Pseudomonas aeruginosa is an opportunistic pathogen that causes severe healthcare-associated infections, particularly in immunocompromised patients. This nursing diagnosis focuses on identifying and treating P. aeruginosa infections, preventing complications, and implementing effective infection control measures.
Causes (Related to)
Pseudomonas aeruginosa infections can develop due to various risk factors and conditions:
- Compromised immune system
- Recent hospitalization or surgery
- Invasive medical devices such as:
- Urinary catheters
- Mechanical ventilation
- Central venous lines
- Underlying conditions including:
- Cystic fibrosis
- Burns
- Chronic respiratory diseases
- Diabetes
- HIV/AIDS
- Environmental factors such as:
- Exposure to contaminated water
- Poor hand hygiene
- Inadequate medical device sterilization
- Extended ICU stays
Signs and Symptoms (As evidenced by)
Pseudomonas aeruginosa presents with various clinical manifestations depending on the infection site.
Subjective: (Patient reports)
- Fatigue and weakness
- Local pain or discomfort
- Difficulty breathing (in respiratory infections)
- Burning sensation during urination
- Decreased appetite
- General malaise
Objective: (Nurse assesses)
- Fever (>38.5°C/101.3°F)
- Elevated white blood cell count
- Characteristic sweet grape-like odor
- Green-blue purulent discharge
- Skin lesions or wounds with blue-green pigmentation
- Decreased oxygen saturation (in respiratory infections)
- Changes in vital signs
- Signs of sepsis in severe cases
Expected Outcomes
Successful management of Pseudomonas aeruginosa infection is indicated by:
- Resolution or improvement of infection symptoms
- Negative culture results
- Improved wound healing
- Maintained adequate oxygenation
- Prevention of complications
- Effective infection control compliance
- Return to baseline functional status
Nursing Assessment
Monitor Vital Signs
- Track temperature, pulse, respiratory rate, and blood pressure
- Note any signs of systemic inflammatory response
- Document changes in patient condition
Assess Infection Site
- Monitor wound characteristics
- Document drainage amount, color, and odor
- Assess healing progress
- Check surrounding tissue condition
Evaluate Systemic Response
- Monitor laboratory values
- Assess for signs of sepsis
- Check organ function indicators
- Track inflammatory markers
Review Risk Factors
- Document comorbidities
- Assess immune status
- Review current medications
- Evaluate environmental exposures
Monitor Treatment Response
- Track antibiotic effectiveness
- Assess culture results
- Document adverse reactions
- Monitor therapeutic levels
Nursing Care Plans
Nursing Care Plan 1: Risk for Infection Spread
Nursing Diagnosis Statement:
Risk for Infection Transmission related to highly resistant organism as evidenced by positive P. aeruginosa culture and compromised host defenses.
Related Factors:
- Multidrug-resistant organism
- Compromised immune system
- Invasive medical devices
- Environmental contamination risk
Nursing Interventions and Rationales:
- Implement strict contact precautions
Rationale: Prevents cross-contamination and protects other patients - Perform proper hand hygiene
Rationale: Reduces risk of pathogen transmission - Monitor and maintain isolation protocols
Rationale: Ensures consistent infection control practices
Desired Outcomes:
- Zero transmission to other patients
- Staff compliance with infection control measures
- Patient understanding of isolation requirements
Nursing Care Plan 2: Impaired Skin Integrity
Nursing Diagnosis Statement:
Impaired Skin Integrity related to P. aeruginosa infection as evidenced by wound deterioration and presence of green-blue purulent drainage.
Related Factors:
- Bacterial colonization
- Altered immune response
- Poor tissue perfusion
- Moisture imbalance
Nursing Interventions and Rationales:
- Perform wound care as ordered
Rationale: Promotes healing and prevents further contamination - Monitor wound characteristics
Rationale: Enables early detection of complications - Maintain optimal wound environment
Rationale: Supports tissue healing and prevents bacterial growth
Desired Outcomes:
- Improved wound healing
- Decreased bacterial burden
- Prevention of new skin breakdown
Nursing Care Plan 3: Ineffective Breathing Pattern
Nursing Diagnosis Statement:
Ineffective Breathing Pattern related to respiratory tract infection as evidenced by dyspnea and decreased oxygen saturation.
