Materiały źródłowe

• #1 Bronchiolitis & Nursing care | PPT

  https://www.slideshare.net/slideshow/bronchiolitis-nursing-care/238657907

  Bronchiolitis is an inflammation of the bronchioles most commonly caused by respiratory syncytial virus (RSV). It occurs most often during winter and spring in children under 3 months old. The infection spreads through infected droplets and causes mucus production, cell death and swelling in the bronchioles leading to obstructed airflow. Symptoms include fever, cough, wheezing and fast, shallow breathing. Diagnosis involves physical exam, chest x-ray, and testing nasal secretions for RSV. Treatment focuses on oxygen, bronchodilators, corticosteroids and chest physiotherapy. […] 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).

• #2 Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV) | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-bronchiolitis-respiratory-syncytial-virus-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. […] Acquire knowledge of evidence-based nursing interventions for managing bronchiolitis and RSV, including respiratory support, hydration strategies, and measures to alleviate distress. Understand the role of family education in home care. […] Monitor respiratory rate, depth, and pattern, noting signs of increased work of breathing such as retractions, nasal flaring, and use of accessory muscles. […] Administer medications as ordered, such as bronchodilators or antiviral agents, to alleviate symptoms and manage the viral infection.

• #3 Bronchiolitis ward management

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Bronchiolitis_Ongoing_Management/

  Bronchiolitis is an acute viral infection of the lower respiratory tract (LRTI). It generally affects children less than 12 months of age and it is the most frequent cause of hospitalization in infants under 6 months of age. […] To outline hospital management of infants with bronchiolitis admitted to the ward. Children who require additional support may be managed in the Paediatric Intensive Care Unit (PICU) or Neonatal Intensive Care Unit (NICU). […] For infants with mild bronchiolitis document respiratory assessment and observations every four hours as a minimum, offer smaller more frequent oral feeds, cluster cares / minimal handling. […] For infants with moderate bronchiolitis If patient transgresses into ViCTOR orange zone consider escalation and/or medical modification of patient vital sign: RCH ViCTOR.

• #4 Bronchiolitis & Nursing care | PPT

  https://www.slideshare.net/slideshow/bronchiolitis-nursing-care/238657907

  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. […] RISK FACTORS OF BRONCHIOLITIS Chronic lung disease Congenital heart disease Younger than 3 months old Prematurity Downs syndrome Cystic fibrosis Neuromuscular disease. […] 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. […] CLINICAL FEATURES Moderate fever Runny nose Loss of appetite Shortness of breath Chest tightness. Shallow fast breathing. Malaise Cough Dehydration.

• #5 Bronchiolitis & Nursing care | PPT

  https://www.slideshare.net/slideshow/bronchiolitis-nursing-care/238657907

  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. […] RISK FACTORS OF BRONCHIOLITIS Chronic lung disease Congenital heart disease Younger than 3 months old Prematurity Downs syndrome Cystic fibrosis Neuromuscular disease. […] 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. […] CLINICAL FEATURES Moderate fever Runny nose Loss of appetite Shortness of breath Chest tightness. Shallow fast breathing. Malaise Cough Dehydration.

• #6 Bronchiolitis – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/bronchiolitis.html

  The diagnosis of bronchiolitis and assessment of disease severity should be based on history and physical examination. Laboratory and radiologic studies should not be routinely ordered for diagnosis. […] Risk factors for severe disease such as age 12 weeks, premature birth, underlying cardiopulmonary disease, or immunodeficiency should be assessed when making decisions about evaluation and management of children with bronchiolitis. […] Bronchodilators (albuterol, salbutamol), epinephrine, and corticosteroids should not be administered to infants and children with the diagnosis of bronchiolitis. […] Nebulized hypertonic saline should not be administered to infants with the diagnosis of bronchiolitis in the emergency department. Nebulized hypertonic saline may be administered to infants and children hospitalized for bronchiolitis.

• #7 Bronchiolitis – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/bronchiolitis.html

  The diagnosis of bronchiolitis and assessment of disease severity should be based on history and physical examination. Laboratory and radiologic studies should not be routinely ordered for diagnosis. […] Risk factors for severe disease such as age 12 weeks, premature birth, underlying cardiopulmonary disease, or immunodeficiency should be assessed when making decisions about evaluation and management of children with bronchiolitis. […] Bronchodilators (albuterol, salbutamol), epinephrine, and corticosteroids should not be administered to infants and children with the diagnosis of bronchiolitis. […] Nebulized hypertonic saline should not be administered to infants with the diagnosis of bronchiolitis in the emergency department. Nebulized hypertonic saline may be administered to infants and children hospitalized for bronchiolitis.

• #8 Bronchiolitis

  https://www.rch.org.au/clinicalguide/guideline_index/Bronchiolitis/

  Bronchiolitis is a clinical diagnosis. Investigations are not indicated […] The goal of management is to maintain hydration and oxygenation. Medication beyond simple analgesia is not indicated […] Infants with a history of prematurity or cardiopulmonary disease are at higher risk of deterioration and are more likely to require admission […] Use nasal prong oxygen for persistent SpO2 90%. High flow nasal prong (HFNP) therapy should be reserved for failure of nasal prong supplemental oxygen […] In most children with bronchiolitis, no investigations are required or recommended. Investigations should only be undertaken when there is deterioration or diagnostic uncertainty (eg cardiac murmur with signs of congestive cardiac failure) […] The main treatment of bronchiolitis is supportive. This involves ensuring appropriate oxygenation and fluid intake, and minimal handling

• #9 Bronchiolitis & Nursing care | PPT

  https://www.slideshare.net/slideshow/bronchiolitis-nursing-care/238657907

  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. […] RISK FACTORS OF BRONCHIOLITIS Chronic lung disease Congenital heart disease Younger than 3 months old Prematurity Downs syndrome Cystic fibrosis Neuromuscular disease. […] 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. […] CLINICAL FEATURES Moderate fever Runny nose Loss of appetite Shortness of breath Chest tightness. Shallow fast breathing. Malaise Cough Dehydration.

