Signs and symptoms of pneumonia may include:
- Fever, sweating and shaking chills
- Cough, which may produce phlegm
- Chest pain when you breathe or cough
- Shortness of breath
- Fatigue
- Nausea, vomiting or diarrhea
Nursing Diagnosis for Pneumonia : Imbalanced Nutrition: less than body requirements
Nursing Interventions for Pneumonia
- Compare usual food intake to USDA Food Pyramid, noting slighted or omitted food groups. Milk consumption has decreased among children while intake of fruit juices and carbonated beverages has increased. A higher incidence of bone fractures in teenage girls has been associated with a greater consumption of carbonated beverages (Wyshak, 2000). Possibly also related is the substitution of soda for milk. Omission of entire food groups increases risk of deficiencies.
- Observe client's ability to eat (time involved, motor skills, visual acuity, ability to swallow various textures). Poor vision was associated with lower protein and energy (calorie) intakes in home care clients independent of other medical conditions (Payette et al, 1995). NOTE: If client is unable to feed self, refer to Nursing Interventions and Rationales for Feeding Self-care deficit. If client has difficulty swallowing, refer to Nursing Interventions and Rationales for Impaired Swallowing.
- Evaluate client's laboratory studies (serum albumin, serum total protein, serum ferritin, transferrin, hemoglobin, hematocrit, vitamins, and minerals). An abnormal value in a single diagnostic study may have many possible causes, but serum albumin less than 3.2 g/dl was shown to be highly predictive of mortality in hospitals, and serum cholesterol of less than 156 mg/dl was the best predictor of mortality in nursing homes (Morley, 1997).
- Assess for recent changes in physiological status that may interfere with nutrition. The consequences of malnutrition can lead to a further decline in the patient's condition that then becomes self-perpetuating if not recognized and treated. Extreme cases of malnutrition can lead to septicemia, organ failure, and death (Arrowsmith, 1997). Diarrhea in patients receiving warfarin has been suggested as possibly causing lower intake and/or malabsorption of vitamin K (Black, 1994; Smith, Aljazairi, Fuller, 1999).
- Observe client's relationship to food. Attempt to separate physical from psychological causes for eating difficulty. It may be difficult to tell if the problem is physical or psychological. Refusing to eat may be the only way the client can express some control, and it may also be a symptom of depression (Evans, 1992).
- Provide companionship at mealtime to encourage nutritional intake. Mealtime usually is a time for social interaction; often clients will eat more food if other people are present at mealtimes.
- Consider six small nutrient-dense meals vs. three larger meals daily to reduce the feeling of fullness. Eating small, frequent meals reduces the sensation of fullness and decreases the stimulus to vomit (Love, Seaton, 1991).