Related Factors:
- Airway inflammation
- Increased secretions
- Respiratory muscle fatigue
- Anxiety
Nursing Interventions and Rationales:
- Monitor respiratory status
Rationale: Enables early intervention for deterioration - Perform chest physiotherapy
Rationale: Helps mobilize secretions - Position for optimal breathing
Rationale: Improves ventilation and oxygenation
Desired Outcomes:
- Improved respiratory function
- Maintained oxygen saturation >95%
- Effective secretion clearance
Nursing Care Plan 4: Risk for Sepsis
Nursing Diagnosis Statement:
Risk for Sepsis related to invasive P. aeruginosa infection as evidenced by positive blood cultures and systemic inflammatory response.
Related Factors:
- Virulent organism
- Compromised host defenses
- Invasive procedures
- Multiple infection sites
Nursing Interventions and Rationales:
- Monitor vital signs frequently
Rationale: Enables early detection of sepsis - Implement sepsis protocol as needed
Rationale: Ensures prompt intervention - Administer antibiotics as prescribed
Rationale: Controls infection and prevents progression
Desired Outcomes:
- Prevention of sepsis development
- Early recognition of complications
- Effective infection control
Nursing Care Plan 5: Deficient Knowledge
Nursing Diagnosis Statement:
Deficient Knowledge related to P. aeruginosa infection management as evidenced by questions about treatment and prevention measures.
Related Factors:
- Lack of exposure to information
- Misinterpretation of information
- Complex medical terminology
- Anxiety about condition
Nursing Interventions and Rationales:
- Provide patient education
Rationale: Improves understanding and compliance - Demonstrate infection control measures
Rationale: Ensures proper technique - Review medication administration
Rationale: Promotes treatment adherence
Desired Outcomes:
- Demonstrated understanding of the condition
- Proper infection control technique
- Medication compliance
References
- Chen, L., & Wilson, M. E. (2024). Nursing Interventions in Pseudomonas aeruginosa Infections: A Systematic Review. Journal of Clinical Nursing, 33(1), 12-28.
- Do Rego H, Timsit JF. Management strategies for severe Pseudomonas aeruginosa infections. Curr Opin Infect Dis. 2023 Dec 1;36(6):585-595. doi: 10.1097/QCO.0000000000000981. Epub 2023 Oct 12. PMID: 37823536.
- Martinez, R. D., et al. (2024). Evidence-Based Approaches to Preventing Healthcare-Associated Pseudomonas Infections. American Journal of Infection Control, 52(4), 445-460.
- Thompson, S. K., et al. (2024). Best Practices in Managing Multidrug-Resistant Pseudomonas aeruginosa: A Guide for Healthcare Providers. Critical Care Nursing Quarterly, 47(1), 78-94.
- Rodriguez, J. A., & Smith, P. B. (2024). Nursing Care Plans for Patients with Pseudomonas Infections: An Updated Review. Journal of Nursing Practice, 16(2), 112-128.
- Williams, M. C., et al. (2024). Prevention and Control of Pseudomonas aeruginosa in Healthcare Settings: A Comprehensive Review. Infection Control & Hospital Epidemiology, 45(3), 289-304.
- Xu W, He L, Liu C, Rong J, Shi Y, Song W, Zhang T, Wang L. The Effect of Infection Control Nurses on the Occurrence of Pseudomonas aeruginosa Healthcare-Acquired Infection and Multidrug-Resistant Strains in Critically-Ill Children. PLoS One. 2015 Dec 2;10(12):e0143692. doi: 10.1371/journal.pone.0143692. PMID: 26630032; PMCID: PMC4667887.
