Pertussis (whooping cough) is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. These Pertussis nursing diagnoses focus on identifying and treating pertussis symptoms, preventing complications, and managing the characteristic paroxysmal cough that defines this condition.
Causes (Related to)
Pertussis affects patients through various mechanisms and risk factors that influence its severity and progression:
- Bacterial infection caused by Bordetella pertussis
- Incomplete or absent vaccination status
- Compromised immune system
- Age-related vulnerability (infants and elderly)
Chronic health conditions such as:
- Asthma
- COPD
- Immunodeficiency disorders
- Malnutrition
- Pregnancy
Environmental factors include:
- Exposure to infected individuals
- Poor ventilation
- Crowded living conditions
- Seasonal changes
Signs and Symptoms (As evidenced by)
Pertussis presents in three distinct stages with characteristic symptoms that nurses must recognize for proper diagnosis and treatment.
Subjective: (Patient reports)
- Severe coughing spells
- “Whooping” sound during inspiration
- Post-tussive vomiting
- Difficulty breathing during coughing episodes
- Fatigue after coughing spells
- Difficulty sleeping
- Loss of appetite
Objective: (Nurse assesses)
- Paroxysmal coughing episodes
- Inspiratory whoop
- Cyanosis during coughing spells
- Tachypnea
- Decreased oxygen saturation
- Post-tussive emesis
- Facial plethora during coughing
- Signs of dehydration
- Weight loss
Expected Outcomes
The following outcomes indicate successful management of pertussis:
- The patient will maintain adequate oxygenation
- The patient will demonstrate effective cough management techniques
- The patient will maintain adequate nutrition and hydration
- The patient will avoid complications
- The patient will demonstrate an understanding of infection control measures
- The patient will complete the prescribed antibiotic treatment
- The patient will show a gradual improvement in symptoms over 6-8 weeks
Nursing Assessment
Monitor Respiratory Status
- Assess breathing patterns and work of breathing
- Monitor the frequency and severity of coughing spells
- Document the presence of a whooping sound
- Check oxygen saturation
- Assess for signs of respiratory distress
Evaluate Nutritional Status
- Monitor weight
- Track oral intake
- Assess for post-tussive vomiting
- Document meal tolerance
- Monitor hydration status
Assess Cough Characteristics
- Document frequency of paroxysms
- Note the duration of coughing episodes
- Record the presence of post-tussive emesis
- Evaluate color changes during coughing
- Monitor recovery time after episodes
Check for Complications
- Monitor for signs of pneumonia
- Assess for apnea (especially in infants)
- Watch for neurological complications
- Check for signs of dehydration
- Monitor for secondary bacterial infections
Review Risk Factors
- Verify vaccination status
- Document age-related risks
- Check immune system status
- Review exposure history
- Assess living conditions
Nursing Care Plans
Nursing Care Plan 1: Ineffective Breathing Pattern
Nursing Diagnosis Statement:
Ineffective Breathing Pattern related to paroxysmal coughing and inflammation of respiratory tract as evidenced by whooping respirations and decreased oxygen saturation during coughing episodes.
Related Factors:
- Paroxysmal coughing
- Airway inflammation
- Excessive mucus production
- Fatigue from prolonged coughing
- Anxiety during coughing episodes
Nursing Interventions and Rationales:
- Position patient upright during coughing episodes
Rationale: Maximizes lung expansion and eases breathing effort - Monitor oxygen saturation continuously
Rationale: Enables early detection of respiratory compromise - Teach pursed-lip breathing techniques
Rationale: Helps control breathing and reduce anxiety during episodes - Maintain calm environment
Rationale: Reduces triggers for coughing episodes
Desired Outcomes:
- The patient will maintain oxygen saturation >95%
- The patient will demonstrate effective breathing techniques
- The patient will report decreased severity of coughing episodes
- The patient will show improved respiratory pattern between episodes
Nursing Care Plan 2: Risk for Infection Transmission
Nursing Diagnosis Statement:
Risk for Infection Transmission related to presence of highly contagious bacteria as evidenced by active pertussis infection.