• #10 Bronchiolitis Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/8272-bronchiolitis

  Bronchiolitis is a viral infection that targets the small airways of a childs lungs. It causes wheezing, coughing and a slight fever. Its most common during colder months. Contact your childs healthcare provider or emergency services if your child has trouble breathing. […] Bronchiolitis is a viral infection that affects children younger than 2 years old. It causes the airways (bronchioles) in your childs lungs to narrow, which makes breathing difficult. If your child develops this infection, monitor their breathing and contact a healthcare provider if they have trouble breathing. […] Bronchiolitis is the most common lower respiratory tract infection among children younger than 2 years old. […] Bronchiolitis can be life-threatening if your child has severe symptoms that affect their ability to breathe. If you notice your child has difficulty breathing, contact 911 or local emergency services or visit the emergency room immediately.

• #11 Bronchiolitis ward management

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Bronchiolitis_Ongoing_Management/

  Bronchiolitis is an acute viral infection of the lower respiratory tract (LRTI). It generally affects children less than 12 months of age and it is the most frequent cause of hospitalization in infants under 6 months of age. […] To outline hospital management of infants with bronchiolitis admitted to the ward. Children who require additional support may be managed in the Paediatric Intensive Care Unit (PICU) or Neonatal Intensive Care Unit (NICU). […] For infants with mild bronchiolitis document respiratory assessment and observations every four hours as a minimum, offer smaller more frequent oral feeds, cluster cares / minimal handling. […] For infants with moderate bronchiolitis If patient transgresses into ViCTOR orange zone consider escalation and/or medical modification of patient vital sign: RCH ViCTOR.

• #12 Bronchiolitis ward management

  https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Bronchiolitis_Ongoing_Management/

  For infants with severe bronchiolitis: include above management and if patient transgresses into ViCTOR red zone escalate as per: RCH ViCTOR. […] Educate parents and visitors on how and when to perform hand hygiene and promote cough etiquette. […] Provide advice to parents on expected course of illness Kids Health Info: Bronchiolitis. […] Consider environmental factors such as lowering lighting and reducing noise levels. […] Promotion of rest and comfort measures such as positioning and analgesia.

• #13 Bronchiolitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bronchiolitis/diagnosis-treatment/drc-20351571

  Because viruses cause bronchiolitis, antibiotics which are used to treat infections caused by bacteria don’t work against viruses. […] In severe cases, your child’s health care provider may try a nebulized albuterol treatment to see if it helps. […] Oral corticosteroid medicines and pounding on the chest to loosen mucus, a treatment called chest physiotherapy, have not been shown to be effective for bronchiolitis and are not recommended. […] A small number of children may need a stay in the hospital. Your child may receive oxygen through a face mask to get enough oxygen into the blood. Your child also may get fluids through a vein to prevent dehydration. In severe cases, a tube may be guided into the windpipe to help breathing. […] Here are some tips: […] Give your child liquids to stay hydrated. […] Don’t use other over-the-counter medicines, except for fever reducers and pain relievers, to treat coughs and colds in children under 6 years old. […] Preparing for questions will help you make the most of your time with your child’s health care provider.

• #14 Bronchiolitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568705/

  Bronchiolitis is a common lung infection in young individuals. The viral infection involves the lower respiratory tract and can present with signs of mild to moderate respiratory distress. Bronchiolitis is a mild, self-limited infection in the majority of children but may sometimes progress to respiratory failure in infants. Bronchiolitis is managed supportively with hydration and oxygen. No specific medications treat the infection. […] The hallmark of management for children with bronchiolitis is symptomatic care. All infants and children who are diagnosed with bronchiolitis should be carefully assessed for adequacy of hydration, respiratory distress, and the presence of hypoxia. […] Children who present with mild to moderate symptoms can be treated with interventions like nasal saline, antipyretics, and a cool-mist humidifier. Those children with severe symptoms of acute respiratory distress, signs of hypoxia, and/or dehydration should be admitted and monitored. These children need aggressive hydration.

• #15 Bronchiolitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568705/

  The management of bronchiolitis is supportive hydration and oxygen. No specific medications treat the infection. […] Provide oxygen if saturations are low. […] Assist with oral hydration. […] Listen to the lungs. […] Monitor oxygenation. […] Assess vitals. […] Intake and output. […] The diagnosis and management of bronchiolitis are with an interprofessional team that includes the emergency department physician, nurse practitioner, pediatrician, primary caregiver, and infectious disease consultant. The diagnosis is clinical, and in most cases, the treatment is supportive. […] While most children benefit from hydration, some may require antipyretics and a cool-mist humidifier. About 1%-3% of children with severe bronchiolitis may require admission for more aggressive respiratory support.

