Bronchitis Nursing Diagnosis and Nursing Care Plan: Acute viral inflammation of the lower respiratory tract that affects the bronchioles and alveoli is known as bronchiolitis. The smaller airways get blocked as a result of cellular debris, exudate, accumulated thick mucus, and mucosal edema brought on by inflammation (bronchioles). Reduced expiration, air entrapment, and hyperinflation of the alveoli are the results of this. As a result of the obstruction's interference with gas exchange, there may be hypoxemia and hypercapnia in extreme instances, which may result in respiratory acidosis. Hospitalization is required for children with this problem and other severe illnesses who are in a weakened state.
Types of Bronchitis
There are two types of bronchitis, and these are the following:
Acute bronchitis: A more prevalent variety of bronchitis where symptoms often last for many weeks but do not persist or worsen after that time.
Chronic bronchitis: Thought to be a dangerous, persistent ailment that may recur or manifest later.
Signs and Symptoms of Bronchitis
- Having trouble breathing
- chest discomfort
- persistent dry cough with possible white, green, or yellow mucus appearance
Meanwhile, the following are some signs of acute bronchitis:
- Fever and sore throat
- Chills
- Body pain
- Exhaustion
- Congestion
Causes of Bronchitis
Bronchitis is frequently the outcome of infections with the common viruses that cause the flu and colds. In addition to infectious agents, bacteria can also result in the development of this condition. In order to combat the virus, the body's immune system therefore creates mucus, which may clog the bronchioles, making breathing and respiration harder.
Chronic bronchitis has several frequent causes, including
- Long-term smoking, or being around others who are smoking
- Environmental air pollution, as well as other waste, dust, and chemical emissions
Potential Dangers of Bronchitis
- The main contributing factor to chronic bronchitis is smoking. Acute and chronic bronchitis are more likely to occur when smoking is unchecked and persistent.
- Those who experience asthma or other allergies
- Immunocompromised or having a weakened immune system - immunocompromised patients, children, and elderly people who are susceptible to colds are more likely to get bronchitis.
- A history of pulmonary illness in the family
Complications
Bronchitis patients are more prone to experience the following issues:
- When coughing there is blood or tenacious mucus
- I can't sleep because I keep coughing too much
- Chest pain
- Abnormal breathing noise that frequently sounds like a dog barking
- Loss of weight
Diagnosis
Having the signs and symptoms verified by a physical examination is an important diagnostic procedure. The attending physician could inquire about whether the patient has a cough, a fever, a cold, and potentially mucus when they expectorate. The attending physician may further request the following tests:
- When doing an auscultation, the presence of an irregular breathing sound may be a sign of bronchitis.
- To rule out other lung illnesses or disorders, such as pneumonia, a chest X-ray is performed.
- A blood test
- Snot swab
- Examining the oxygen levels
Bronchitis Treatment
The symptoms of acute bronchitis normally go away on their own or within a few weeks. However, if bacteria may be the reason (which is unusual), the attending doctor might advise the patient to take antibiotics. The attending physician may suggest using an inhaler to help promote optimal aeration by opening the airways if the patient has asthma or allergies. Here are some other strategies for treating acute bronchitis symptoms:
- Getting lots of sleep
- Drinking water
- Using a humidifier to break up mucus
- Using over-the-counter cough medications for treatment
Prevention for Bronchitis
Smoking should be avoided since it increases the chance of contracting or developing bronchitis. Additional suggestions include:
- Current vaccinations against the flu and pertussis
- Always wash your hands after using the restroom.
- Using a face mask in places with irritating or polluted air
Bronchitis Nursing Diagnosis and Nursing Care Plan
#1 Nursing Care Plan Bronchitis - Ineffective Airway Clearance
Nursing Diagnosis
- Ineffective Airway Clearance
May be related to
- Blockage, secretions, and infection of the trachea
Possibly evidenced by
- Reduced or nonexistent breath sounds
- Wheezes, rhonchis, and crackles
- Recurrent, unproductive, and severe hacking cough
- Alteration in the pace and depth of breathing
- Modest respiratory excursion and dyspnea
- Hyperresonance
- More mucus production and nasal discharge
- Tachypnea
- Fever
Desired Outcomes
- Child will cough forcefully and make clear breath sounds; cyanosis and dyspnea are absent.
