Nursing Care Plan (NCP) for Infection

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Outline

Pathophysiology

An infection is a disease caused by microorganisms infecting tissues. 

Etiology

The organisms that can cause disease are very diverse that include viruses, bacteria, fungi, and parasites. You can acquire such infections by contaminated food/water, a bite, cut, or being in contact with someone with an infection.

Desired Outcome

Patient will remain free from infection and demonstrate proper hand hygiene

Subjective Data

  • Diarrhea 
  • Fatigue 
  • Muscle aches
  • Coughing 
  • Pain
  • Chills
  • Sore throat

Objective Data

  • Fever 
  • Tachycardia
  • BP changes 
  • Elevated WBC count 
  • Redness/swelling/heat/drainage from wound

Nursing Interventions

Nursing Intervention (ADPIE) Rationale
General head to toe assessment  noting color, moisture, swelling, drainage, injuries can show signs of infection 
Assess patient’s immune history/medication history  lab values- (WBC, serum protein, serum albumin)- closely linked to patient’s nutritional status and immune function. 

Medications (corticosteroids and antineoplastic agents)- suppress immune system which increase infection risk for patients 

Assess VS  get baseline vitals and note if patient has a fever, tachycardia, or changes in blood pressure depending on the extent of the infection 
Diagnostics/Labs (blood tests, urine sample, throat swabs, stool samples, x-rays) these tests can determine the particular microbe that is causing the illness and better tailor the physician for treatment plan 
Give medications (antibiotics, antivirals, antifungals, anti-parasitics) depending on cause of infection will depend on type of medication therapy given
Use of proper hand hygiene (washing hands, using hand sanitizer, wiping down surface areas) helps in preventing the spread of the infection 
Encourage fluid intake, well balanced diet/rest  fluids help aid in rehydrating a patient and fluid loss during a fever. 

Balanced diet-omega 3’s, omega 6’s, protein, vitamins A, C, and E, zinc, and iron (immune support)

Rest-reduces stress and helps boost the immune system an able to fight off the infection 

Writing a Nursing Care Plan (NCP) for Infection

A Nursing Care Plan (NCP) for Infection starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.

References

https://www.cdc.gov/infectioncontrol/spread/index.html

https://www.mayoclinic.org/diseases-conditions/infectious-diseases/symptoms-causes/syc-20351173

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Transcript

Hi everyone. Today, we are going to be putting together a nursing care plan for infection. Let’s get started. First, we’re going to go over the pathophysiology. So an infection it’s a disease caused by microorganisms that infect the tissue. Some nursing considerations. You want to make sure you’re doing a full head to toe assessment, vital signs, diagnostic tests, administering medications, proper hand hygiene, and a well balanced diet and rest. Some desired outcomes: the patient’s going to remain free from infection and demonstrate proper hand hygiene. 

So we’re going to go over our care plan here. We’re going to make sure we’re going to go over some of that subjective data and some objective data. So what are we going to see with the patient that has an infection? So some subjective data that you are going to see, or what they’re going to talk about are some possible aches, coughing, and sore throat. Some objective: there’ll be a fever, tachycardia, and BP changes. Some other things that you’ll see, they may complain of some diarrhea, fatigue, pain, chills. There could be an elevated white blood cell count for infection, redness and swelling, heat, and drainage from the wound. It depends on the type of infection as far as what you’ll see. So one of the first things that we’re going to do is a full on head to toe assessment. So you’re going to be noting any color changes, moisture, swelling, any drainage coming from anywhere. Injuries can show any sort of signs of infection. Another intervention that we’re going to be doing. We want to assess the patient’s immune history and medication history; that can be cancer or any sort of autoimmune disorder. Medications. There are certain medications that suppress the immune system, such as corticosteroids and antineoplastic agents. Another intervention we want to do, we want to make sure we’re assessing the vital signs. So we’re going to be seeing anything from fever, elevated heart rate, and any changes in blood pressure. Typically those are elevated. We’re going to do some diagnostic tests and some lab tests. So we’re going to be checking some blood work and then the white blood cell count. We’re possibly going to be doing throat swabs, maybe a stool sample, urine sample; anything that will help determine the cause of the infection, and dependent on what comes through, will depend on what the physician does for a treatment plan. Another intervention that we’re going to be doing is to give medications. Depending on what the infection is will depend on getting antibiotics, antivirals, antifungals, and anti parasitics. So it just depends on the cause of the infection for the type of medication we’ll be giving to the patient. Another invention we’re going to be doing. We want to make sure that they are doing proper hand hygiene. So you want to make sure that you’re washing your hands and using hand sanitizer and wiping down any surface areas. This all helps with preventing the spread of infection. You also want to make sure we’re encouraging fluid intake, eating a well-balanced diet, and plenty of rest. Fluids will help with rehydrating the patient. Usually when they have a fever with a balanced diet, you want to make sure that they have some omega threes. So omega sixes, protein, vitamin A, C, and E, zinc, and iron, which all help support the immune system. Rest is going to help reduce stress and helps boost your immune system to be able to fight off the infection. Right? 

We’re going to go on to key points here. So an infection is a disease caused by microorganisms that infect the tissues. Organisms that can cause infection are viruses, bacteria, fungi, and parasites. Some subjective and objective data that you’ll see in these patients. They’ll complain of fatigue, coughing, pain, sore throat, fever, tachycardia, elevated white blood cells, redness, swelling, drainage from the wound, muscle aches. Again, depending on what the infection is, will depend on what you’ll see in the patient. You want to do a full assessment, do some diagnostic tests or labs. So make sure you’re doing that full head to toe assessment, check in their past medical history, medications, check their vitals, do some blood tests, urine samples, stool sample, or throat swab, give certain medications, and diet. So you want to give antibiotics, antivirals, antifungals, anti parasitics, just depending on the cause of the infection. You want to promote fluid intake and make sure they have a very well balanced diet and are getting plenty of rest. You want to make sure that they’re trying to get over this infection as quickly as they’re able to. And there you have it with the care plan you guys. 

Awesome. We love you guys. Go out, be your best self today and as always happy nursing.

 

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