• #16 7 Bronchiolitis & Respiratory Syncytial Virus (RSV) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/bronchiolitis-nursing-care-plans/

  Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with this condition based on the nurses clinical judgement and understanding of the patients unique health condition. […] Goals and expected outcomes may include: The child will demonstrate effective coughing and clear breath sounds. The child will be free of cyanosis and dyspnea. The child will maintain an effective breathing pattern, as evidenced by relaxed breathing at a normal rate and depth and the absence of dyspnea. The child will be free of signs or symptoms of hypoxia. […] Therapeutic interventions and nursing actions for patients with bronchiolitis respiratory syncytial virus (RSV) may include: Assess the airway for patency. Maintaining a patent airway is always the first priority, especially in cases like trauma, acute neurological decompensation, or cardiac arrest.

• #17 7 Bronchiolitis & Respiratory Syncytial Virus (RSV) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/bronchiolitis-nursing-care-plans/

  Administering medications and providing pharmacological support are critical components in the management of patients with bronchiolitis and respiratory syncytial virus (RSV) infection. […] Administer supplemental humidified oxygen as prescribed. Administer supplemental humidified oxygen, if necessary, to maintain a transcutaneous oxygen saturation higher than 90%. […] Providing patient education and health teachings to parents and child patients with bronchiolitis and respiratory syncytial virus (RSV) is crucial for their understanding of the condition, its management, and the promotion of overall well-being.

• #18 Bronchiolitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568705/

  The management of bronchiolitis is supportive hydration and oxygen. No specific medications treat the infection. […] Provide oxygen if saturations are low. […] Assist with oral hydration. […] Listen to the lungs. […] Monitor oxygenation. […] Assess vitals. […] Intake and output. […] The diagnosis and management of bronchiolitis are with an interprofessional team that includes the emergency department physician, nurse practitioner, pediatrician, primary caregiver, and infectious disease consultant. The diagnosis is clinical, and in most cases, the treatment is supportive. […] While most children benefit from hydration, some may require antipyretics and a cool-mist humidifier. About 1%-3% of children with severe bronchiolitis may require admission for more aggressive respiratory support.

• #19 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  Most infants and children can continue to eat, breastfeed, or drink normally while in the hospital. […] Infants and children who are hospitalized for management of bronchiolitis often require breathing treatments, which may include: Oxygen therapy, Nebulizer treatments, Intubation. […] Most children who require hospitalization are well enough to return home within three to four days.

• #20 Bronchiolitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bronchiolitis/diagnosis-treatment/drc-20351571

  Because viruses cause bronchiolitis, antibiotics which are used to treat infections caused by bacteria don’t work against viruses. […] In severe cases, your child’s health care provider may try a nebulized albuterol treatment to see if it helps. […] Oral corticosteroid medicines and pounding on the chest to loosen mucus, a treatment called chest physiotherapy, have not been shown to be effective for bronchiolitis and are not recommended. […] A small number of children may need a stay in the hospital. Your child may receive oxygen through a face mask to get enough oxygen into the blood. Your child also may get fluids through a vein to prevent dehydration. In severe cases, a tube may be guided into the windpipe to help breathing. […] Here are some tips: […] Give your child liquids to stay hydrated. […] Don’t use other over-the-counter medicines, except for fever reducers and pain relievers, to treat coughs and colds in children under 6 years old. […] Preparing for questions will help you make the most of your time with your child’s health care provider.

• #21 Bronchiolitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568705/

  Bronchiolitis is a common lung infection in young individuals. The viral infection involves the lower respiratory tract and can present with signs of mild to moderate respiratory distress. Bronchiolitis is a mild, self-limited infection in the majority of children but may sometimes progress to respiratory failure in infants. Bronchiolitis is managed supportively with hydration and oxygen. No specific medications treat the infection. […] The hallmark of management for children with bronchiolitis is symptomatic care. All infants and children who are diagnosed with bronchiolitis should be carefully assessed for adequacy of hydration, respiratory distress, and the presence of hypoxia. […] Children who present with mild to moderate symptoms can be treated with interventions like nasal saline, antipyretics, and a cool-mist humidifier. Those children with severe symptoms of acute respiratory distress, signs of hypoxia, and/or dehydration should be admitted and monitored. These children need aggressive hydration.

• #22 Bronchiolitis – discharge Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/discharge-instructions/bronchiolitis-discharge

  Your child has bronchiolitis, which causes swelling and mucus to build up in the smallest air passages of the lungs. […] Now that your child is going home from the hospital, follow your health care provider’s instructions on how to care for your child. Use the information below as a reminder. […] In the hospital, your provider helped your child breathe better. They also made sure your child received enough fluids. […] Your child will likely still have symptoms of bronchiolitis after leaving the hospital. […] Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to make the air moist. Follow the directions that came with the humidifier. […] If your child’s nose is stuffy, your child will not be able to drink or sleep easily. You can use warm tap water or saline nose drops to loosen the mucus. Both of these work better than any medicine you can buy.

• #23 Managing infants with bronchiolitis | Nursing in Practice

  https://www.nursinginpractice.com/clinical/paediatrics/managing-infants-with-bronchiolitis/

  In those infants who are deemed fit to be managed at home, parents should be given the following advice: Offer small volumes of feeds more frequently. For infants who are not yet weaned, fluid requirement is usually 150ml/kg/day. While unwell with bronchiolitis an intake of approximately 75% or 110ml/kg/day would be acceptable. […] Bronchiolitis is highly contagious. Transmission is both through aerosolised droplets and close contact with contaminated secretions. The best way to reduce the spread of bronchiolitis is with regular hand-washing. […] NICE guidelines outline the following key safety information that should be provided to parents about caring for children at home: How to recognise developing red flag symptoms, which includes worsening increased work of breathing, fluid intake less than 50-75% of normal or no wet nappy for 12 hours, apnoea and cyanosis.