Nursing Interventions | Rationale |
Check for patency of the airway. | The preservation of a patent airway is always first priority, particularly in situations involving trauma, severe neurological impairment, or cardiac arrest. |
Analyze breathing. Take note of the breathing's quality, pace, pattern, depth, nostril flare-ups, dyspnea when exerted, splinting signs, usage of auxiliary muscles, and posture. | Respiratory compromise might result from a shift in normal breathing. A compensatory reaction to airway blockage may involve an increase in respiratory rhythm and rate. |
Use auscultation to listen for breath sounds. | Fluid and mucus buildup can cause abnormal breath sounds to be audible. This can be a sign that the airway is blocked. |
Examine the cough's characteristics, such as its type—moist, dry, hacking, paroxysmal, brassy, or croupy—onset, duration, frequency, and whether it occurs at night, during the day, or during activity; the amount and characteristics of its mucus—clear, yellow, or green—as well as its thick, tenacious, and foamy consistency—as well as the patient's ability to expectorate and any nasal drainage or stuffy nose. | Coughing is a way to get rid of secretions. Ineffective coughing makes it difficult to clean the airways and keeps mucus from draining. Ineffective coughing may be brought on by respiratory muscle exhaustion, acute bronchospasm, or thick and persistent secretions. |
By planning procedures and care and disturbing the infant/child as little as possible during the acute stages of the disease, you may make provisions for rest intervals. | Avoids wasting energy in a way that will make you tired. |
For infants and young children, raise the head of the bed by at least 30 degrees. Older children may sit up and rest their heads on a pillow on the overbed table. | An upright posture prevents the enlargement of the lungs by preventing the upward movement of the stomach contents. Better air exchange and lung expansion are encouraged in this position. |
Encourage regular, measured hydration consumption during 24-hour periods. | Fluids reduce mucosal dryness and increase ciliary activity, which helps secretions flow. |
Reposition the infant on the sides after two hours and align their bodies properly. | Prevents secretions from building up and pooling. |
Unless the technique is contraindicated, assist the kid in doing deep breathing and coughing exercises while they are lying down for postural drainage; for smaller children, blow cotton balls across the table or use an incentive spirometer for older children. | Promotes deeper breathing by widening the tracheobronchial tree and triggering the cough reflex to eliminate secretions. Vibration loosens and dislodges secretions, and gravity empties the airways and lung segments. |
Teach parents and possibly older children how to administer medications correctly, including the name of each drug, its action, dosage, why it is given, how often it should be taken, when it should be taken (day or night), any side effects that should be reported, and how to do so in food (by crushing, chewing, using a measured dropper, or another recommended method) (nose drops, inhaler). | Ensures compliance with correct drug dosage and other considerations for administrations for desired results, and what to do if side effects occur. |
Bronchitis Nursing Diagnosis and Nursing Care Plan
#2 Nursing Care Plan Bronchitis - Ineffective Breathing Pattern
Nursing Diagnosis
- Ineffective Breathing Pattern
May be related to
- Increased breathing effort
- Process of inflammation
- Blockage of the trachea
Possibly evidenced by
- Cough
- Nasal flare-ups
- Dyspnea
- Tachypnea
- Shallow breathing excursion
- Subcostal and suprasternal retractions
- Abnormal arterial blood gases (ABGs)
Desired Outcomes
- As seen by calm breathing at a typical rate and depth and the lack of dyspnea, the child will maintain an efficient breathing pattern.
