Bronchitis is an inflammation of the bronchial tubes caused by viruses, bacteria, smoke, or other irritants. It can be acute or chronic. Acute bronchitis causes a cough with sputum, sore throat, fever and lasts a few weeks. Chronic bronchitis is persistent and can be caused by smoking. Nursing management includes assessing cough and sputum, teaching airway clearance techniques, administering medications, preventing infections, and reducing anxiety through education. With treatment, acute bronchitis usually resolves without complications, while chronic bronchitis requires ongoing management.
6. Definition Bronchitis is an inflammation
of the bronchial tubes, which
includes the right and left
bronchi, secondary bronchi
and bronchioles.
7. Incidence
Can vary depending on various factors such as
age, season, environmental factors, and presence
of other underlying medical conditions.
According to a study published in the Journal of
Pediatrics in 2019(US), the incidence of acute
bronchitis in children aged 0-17 years was
approximately 12.2 cases per 1000 person-years.
8. Incidence contd…
Another study published in the Indian Journal of
Community Medicine in 2019 reported that the
prevalence of bronchitis among school-aged
children in an urban area of India was 4.8%.
Another study published in the Journal of Health
Research in 2018 reported that the prevalence of
bronchitis, among children aged 0-5 years in a
urban community in Nepal was 20.7%.
10. Causes
Acute Bronchitis
Virus (most common): Common viruses are
respiratory syncytial virus, rhino virus, Influenza
virus, adeno virus and measles virus.
Others irritating fumes i.e. tobacco, smoke, dust or
polluted air.
Bacteria (rare cause): Streptococci, Pneumonia, H.
influenza, Staphylococcal etc
11. Causes contd…
Chronic Bronchitis
Repeated irritation
Smoking
long term exposure to air pollution, dust etc.
Genetic factors
Repeated history of acute bronchitis or gastro
esophageal reflux disease (GERD).
13. Pathophysiology
Virus, bacteria, smoke or other
environment pollutants irritate
airway
Hyper secretion of mucus and
inflammation
Bronchial wall become thickened
14. Pathophysiology
Bronchial lumen narrow, mucus pluged
airways
Alveoli adjacent to bronchioles may become
damaged and fibrous
Fibrosis of bronchial and airflow limitation
Bronchitis
17. Clinical Features contd…
Acute Bronchitis
Wheezing in expiration
After coughing Chest pain in
older child
Headache, fatigue, dyspnea
and malaise anorexia, lethargy
if caused by influenza virus.
24. Medical management contd…
Chronic bronchitis
Administration of antibiotic such as amoxicillin,
clavulanic acid, cephalosporin and quinolones
Corticosteroids.
Bronchodilators.
Smoking cessation /avoid and other irritants.
25. Nursing Management
Assessment
Assess severity of
cough and
characteristics of
sputum production.
Obtain history of
respiratory infection,
course, and length of
symptoms.
Auscultate chest for
crackles.
Obtain medical history
28. Nursing Management contd…
Interventions
Establishing Effective Airway Clearance
Administer or teach self-administration of
antibiotics, as ordered.
Encourage patient mobilization and, possibly,
hydration, effective cough technique, and if needed,
chest physiotherapy.
Avoid child to drink beverages that contain
caffeine.
29. Nursing Management contd…
Interventions
Establishing Effective Airway Clearance
If ordered, administer or teach self-administration
of inhaled bronchodilators.
Caution patients on the use of over-the-counter
cough suppressants, antihistamines, and
decongestants.
30. Nursing Management contd…
Interventions
To prevent infection
Encourage proper hand hygiene and respiratory
etiquette.
Teach the child and family about the importance
of completing prescribed antibiotics as ordered.
31. Nursing Management contd…
Interventions
To prevent infection
Assess the child for signs of infection, such as
fever or increased respiratory distress
Encourage immunization
Avoid exposure to environmental irritants.
32. Nursing Management contd…
Interventions
To relieve anxiety
Provide a calm and quiet environment to reduce
anxiety
Encourage relaxation techniques, such as deep
breathing, visualization or playing.
33. Nursing Management contd…
Interventions
To relieve anxiety
Provide age-appropriate explanations and
education about the illness and treatment.
Encourage the child to express feelings and
concerns.
36. Prognosis
The prognosis for bronchitis in children can
vary depending on various factors such as the
age of the child, the underlying cause of the
bronchitis, and the severity of the symptoms.
In general, acute bronchitis in children is
usually self-limited and resolves within a few
weeks with appropriate treatment.
37. Prognosis contd…
Most children with acute bronchitis recover
fully without any complications.
However, in some cases, the inflammation in
the bronchial tubes can be severe and may
lead to complications.
38. Prognosis contd…
Children with chronic bronchitis may require
ongoing treatment to manage their symptoms
and prevent complications. If treated earlier
prognosis is good.
41. References
Uprety K.(2021).Child health nursing.3rd ed.Akshav
publication.ktmandu.pg.411-413
Sharma S.(2020).Lippincott manual of nursing
practice.Wolters publication.India.pg.216-217
Mandal GN.(2019).Text book of medical surgical nursing
.6thed. Makalu publication.dillibazar.kathmandu.pg.65-68
Hockenberry M.Wilson D.(2018)Wong’s essential of
pediatric nursing.10th ed. RELX Pvt.Ltd. New
delhi.India.pg.481-483
Sharma M(2019).Essential text book of medical surgical
nursing.3rd ed.Samiksha publication Pvt.
Ltd.putalisadak.kathmandu.pg.41-42