• #24 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print

  If your child has a fever and/or is uncomfortable, you can give acetaminophen or, if the infant is six months or older, ibuprofen. […] Other therapies, such as antibiotics, cough medicines, and decongestants, are not recommended. […] Hospital care—A small minority of infants and children with bronchiolitis (<5 percent) require monitoring and treatment in a hospital. Most children receive monitoring of vital signs and supportive care, including oxygen therapy and intravenous (IV) fluids, if necessary. [...] Most children with bronchiolitis who are otherwise healthy begin to improve within two to five days. However, coughing and wheezing may persist in some infants for a week or longer, and it may take as long as four weeks for the child to return to their "normal" self. [...] Because the viruses that cause bronchiolitis are contagious, precautions must be taken to prevent spreading the virus to other patients and/or children.

• #25

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ug1890spec

  Fever and discomfort: You may give acetaminophen (like Tylenol or Tempra) or ibuprofen (like Advil or Motrin) to keep your child comfortable. Follow the directions on the package or the directions from your healthcare provider. Do not give aspirin to anyone younger than 18 years because of the risk of Reye syndrome, a serious illness. […] In Hospital When bronchiolitis is very bad, your child may need to stay in the hospital for a few days. Doctors and nurses will do many things to help your child breathe and keep them comfortable, including: Keeping your child calm and sitting upright to make breathing easier. Listening to your childs lungs and watching their breathing. Gently suctioning your childs nose and using nasal saltwater drops. Giving your child extra oxygen. Giving your child extra nutrition with a feeding tube or fluids with an intravenous (IV), if needed.

• #26 Bronchiolitis – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/bronchiolitis.html

  The diagnosis of bronchiolitis and assessment of disease severity should be based on history and physical examination. Laboratory and radiologic studies should not be routinely ordered for diagnosis. […] Risk factors for severe disease such as age 12 weeks, premature birth, underlying cardiopulmonary disease, or immunodeficiency should be assessed when making decisions about evaluation and management of children with bronchiolitis. […] Bronchodilators (albuterol, salbutamol), epinephrine, and corticosteroids should not be administered to infants and children with the diagnosis of bronchiolitis. […] Nebulized hypertonic saline should not be administered to infants with the diagnosis of bronchiolitis in the emergency department. Nebulized hypertonic saline may be administered to infants and children hospitalized for bronchiolitis.

• #27 Bronchiolitis

  https://www.rch.org.au/clinicalguide/guideline_index/Bronchiolitis/

  Children are often more settled if comfort oral feeds are continued […] When non-oral hydration is required, nasogastric (NG) hydration is the route of choice and can be safely used in children on respiratory support […] Beyond simple analgesia, medications are not routinely indicated […] Deep nasal suction beyond the nasopharynx is not recommended. Superficial nasal suction may be considered in those with moderate disease to assist feeding […] Is not indicated […] Infants can be discharged when SpO2 90% and feeding is adequate […] Parents should be educated about the illness, the expected progression and when and where to seek further advice.

• #28 Bronchiolitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bronchiolitis/diagnosis-treatment/drc-20351571

  Because viruses cause bronchiolitis, antibiotics which are used to treat infections caused by bacteria don’t work against viruses. […] In severe cases, your child’s health care provider may try a nebulized albuterol treatment to see if it helps. […] Oral corticosteroid medicines and pounding on the chest to loosen mucus, a treatment called chest physiotherapy, have not been shown to be effective for bronchiolitis and are not recommended. […] A small number of children may need a stay in the hospital. Your child may receive oxygen through a face mask to get enough oxygen into the blood. Your child also may get fluids through a vein to prevent dehydration. In severe cases, a tube may be guided into the windpipe to help breathing. […] Here are some tips: […] Give your child liquids to stay hydrated. […] Don’t use other over-the-counter medicines, except for fever reducers and pain relievers, to treat coughs and colds in children under 6 years old. […] Preparing for questions will help you make the most of your time with your child’s health care provider.

• #29 Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months | Canadian Paediatric Society

  https://cps.ca/documents/position/bronchiolitis

  The most important component of monitoring infants admitted with bronchiolitis is regular and repeated clinical assessments by staff with appropriate expertise in the respiratory assessment of young children. […] Discharge from hospital should be based on clinical judgement and consider the family’s ability to recognize and respond to signs of deterioration. […] Current evidence does not support the use of hypertonic 3% sodium chloride in routine cases of bronchiolitis. […] The use of salbutamol (Ventolin) is not recommended in routine cases. […] The use of corticosteroids is not recommended in routine cases. […] The use of antibiotics is not recommended unless there is evidence, or strong suspicion of an underlying bacterial infection. […] The use of chest physiotherapy is not recommended.

• #30 Bronchiolitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568705/

  The key is the education of the caregiver. Clinicians, including the pharmacist and nurse practitioner, should educate the caregiver with regards to the positioning of the infant, temperature control in the home, importance of oral hydration, avoiding exposure to tobacco smoke and other irritants, handwashing, and compliance with medications.

