Bronchiolitis


  1. General information
    1. Pulmonary viral infection characterized by wheezing
    2. Usually caused by respiratory syncytial virus
    3. Virus invades epithelial cells of nasopharynx and spreads to lower respiratory tract, causing increased mucus production, decreased diameter of bronchi, hyperinflation, and possible atelectasis
    4. Affects infants ages 2-8 months
    5. Increased incidence of asthma as child grows older
  2. Medical management: IV epinephrine (if provides relief, follow with epinephrine suspension [Sus-Phrine], which is longer acting, then theophylline); if no response to epinephrine, all treatment is supportive
  3. Assessment findings
    1. Difficulty feeding, fever
    2. Cough, coryza
    3. Wheezing, prolonged expiratory phase, tachypnea, nasal flaring, retractions (intercostal more pronounced than supraclavicular retractions)
    4. Diagnostic tests
      1. WBC normal
      2. X-ray reveals hyperaeration
  4. Nursing interventions
    1. Provide high-humidity environment, with oxygen in some cases (instruct parents to take child into steamy bathroom if at home).
    2. Offer small, frequent feedings; clear fluids if trouble with secretions.
    3. Provide adequate rest.
    4. Administer antipyretics as ordered to control fever.

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