2. Monitor signs of paralysis of the soft palate and durum.
R /: food in small portions easily consumed by the client and avoid the occurrence of anorexia.

3. Give foods that stimulate appetite.
R /: Increase food intake

4. Measure body weight each day.
R /: Monitoring the effectiveness of weight and lack of nutrition are given.



Nursing Diagnosis III : Impaired gas exchange related to pseudomembranous

Goal : Maintaining the effectiveness of breathing.

Outcomes:
  • No sound extra breath.
  • No respirator muscle pull.
  • There is no cough.
  • No secretion of excessive respiratory tract.
  • Respiratory frequency within normal limits.
Intervention
1. Auscultation of breath sounds, note the presence of an additional breath sounds.
R/ : The presence of airway obstruction in the airways manifested.

2. Help the patient in a comfortable position, the head higher than the feet.
R/ : lower diaphragm can improve chest expansion.

3. Increase fluid intake as needed.
R/ : Thurasi helps reduce viscosity and facilitate secret spending.

4. Help perform chest physiotherapy.
R/ : Postural drainare and percussion is an important cleansing action to remove the secret and improve ventilation.

5. Perform suction.
R/ : When cleaning mechanism or airway suctioning done coughing ineffective.

6. Give oxygen as indicated.
R/ : Maximizing transport in tissue.
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