• #31 7 Bronchiolitis & Respiratory Syncytial Virus (RSV) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/bronchiolitis-nursing-care-plans/

  Administering medications and providing pharmacological support are critical components in the management of patients with bronchiolitis and respiratory syncytial virus (RSV) infection. […] Administer supplemental humidified oxygen as prescribed. Administer supplemental humidified oxygen, if necessary, to maintain a transcutaneous oxygen saturation higher than 90%. […] Providing patient education and health teachings to parents and child patients with bronchiolitis and respiratory syncytial virus (RSV) is crucial for their understanding of the condition, its management, and the promotion of overall well-being.

• #32 Bronchiolitis – discharge Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/discharge-instructions/bronchiolitis-discharge

  Before anyone touches your child, they must wash their hands with warm water and soap or use an alcohol-based hand cleanser before doing so. Try to keep other children away from your child. […] It is very important for your child to drink enough fluids. […] Some asthma medicines help children with bronchiolitis. Your provider may prescribe such medicines for your child. […] Contact your provider right away if your child has any of the following: Hard time breathing, Chest muscles are pulling in with each breath, Breathing faster than 50 to 60 breaths per minute (when not crying), Making a grunting noise, Sitting with shoulders hunched over, Wheezing becomes more intense, Skin, nails, gums, lips, or area around the eyes is bluish or grayish, Extremely tired, Not moving around very much, Limp or floppy body, Nostrils are flaring out when breathing.

• #33 How parents can spot, treat and prevent bronchiolitis. | Greater Manchester Integrated Care Partnership

  https://gmintegratedcare.org.uk/health-advice/how-parents-can-spot-treat-and-prevent-bronchiolitis/

  Make same day contact with 111 or your GP if the young child: Is feeding less than half their normal intake, Is paler than normal, Is producing less than two wet nappies a day, Has a high temperature, 38.5 degrees or above, or above 38 degrees if under three months. […] Get urgent help from 999 or going to AE if your child: Has blueish lips, Is unresponsive, Is very irritable, Is working harder to breathe, Displays long pauses in breathing (over 10 seconds) take a video of your baby breathing to show healthcare professionals.

• #34 Discharge Instructions for Bronchiolitis (Child) | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-bronchiolitis-child

  Your child has been diagnosed with bronchiolitis. This is inflammation in the small airways (bronchioles) in the lungs. It’s caused by a virus. It is not the same as bronchitis, which is an infection of the larger airways. Bronchiolitis is most common in children under 2 years old. It often starts as a cold and then gets worse. Some children with bronchiolitis need to be in the hospital. This is because they need oxygen to help them breathe. Or they may be dehydrated and need more fluids. Here is how to care for your child at home. […] Make sure your child drinks plenty of fluids. This is to prevent too much fluid loss (dehydration). Ask your child’s healthcare provider how much to give. […] Try keeping your child’s head raised (elevated) to make it easier to breathe. Don’t use pillows for a baby.

• #35 Bronchiolitis | What Parents Need to Know

  https://www.cincinnatichildrens.org/health/b/bronchiolitis

  It is normal for your child to have symptoms for a few days after discharge. […] Be sure no one smokes in the house. Smoke is very bad for babies and especially bad for babies with bronchiolitis. […] Use saltwater nose drops and suction your baby’s nose if stuffy and if plugged up before feedings or putting your baby down to sleep. You can buy saltwater nose drops at any drug store, or you can make saltwater nose drops at home.

• #36 RSV-Bronchiolitis

  https://www.rainbowpediatricpc.com/is-your-child-sick/RSV-Bronchiolitis

  Your child has been diagnosed with bronchiolitis. […] Bronchiolitis is common during the first 2 years of life. Most children just have coughing and fast breathing. Some develop wheezing. This means the lower airway is getting tight. If you were given a follow-up appointment, be sure to keep it. Here is some care advice that should help. […] Some children with bronchiolitis are helped by asthma-type medicines. Most children are not helped by these medicines. If one has been prescribed for your child, give it as instructed. Keep giving the medicine until your child’s wheezing is gone for 24 hours. […] Any age: breathe warm mist (such as with warm shower running in a closed bathroom). Age less than 1 year: give smaller, more frequent feedings with breastmilk or formula. Age 1 year and older: give warm fluids to drink, such as apple juice and herbal tea. Reason: relax the airway and loosen up any phlegm.

• #37 Managing infants with bronchiolitis | Nursing in Practice

  https://www.nursinginpractice.com/clinical/paediatrics/managing-infants-with-bronchiolitis/

  In those infants who are deemed fit to be managed at home, parents should be given the following advice: Offer small volumes of feeds more frequently. For infants who are not yet weaned, fluid requirement is usually 150ml/kg/day. While unwell with bronchiolitis an intake of approximately 75% or 110ml/kg/day would be acceptable. […] Bronchiolitis is highly contagious. Transmission is both through aerosolised droplets and close contact with contaminated secretions. The best way to reduce the spread of bronchiolitis is with regular hand-washing. […] NICE guidelines outline the following key safety information that should be provided to parents about caring for children at home: How to recognise developing red flag symptoms, which includes worsening increased work of breathing, fluid intake less than 50-75% of normal or no wet nappy for 12 hours, apnoea and cyanosis.

