Bronchiolitis is a common infection of the lungs in children and infants that causes inflammation and mucus secretion in the bronchioles, which obstructs the flow of air. Atelectasis may occur or air may become trapped. Breastfed infants receive antibodies from the mother in the colostrum that help reduce the likelihood of developing bronchiolitis.
Respiratory syncytial virus (RSV) is a common respiratory virus that causes cold-like symptoms in children and is the most common cause of bronchiolitis in infants. Premature babies and children with a compromised immune system can experience severe infection from RSV.
Bronchiolitis is caused by a virus, most commonly the Respiratory Syncytial Virus (RSV) and rhinovirus, otherwise known as the common cold. These viruses get into the airways and cause inflammation, increased mucus production and obstruction. RSV and bronchiolitis are very contagious and are spread through airborne droplets and direct contact with mucus.
Patient will have adequate oxygenation and gas exchange; patient will be afebrile; patient will maintain adequate nutrition
Assess respiratory status, auscultate lungs for adventitious lung sounds
Assess vital signs and capillary refill
Encourage oral fluids or initiate and administer IV fluids as necessary
Fluids help to thin the secretions and make it easier to suction or expel.
Infants may have difficulty feeding and children often refuse food and drink due to increased nasal congestion
Position patient upright
To help the lungs expand and increase air exchange. Depending on the age of the patient, a child may sit forward leaning on a table while an infant can be held upright
Provide suction as necessary, per facility protocol
To help clear airways. Avoid excessive or prolonged suction that can cause further inflammation of the airways.
Monitor pulse oximetry and provide supplemental humidified oxygen via mask, tent or hood as required
If oxygen saturation drops below 90%, patient may benefit from supplemental oxygen. Humidification provides comfort and helps keep mucus thin and moveable.
Administer medications and breathing treatments per facility protocol
Use incentive spirometer / practice deep breathing techniques
Deep breathing helps open and clear bronchioles and can be effective for older children. Teach them to use incentive spirometer or try blowing a balloon or bubbles.
Provide education to parents for home treatment
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