Nursing care of patient with respiratory disorder

1. BRONCHIOLITIS
Mr.Veerabhadra.B.Badiger
Asst Professor
Dept Of Medical Surgical Nsg..

2. BRONCHIOLITIS
 Bronchiolitis is an inflammation of bronchioles.
 Bronchiolitis is a common disease of the lower
respiratory tract that is most commonly caused by
the respiratory syncytial virus (RSV).
 The incubation period is approximately 4 days
 The infection spreads by infected droplets
(airborne or through direct contact with
secretions)

4. Incidence rate:
 Peak incidence occurs during winter and spring,
 More common in boys than in girls (ratio 1.5:1).
Causative agent
 Respiratory syncytial virus (RSV) 75% of the
cases
 Parainfluenza virus (type 3),
 Mycoplasma, or adenoviruses

5. RISK FACTORS OF BRONCHIOLITIS
 Chronic lung disease
 Congenital heart disease
 Younger than 3 months old
 Prematurity
 Down’s syndrome
 Cystic fibrosis
 Neuromuscular disease

6. PATHOPHYSIOLOGY
Due to etiological factors.
Infection of the bronchiolar and ciliated epithelial cells produces
increased mucous secretion
cell death and sloughing
Peribronchiolar lymphocytic infiltrate and submucousal edema.
distal airway obstruction.
During expiration, the additional dynamic narrowing produces
disproportionate airflow decrease and air trapping

7. CLINICAL FEATURES
 Moderate fever
 Runny nose
 Loss of appetite
 Shortness of breath
 Chest tightness.
 Shallow & fast breathing.
 Malaise
 Cough
 Dehydration

8. DIAGNOSTIC STUDIES
 Complete health history
 Physical examination: wheezing , Labored
breathing
 Complete blood count
 Arterial blood gases analysis.
 Sputum culture & sensitivity.
 Blood culture & sensitivity
 Chest X-ray
 CT / MRI Chest
 Immunofluorescence analysis of nasal washings to
detect RSV
 Nasopharyngeal swab

9. Chest x-ray image of Bronchiolitis

10. CT scan image of
Branchiolitis

11. Nasal swab

12. MANAGEMENT
 Oxygen therapy:
 Antibiotics: Based on type of infection.
 Branchodilators: Theophylline & Etophylline
 Nebulization : Albuterol.
 Oral corticosteroids.: Prednisolone.
 Chest physiotherapy & Postural drainage

13. NURSING CARE
 Assess the general condition
 Collect complete health history & perform
physical assessment.
 Monitor vital signs & Spo2.
 Provide comfortable bed & position
 Administer oxygen if patient develops dyspnea.
 Check sputum for blood.
 Administer drug as ordered & check for side
effects.
 Perform chest physiotherapy
 Health teaching on medication , treatment
regimen.