• #38 Bronchiolitis – discharge Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/discharge-instructions/bronchiolitis-discharge

  Before anyone touches your child, they must wash their hands with warm water and soap or use an alcohol-based hand cleanser before doing so. Try to keep other children away from your child. […] It is very important for your child to drink enough fluids. […] Some asthma medicines help children with bronchiolitis. Your provider may prescribe such medicines for your child. […] Contact your provider right away if your child has any of the following: Hard time breathing, Chest muscles are pulling in with each breath, Breathing faster than 50 to 60 breaths per minute (when not crying), Making a grunting noise, Sitting with shoulders hunched over, Wheezing becomes more intense, Skin, nails, gums, lips, or area around the eyes is bluish or grayish, Extremely tired, Not moving around very much, Limp or floppy body, Nostrils are flaring out when breathing.

• #39 Bronchiolitis | What Parents Need to Know

  https://www.cincinnatichildrens.org/health/b/bronchiolitis

  Bronchiolitis is a common illness of infants and young children. It occurs during winter and early spring and affects the entire respiratory tract, including the bronchioles. The bronchioles are the smallest air passages of the lungs. […] Bronchiolitis is usually mild, and the child gets better after three or four days. However, sometimes the infection is more serious and admission to a hospital is required. […] Because the virus causing bronchiolitis can be spread to others, your child will be put into an isolation room. An isolation sign will be posted on the door to remind others of precautions, including the following. […] Everyone going in and out of the room must wash his/her hands. Hands must also be washed after providing direct care to the child; whenever hands are soiled by secretions or excretions; and after touching toys, medical equipment and furniture. Hand washing is the best way to prevent the spread of infection.

• #40 Bronchiolitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568705/

  The management of bronchiolitis is supportive hydration and oxygen. No specific medications treat the infection. […] Provide oxygen if saturations are low. […] Assist with oral hydration. […] Listen to the lungs. […] Monitor oxygenation. […] Assess vitals. […] Intake and output. […] The diagnosis and management of bronchiolitis are with an interprofessional team that includes the emergency department physician, nurse practitioner, pediatrician, primary caregiver, and infectious disease consultant. The diagnosis is clinical, and in most cases, the treatment is supportive. […] While most children benefit from hydration, some may require antipyretics and a cool-mist humidifier. About 1%-3% of children with severe bronchiolitis may require admission for more aggressive respiratory support.

• #41 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  Hospital care—A small minority of infants and children with bronchiolitis (<5 percent) require monitoring and treatment in a hospital. [...] Most children who require hospitalization are well enough to return home within three to four days. [...] Recovery—Most children with bronchiolitis who are otherwise healthy begin to improve within two to five days.

• #42 Managing infants with bronchiolitis | Nursing in Practice

  https://www.nursinginpractice.com/clinical/paediatrics/managing-infants-with-bronchiolitis/

  Bronchiolitis is a clinical diagnosis and investigations are rarely indicated. The majority of patients with bronchiolitis can be safely cared for at home. No pharmacological treatments have been proven to be of benefit and treatment is largely supportive. […] The NICE guidelines therefore suggest that there are no pharmacological therapies that should be used routinely. Antibiotics are of no value in uncomplicated bronchiolitis as it is a viral illness. […] The NICE guidelines recommend immediate referral by emergency ambulance in cases where: Apnoea is observed or reported. The child looks seriously unwell to a healthcare professional. There is severe respiratory distress grunting, marked recession or a respiratory rate of more than 70 breaths per minute. The child has central cyanosis. Sp02 is persistently below 92% when breathing air.

• #43 Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months | Canadian Paediatric Society

  https://cps.ca/documents/position/bronchiolitis

  Bronchiolitis is a self-limiting disease, usually managed with supportive care at home. […] For those requiring admission, supportive care with assisted feeding, minimal handling, gentle nasal suctioning and oxygen therapy still forms the mainstay of treatment. […] Management is primarily supportive including hydration, minimal handling, gentle nasal suctioning and oxygen therapy. […] The decision to admit to hospital should be based on clinical judgment, factoring in the risk for progression to severe disease, respiratory status, ability to maintain adequate hydration and the family’s ability to cope at home. […] Patients with bronchiolitis should be cared for in an environment with ready access to suction equipment and supplemental oxygen that can be delivered at measurable rates.

• #44 Treating Acute Bronchiolitis Associated with RSV | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0115/p325.html

  The decision to hospitalize a child with RSV infection largely depends on the child’s age, the clinically assessed severity of disease, and other risk factors. […] Most children with RSV infection develop mild to moderate symptoms and can be treated at home provided they have close supervision by parents or caregivers who have been informed of what to watch for. […] The basic management principles for infants hospitalized with acute viral bronchiolitis are oxygen therapy, fluids to prevent dehydration, respiratory support, and parental education. […] Supplemental oxygen should be administered with a headbox or tent if the patient’s oxygen saturation consistently falls below 92 percent on room air. […] Intravenous fluids may be considered when the patient is vomiting or unable to take oral feedings at a level sufficient to prevent dehydration.

• #45 Bronchiolitis | What Parents Need to Know

  https://www.cincinnatichildrens.org/health/b/bronchiolitis

  Most babies can feed as normal. Your baby will get plenty of liquids while in the hospital. Liquids are one of the most important things needed by a baby with bronchiolitis. […] When babies have bronchiolitis, the nose often gets plugged. This can make it hard to breathe while eating. Often the nose of an infant with bronchiolitis will be suctioned before being fed. […] Every few hours, or more often, your child’s nurse or respiratory therapist will check to see how easily your baby is breathing. This assessment will help decide: 1) if extra oxygen is needed, or 2) if the baby is ready to gradually come off the extra oxygen. […] Very few babies with bronchiolitis stay in the hospital more than two to three days. They usually go home when: Breathing is slower and easier, They are eating well, Any medicines or oxygen, if still needed, can be given at home, There is someone in the home who can use a nasal bulb suction, Your baby’s doctor is comfortable with and agrees to all of the discharge plans, A follow-up appointment with the doctor has been arranged, And, most importantly, you are comfortable that your baby is ready for discharge.

