Nursing Care Plan for Respiratory Tract Infection

Respiratory tract infection is a condition in which the respiratory tract (nose, pharing and larynx) is inflamed that causes airway obstruction and will cause a retraction of the chest wall during breathing. (Pincus Catzel & Ian Roberts; 1990; 450).

Respiratory tract infection is a decrease in the ability of the natural defenses of the airway in the face of foreign organisms (Whaley and Wong; 1991; 1418).

In the general hospital has become a referral hospital are 8.76% -30.29% and neonatal infants who still have an infection with a mortality rate reached 11.56% -49.9%. The development of advanced treatment presents a new problem that is increasing nosocomial infection that usually ends with a state that ends with the death of septicemia (Victor and Hans; 1997; 220).

Diagnosis of this disease is doing cultures (bacteria culture) with the swab as a mediator to indicate the presence of bacteria in the respiratory tract. In the differential count (leukocytes) are less helpful because the count of this kind can not distinguish the cause of the infection from a virus or strep because both can cause polymorphonuclear leukocytosis (Pincus Catzel & Ian Roberts; 1990; 453).

Respiratory tract infection is a disease that has a fairly high incidence. The cause of this disease is an infection agent / germs. In addition, there are several factors that influence namely the age of the infants / neonates, the size of the respiratory tract , the child's immune system against diseases and weather conditions (Whaley and Wong ; 1991; 1419).

Infectious agent is a virus or bacteria that is the cause of the occurrence of respiratory tract infections. There are several types of bacteria that are a major cause of the class A beta-hemolytic streptococcal, Staphylococcus, Haemophilus influenzae, chlamydia trachomatis, mycoplasma and pneumococcal.

Age infants or neonates, children who received breast milk on the incidence of under 3 months of age because of the low gain immunity from mother's milk.

The size of the width of the cross section of the respiratory tract also influential in the degree of severity of the disease. Due to the increasingly narrow aperture with edematous then it will be covered in its entirety from the airway.

General clinical condition also influential in the process of infection include malnutrition, anemia, fatigue. Circumstances that occur directly affects the respiratory tract, namely allergies, asthma and pulmonary congestion.

Respiratory tract infections usually occur when there is a change of the season, but is also common in winter (Whaley and Wong; 1991; 1420).

The disease is usually manifested in the form of fever, obstruction Hisung with watery secretions clogs up the airways, the baby becomes restless and difficult or even not at all like a drink (Pincus Catzel & Ian Roberts; 1990; 451).

Management of infants with colds should be treated in the prone position, thus secretions can flow smoothly so that drainage of secretions would be easier exit (Pincus Catzel & Ian Roberts; 1990; 452).

Signs and symptoms
  • Fever, in neonates may be rare, but symptoms of fever arise if the child has reached the age of 6 months to 3 years. Often the first sign of fever appears as an infection. Body temperature can reach 39.5 OC - 40,5 oC.
  • Meningism, is a sign of meningeal infection in the absence of meninges, usually occurs during periodic baby has fever, symptoms are headache, stiffness and pain in the back and neck, Kernig and Brudzinski's presence.
  • Anorexia, common to all babies who experience pain. Babies will be difficult to drink and do not even want to drink.
  • Vomiting, usually appearing in momentary period but also for the baby can experience pain.
  • Diarrhea (mild transient diarrhea), often accompany a respiratory tract infection due to virus infection.
  • Abdominal pain, abdominal pain may be due to mesenteric lymph nodes.
  • Blockage of the airway / nasal, the narrow airways will more easily become clogged because of secretions.
  • Cough, a common sign of respiratory tract infections of occurrence, perhaps a sign is a sign of the occurrence of acute respiratory tract infections.
  • Breath sounds, wheezing are common, stridor, crackless, and absence of breath sounds (Whaley and Wong ; 1991; 1419).

Assessment mainly on airway
  • The main focus is on the assessment of respiratory pattern, depth, and rhythm of breathing effort.
  • Pattern, fast (tachynea) or normal.
  • Depth, normal breath, shallow or too deep which can usually be detected in the movement of the chest cavity and abdominal movements.
  • Effort, continuous, intermittent, or a sudden stop is accompanied by sneezing.
  • Respiratory rhythm, varies depending on the pattern and depth of breathing.
  • Other observation is that infection is usually characterized by an increase in body temperature, absence of cough, wheezing breath sounds. Could also found the presence of cyanosis, pain in the chest cavity and increased production of sputum (Whaley and Wong; 1991; 1420).