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.

2. Bronchitis
Prepared by:
shiksha khanal
BNS 2nd year

3. General Objective
At the end of this teaching learning
session, the BSc nursing 3rd year students,
will be able to explain about Bronchitis.

4. Content outline

5. Introduction

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%.

9. Types

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).

12. Risk factor

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

15. Clinical Features
Acute Bronchitis
Running nose, dry
hacking unproductive
cough that is worse at
night and becomes
productive in 2-3 days

16. Clinical Features
Acute Bronchitis
Sore throat, pain or
upper retro-sternal
discomfort, Fever up
to 102°F with chills
lasting 3-5 days

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.

18. Clinical Features contd…
Chronic bronchitis
Persistent expectorating Cough
Shortness of breath
Wheezing

19. Diagnostic evaluation
HISTORY
TAKING
CLINICAL
FEATURES
PHYSICAL
EXAMINATION
SPUTUM
CULTURE
CHEST
X-RAY
BLOOD TEST (ABG,
CBC, HB)
PULMONARY FUNCTION
TEST (PFT)

20. Preventive measures
Vaccinations
Avoiding
exposure to
irritants
Good hygiene
practices
Breastfeeding
Keeping children
away from sick
individuals
Maintaining a
healthy lifestyle

21. Medical management

22. Medical management
Acute bronchitis
If there is no secondary bacterial infection then
acute bronchitis is treated with:

23. Medical management contd…
Acute bronchitis
If a secondary bacterial infection is present

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

26. Nursing
Diagnosis
Ineffective Airway Clearance
related to sputum production
as evidenced by persistent
cough.
Risk for infection related to
compromised respiratory
defenses as evidenced by
elevated body temperature.

27. Nursing
Diagnosis
Anxiety related to breathing
difficulty and illness as
evidenced by restlessness.

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.

34. Evaluation
Effective airway maintained
No any sign of infection seen
Patient condition was improved

35. Complications

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.

39. Any Questions

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