• #46 Bronchiolitis Treatment & Management: Approach Considerations, Initial Management, Admission Criteria

  https://emedicine.medscape.com/article/961963-treatment

  Once the relevant criteria are met, the patient may be discharged. […] The ability of the caretaker to manage the infant’s nasal congestion, Improvement in respiratory distress, as evidenced by a respiratory rate lower than 60-70 breaths/min and a resting oxygen saturation above 90% without supplemental oxygen, Adequate oral intake, The education and confidence of the caretaker. […] Various criteria for discharge have been proposed, including clinical improvement, oral intake adequate to maintain hydration status, age older than 2 months without a history of prematurity, no apnea in the preceding 24 hours (in infants younger than 6 months) or the preceding 48 hours (in patients older than 6 months), acceptable oxygen saturation for more than 1 day, either on room air or on stable oxygen therapy of less than 0.5 L/min via nasal cannula if discharged on home oxygen, respiratory rate lower than 60-70 breaths/min, minimal retractions at rest (not crying), no underlying cardiopulmonary disease, when appropriate, home oxygen therapy arranged and parents educated in its use, reliable caregivers with transportation available, follow-up arranged with primary care physician.

• #47 Consensus Clinical Guidelines for Inpatient Management of Viral Bronchiolitis – UCSF Pediatrics

  https://medconnection.ucsfbenioffchildrens.org/bronchiolitis-guidelines/

  Standardize care of pediatric patients with viral bronchiolitis in the acute care and inpatient settings. […] Mainstay of treatment is supportive care with supplemental oxygen, nasal saline, gentle suctioning (no deep suctioning), IV fluids if needed. […] Discharge Criteria: improved work of breathing, maintaining adequate PO hydration, off supplemental oxygen for at least 6hrs, parents able to verbalize anticipated course of recovery. […] Supportive care is the preferred treatment for all viral bronchiolitis. […] Criteria for starting or restarting supplemental O2: O2 sat 88% awake or asleep on RA for period of 10-20 min. […] Criteria for discontinuing supplemental O2: O2 sat consistently 90%, no or minimal respiratory distress, including during PO feeding. […] Consider IV fluids in patients with significant respiratory distress (risk for aspiration or impending respiratory failure) or clear feeding difficulty / dehydration. […] NOT recommended for routine use in bronchiolitis.

• #48 Bronchiolitis (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK568705/

  The management of bronchiolitis is supportive hydration and oxygen. No specific medications treat the infection. […] Provide oxygen if saturations are low. […] Assist with oral hydration. […] Listen to the lungs. […] Monitor oxygenation. […] Assess vitals. […] Intake and output. […] The diagnosis and management of bronchiolitis are with an interprofessional team that includes the emergency department physician, nurse practitioner, pediatrician, primary caregiver, and infectious disease consultant. The diagnosis is clinical, and in most cases, the treatment is supportive. […] While most children benefit from hydration, some may require antipyretics and a cool-mist humidifier. About 1%-3% of children with severe bronchiolitis may require admission for more aggressive respiratory support.

• #49 7 Bronchiolitis & Respiratory Syncytial Virus (RSV) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/bronchiolitis-nursing-care-plans/

  Utilize this comprehensive nursing care plan and management guide to provide effective care for patients diagnosed with bronchiolitis and respiratory syncytial virus (RSV). Gain valuable insights on nursing assessment, interventions, goals, and nursing diagnosis specifically tailored for bronchiolitis and RSV in this guide. […] Nursing care management for bronchiolitis involves assessing and supporting respiratory function, providing comfort, promoting hydration and nutrition, implementing infection control measures, offering supportive care, educating parents, and collaborating with the healthcare team. The goal is to optimize respiratory function, alleviate symptoms, and facilitate recovery. […] The following are the nursing priorities for patients with bronchiolitis respiratory syncytial virus (RSV): Respiratory assessment and monitoring. Oxygenation and airway management. Optimizing nutritional status. Infection control.

• #50 Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV) | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-bronchiolitis-respiratory-syncytial-virus-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. […] Acquire knowledge of evidence-based nursing interventions for managing bronchiolitis and RSV, including respiratory support, hydration strategies, and measures to alleviate distress. Understand the role of family education in home care. […] Monitor respiratory rate, depth, and pattern, noting signs of increased work of breathing such as retractions, nasal flaring, and use of accessory muscles. […] Administer medications as ordered, such as bronchodilators or antiviral agents, to alleviate symptoms and manage the viral infection.

• #51 Bronchiolitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565

  If any of these happen, your child may need to be in the hospital. Severe respiratory failure may require that a tube be guided into the windpipe. This helps your child breathe until the infection improves. […] Because the viruses that cause bronchiolitis spread from person to person, one of the best ways to prevent infection is to wash your hands often. This is especially important before touching your baby when you have a cold, flu or other illness that can be spread. If you have any of these illnesses, wear a face mask. […] If your child has bronchiolitis, keep your child at home until the illness is past to avoid spreading it to others. […] In the U.S., respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia in children who are less than a year old. Two options for immunization can help prevent young infants from getting severe RSV. Both are recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and others.