Nursing Interventions | Rationale |
In the event of a decreased respiratory rate and bouts of apnea, evaluate the patient's respiratory status at least every 2-4 hours, or more frequently as needed. | As the child's energy supplies are reduced, changes in breathing pattern might happen quickly. Air exchange rate and quality are revealed via baseline assessment and monitoring. Regular evaluation and observation give verifiable proof of changes in the caliber of respiratory effort, allowing for quick and efficient action. |
Palpate the chest to determine its structure and listen for breath sounds that could suggest a mobility limitation (absence or diminished crackles or rhonchi). | This is done to listen for diminished or unexpected breath sounds. |
Keep an eye out for shifts in consciousness. | Early signs of low brain oxygen levels include restlessness, disorientation, and/or irritation. |
Utilizing pulse oximetry, determine oxygen saturation and pulse rate. | Pulse oximetry is a useful method to first identify changes in oxygenation; however, in order to determine CO2 levels, arterial blood gases (ABGs) or end-tidal CO2 monitoring would need to be collected. |
Observe the arterial blood gases. | Checks the state of ventilation and oxygenation. |
If the kid is weeping or struggling in the crib or bed, raise the head of the bed or put the youngster in a comforting posture on the parent's lap. | Position encourages better aeration, a reduction in anxiety (particularly in young children), and a reduction in energy use. |
Promote regular rest breaks and educate the patient how to pace their activity. | Increased exercise can make breathing difficulties worse. Make sure the patient takes a break from demanding tasks. |
Help and show how to do the right deep breathing exercises. | Deep inspiration is encouraged, which boosts oxygenation and reduces atelectasis. |
Encourage the patient to successfully cough out their own secretions to keep the airway open. | Allows for sufficient elimination of secretions. |
By using a mask, hood, or tent, give out humidified oxygen. | In addition to helping to maintain oxygenation status and reduce respiratory discomfort, humidified oxygen loosens secretions. |
Bronchitis Nursing Diagnosis and Nursing Care Plan
#3 Nursing Care Plan Bronchitis - Anxiety
Nursing Diagnosis
- Anxiety
May be related to
- Infant or young child's health status has changed.
- Hospitalization of a young kid or newborn, either imminent or real
Possibly evidenced by
- Increased concern that the illness may get worse
- Expressed their anxiety and trepidation about going to the hospital.
- Need for medical care, including IV treatments and mist tents, while hospitalized.
Desired Outcomes
- Child will look calmer and suffer less anxiousness.
Nursing Interventions | Rationale |
Analyze the cause, the severity, the symptoms, and the desire for knowledge to reduce anxiety. | Describes the degree of anxiety and the necessity for actions to reduce it. Anxiety may be triggered by worry or uncertainty about a person's condition, guilt over having a disease, the possibility of losing their parenting role, or a loss of duty if they are hospitalized. |
Ask questions honestly and gently, and be open with your parents. | Encourages a calming, encouraging environment. |
Give people the chance to voice their worries and to ask questions regarding the illness and treatment of a baby or young kid. | Gives a chance to express emotions and obtain knowledge that is necessary to reduce worry. |
Encourage parents to take control of their emotions and participate in decisions involving their newborn or young kid. Encourage them to note any progress that occurs. | Encourages close observation of a baby or young kid to check on any changes in their symptoms. |
Encourage parents to stay with their newborn or young kid, permit open visits and phone calls, ask them to help with care (holding, feeding, and diapering), and propose routines and treatment options. | Gives parents the freedom to support and care for their baby or young kid; absence and uncertainty about the child's well-being may make parents feel more anxious. |
Informing parents about the illness's clinical manifestations, symptoms, and disease process | By letting parents know what to expect, the knowledge provided helps to reduce worry. |
Explain to parents the rationale behind each treatment or kind of therapy, as well as the results of any diagnostic testing. | Reduces the dread of the unknown, which prevents anxiety. |
Give the same explanation of the illness process and transmission as other staff and/or a doctor delivered, correct any inaccuracies, and provide answers to queries in plain language when parents are able to listen. | Prevents unwarranted worry brought on by false knowledge, false beliefs, or inconsistent facts. |
Bronchitis Nursing Diagnosis and Nursing Care Plan
#4 Nursing Care Plan Bronchitis - Fatigue
Nursing Diagnosis
- Fatigue
May be related to
- Respiratory effort
Possibly evidenced by
- Listlessness or sluggishness
- Irritation or emotional instability
- Worn-out look
- A lack of appetite and limpness
Desired Outcomes
- The infant or kid can eat, drink, and play calmly.
