Bronchiolitis

An inflammatory process affecting the bronchioles and alveoli .

Etiology :Respiratory syncytial virus

Path physiology :
1. The inflamed bronchioles become edematous and respiratory secretions accumulate there by occluding the bronchiolar lumen .
2. The narrowing of the small airways compromises expiration and causes air to be trapped in the alveoli.
3. Inadequate ventilation results in hypoxemia and hypercapnia.

Assessments findings :
The child may have clinical manifestations of an upper infection :
1. Nasal drainage , sneezing , coughing , poor appetite and a low – grade fever
2. As these mild symptoms worsen , expect of respiratory distress, tahcypnea, shallow respiration , aspiratory crackles , expiratory wheezing tachycardia , chest retraction , dyspnea and a productive or congested cough
3. In infants who are breast – feeding an inability to suck may cause feeding difficulties from increased respiratory effort

Nursing diagnoses :
1. Activity intolerance
2. Ineffective airway clearance
3. Ineffective breathing pattern
4. High risk for fluid volume deficit
Planning and implementation

1. Assess for respiratory distress by monitoring vital signs and respiratory status
2. Ease respiratory effort by :
a. Administering oxygen therapy as ordered
b. Suctioning as needed
c. Changing position frequently and elevating the head of the bed
3. Promote rest by maintaining bed rest and organizing nursing care to minimize disturbances.
4. Ensure adequate nutrition by providing small amount of feed at time .
5. Support the child’s family by answering questions and explaining all treatments and procedures encourage parents to participate their child’s care as appropriate .
6. Provide family teaching ,covering : home care and follow- up measures.