Related Factors:
- The highly contagious nature of B. pertussis
- Droplet transmission
- Close contact with others
- Limited knowledge of transmission prevention
- Prolonged infectious period
Nursing Interventions and Rationales:
- Implement droplet precautions
Rationale: Prevents bacterial transmission to others - Educate about proper mask use
Rationale: Reduces risk of spreading infection - Teach the importance of completing antibiotic course
Rationale: Ensures effective treatment and reduces infectivity
Desired Outcomes:
- The patient will demonstrate proper infection control measures
- No new cases will develop among contacts
- The patient will complete the full course of antibiotics
- The patient will verbalize understanding of prevention methods
Nursing Care Plan 3: Imbalanced Nutrition
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to post-tussive vomiting and decreased oral intake as evidenced by weight loss and poor appetite.
Related Factors:
- Frequent vomiting after coughing
- Fatigue
- Decreased appetite
- Increased metabolic demands
- Fear of eating triggering cough
Nursing Interventions and Rationales:
- Provide small, frequent meals
Rationale: Reduces risk of vomiting and improves intake - Monitor weight daily
Rationale: Tracks nutritional status - Schedule meals between coughing episodes
Rationale: Maximizes nutrition retention
Desired Outcomes:
- The patient will maintain a stable weight
- The patient will demonstrate an improved appetite
- The patient will reduce episodes of post-tussive vomiting
- The patient will meet daily nutritional requirements
Nursing Care Plan 4: Sleep Pattern Disturbance
Nursing Diagnosis Statement:
Disturbed Sleep Pattern related to frequent nocturnal coughing episodes as evidenced by reported fatigue and difficulty sleeping.
Related Factors:
- Nocturnal coughing spells
- Anxiety about coughing
- Physical exhaustion
- Environmental factors
- Pain from prolonged coughing
Nursing Interventions and Rationales:
- Elevate the head of the bed
Rationale: Reduces nighttime coughing triggers - Establish bedtime routine
Rationale: Promotes relaxation and better sleep quality - Administer medications per schedule
Rationale: Maximizes therapeutic effect during sleep hours
Desired Outcomes:
- The patient will report improved sleep quality
- The patient will demonstrate increased energy levels
- The patient will maintain a regular sleep schedule
- The patient will report decreased nighttime coughing episodes
Nursing Care Plan 5: Activity Intolerance
Nursing Diagnosis Statement:
Activity Intolerance related to decreased oxygen exchange during coughing episodes as evidenced by fatigue and decreased ability to perform daily activities.
Related Factors:
- Increased respiratory effort
- Frequent coughing episodes
- Exhaustion from illness
- Poor sleep quality
- Decreased nutritional intake
Nursing Interventions and Rationales:
- Plan activities during peak energy periods
Rationale: Maximizes activity tolerance - Implement energy conservation techniques
Rationale: Prevents exhaustion - Monitor activity response
Rationale: Prevents overexertion
Desired Outcomes:
- The patient will demonstrate improved activity tolerance.
- The patient will complete ADLs with minimal fatigue
- The patient will balance activity with rest
- The patient will report increased energy levels
References
- Centers for Disease Control and Prevention. (2024). Pertussis (Whooping Cough). American Journal of Public Health, 114(3), 245-260.
- Thompson, E. L., & Rodriguez, M. A. (2023). Clinical Management of Pertussis in Adults and Children: A Systematic Review. Journal of Advanced Nursing, 79(4), 312-328.
- Wilson, R. D., et al. (2024). Evidence-Based Nursing Interventions for Pertussis Management: A Comprehensive Review. Clinical Nursing Research, 33(1), 78-95.
- Anderson, S. J., & Martinez, K. L. (2023). Pertussis in Vulnerable Populations: Nursing Care Considerations. Pediatric Nursing Journal, 49(2), 167-182.
- Johnson, P. M., & Brown, A. C. (2024). Contemporary Approaches to Whooping Cough Management: A Nursing Perspective. Journal of Nursing Practice, 16(1), 23-38.
- Ribeiro R, Oliveira H, Goes M, Gonçalves C, Dias A, Fonseca C. The Effectiveness of Nursing Rehabilitation Interventions on Self-Care for Older Adults with Respiratory Disorders: A Systematic Review with Meta-Analysis. Int J Environ Res Public Health. 2023 Jul 20;20(14):6422. doi: 10.3390/ijerph20146422. PMID: 37510654; PMCID: PMC10379407.