Nursing Interventions | Rationale |
Check for excessive weakness and exhaustion; the capacity for, and quantity of, sleep; and bed-movement. | Information is given to identify the impacts of dyspnea and the laborious nature of breathing over time, which reduces an infant's or young child's capacity to rest, feed, and drink. |
Schedule and make available relaxation intervals in a calm, cosy setting. | Minimises stimulation and encourages relaxation in order to lower the danger of becoming tired. |
Infants and young children should only be disturbed when absolutely required. Care should not be dispersed across a long period of time. | Conserves energy and avoids sleep disruptions. |
Parents should be encouraged to take steps to prevent infant and young child weariness, such as holding and/or rocking the kid, feeding in tiny quantities, playing with the child, and providing entertainment options like TV or toys. | Conserves energy while offering assistance to infants and young children. |
Maintain bed rest while allowing for quiet play with a beloved item. | While calm play avoids excessive activity that depletes energy and raises respiration, rest reduces weariness and respiratory discomfort. |
Teach parents to pick up a baby or young kid who is wailing for more than a minute or two. | Prevents tiredness since sobbing for a long time is exhausting. |
Help parents create a strategy to schedule feeding, bathing, and diaper changes around times when children are sleeping. | Prevents sleep and rest interruptions. |
Bronchitis Nursing Diagnosis and Nursing Care Plan
#5 Nursing Care Plan Bronchitis - Deficient Knowledge
Nursing Diagnosis
- Deficient Knowledge
May be related to
- A scarcity of knowledge on the respiratory syncytial virus
Possibly evidenced by
- Parents express their ignorance about the RSV
Desired Outcomes
- Parents will express verbally their comprehension of the illness, its causes, and its treatments.
Nursing Interventions | Rationale |
Analyze the state of the science around illness prevention, transmission, and treatment. | Establishes a benchmark for the kind of knowledge required to stop the youngster from contracting an illness. |
Teach that hands should not be placed near the nose or eyes since they can spread the virus through direct and indirect contact. | Explains that kissing and caressing a newborn or young kid, as well as contact with insects on hard, polished surfaces, are sources of viral interaction. |
Informing parents about the symptoms and indications of respiratory distress | Encourages parents to get quick medical help when necessary. |
Inform students about the risk of viral transmission to family members and the necessity of keeping young children and infants separate from other people. | Explains how viruses are easily spread, with up to 50% of family members developing viral illnesses. |
Encourage wearing plastic goggles when tending to a newborn or young kid. | Reduces the chance of eye contact with the pathogen. |
Teach your children and family members proper handwashing techniques. | Prevents the spread of germs to the facial region through the hands, which are the major sources of pollution and carriers of organisms. |
Encourage parents to provide their children a healthy food and enough of water, focusing on a high-calorie, balanced diet (specify amounts). | Increases the child's natural bodily defence by encouraging the liquification of secretions and replacing calories utilised to combat illness. |
Inform parents on how to take prescribed drugs. | Increases the detection of negative side effects and drug administration consistency. |
Follow the hospital's infection control procedures if the patient has RSV. | Shields against contact with secretions and the spread of the infection to other patients. |
Parents should be encouraged and instructed to care for their hospitalized children in accordance with their comfort level and the limitations of the required therapies. Inform parents of the RespiGam or Synagis preventive medications (if prescribed; specify).
| Encourages parental identity and control, which may reduce stress and anxiety. |
Educate parents on the usage of the medication Ribavirin if they are being treated in a hospital:
| Encourages comprehension, which might reduce anxiety, and guards against unintentional drug exposure. |
Teach family members how to properly dispose of used tissues, for example. | Prevent the sickness from spreading. |
Explain to parents the significance of restricting guests and checking them for recent sickness. | Stop the spread of the illness to others and stop the RSV-infected child's problems from getting worse. |
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