• #52 Bronchiolitis in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/b/bronchiolitis-in-children.html

  You can help prevent the spread of bronchiolitis. […] Your child may also need a palivizumab shot to help prevent infection with RSV. This medicine belongs to a group of medicines known as immunizing agents. It works by giving your child’s body antibodies to protect it against RSV infection. During RSV season, these shots are advised for high-risk babies. High-risk babies include those born early or those with lung, heart, or immune system diseases. Talk with your childs healthcare provider to see if the shot is right for your child.

• #53 Bronchiolitis – Clinical Practice Guideline | AAFP

  https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/bronchiolitis.html

  Antibiotics should not be used in children with bronchiolitis unless there is a concomitant bacterial infection. […] Supplemental oxygen is not necessary in children and infants with a diagnosis of bronchiolitis if SpO2 exceeds 90%. […] Continuous pulse oximetry is optional for infants and children with bronchiolitis. […] Chest physiotherapy should not be used in the management of bronchiolitis. […] Palivizumab prophylaxis should be administered during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity (32 weeks gestation who require 21% O2 for the first 28 days of life). […] To prevent spread of respiratory syncytial virus (RSV), hands should be decontaminated before and after direct contact with patients, after contact with inanimate objects in vicinity of patient, and after removing gloves. Alcohol rubs are the preferred method for hand decontamination. Clinicians should educate personnel and family on hand sanitation. […] Infants should not be exposed to tobacco smoke. […] Exclusive breastfeeding for at least 6 months is recommended to decrease the morbidity of respiratory infections.

• #54 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics

  Hospital care—A small minority of infants and children with bronchiolitis (<5 percent) require monitoring and treatment in a hospital. [...] Most children who require hospitalization are well enough to return home within three to four days. [...] Recovery—Most children with bronchiolitis who are otherwise healthy begin to improve within two to five days.

• #55 RSV-Bronchiolitis

  https://www.seattlechildrens.org/conditions/a-z/rsv-bronchiolitis/

  If under 1 year old, use bottled water or boiled tap water. […] Wheezing and rapid breathing most often improve over 2 or 3 days. […] Mild wheezing sounds can last up to 1 week. […] Coughing may last 3 weeks. […] Some children (2%) with bronchiolitis need to be in the hospital. […] Your child is contagious for 7 days after the cough first started. […] Your child can return to child care after this time. […] Call your doctor if trouble breathing occurs. […] Wheezing gets worse (becomes tight). […] Trouble feeding occurs. […] Fever lasts more than 3 days. […] You think your child needs to be seen. […] Your child becomes worse.

• #56 7 Bronchiolitis & Respiratory Syncytial Virus (RSV) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/bronchiolitis-nursing-care-plans/

  Utilize this comprehensive nursing care plan and management guide to provide effective care for patients diagnosed with bronchiolitis and respiratory syncytial virus (RSV). Gain valuable insights on nursing assessment, interventions, goals, and nursing diagnosis specifically tailored for bronchiolitis and RSV in this guide. […] Nursing care management for bronchiolitis involves assessing and supporting respiratory function, providing comfort, promoting hydration and nutrition, implementing infection control measures, offering supportive care, educating parents, and collaborating with the healthcare team. The goal is to optimize respiratory function, alleviate symptoms, and facilitate recovery. […] The following are the nursing priorities for patients with bronchiolitis respiratory syncytial virus (RSV): Respiratory assessment and monitoring. Oxygenation and airway management. Optimizing nutritional status. Infection control.

• #57 Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV) | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-bronchiolitis-respiratory-syncytial-virus-rsv

  Educate the patients family on the nature of RSV, the importance of infection control measures, and signs indicating the need for prompt medical attention. […] Assess the relief of symptoms such as cough, wheezing, and respiratory distress to determine the effectiveness of prescribed medications and interventions.

• #58 Bronchiolitis

  https://www.rch.org.au/clinicalguide/guideline_index/Bronchiolitis/

  Bronchiolitis is a clinical diagnosis. Investigations are not indicated […] The goal of management is to maintain hydration and oxygenation. Medication beyond simple analgesia is not indicated […] Infants with a history of prematurity or cardiopulmonary disease are at higher risk of deterioration and are more likely to require admission […] Use nasal prong oxygen for persistent SpO2 90%. High flow nasal prong (HFNP) therapy should be reserved for failure of nasal prong supplemental oxygen […] In most children with bronchiolitis, no investigations are required or recommended. Investigations should only be undertaken when there is deterioration or diagnostic uncertainty (eg cardiac murmur with signs of congestive cardiac failure) […] The main treatment of bronchiolitis is supportive. This involves ensuring appropriate oxygenation and fluid intake, and minimal handling

• #59 Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months | Canadian Paediatric Society

  https://cps.ca/documents/position/bronchiolitis

  Bronchiolitis is a self-limiting disease, usually managed with supportive care at home. […] For those requiring admission, supportive care with assisted feeding, minimal handling, gentle nasal suctioning and oxygen therapy still forms the mainstay of treatment. […] Management is primarily supportive including hydration, minimal handling, gentle nasal suctioning and oxygen therapy. […] The decision to admit to hospital should be based on clinical judgment, factoring in the risk for progression to severe disease, respiratory status, ability to maintain adequate hydration and the family’s ability to cope at home. […] Patients with bronchiolitis should be cared for in an environment with ready access to suction equipment and supplemental oxygen that can be delivered at measurable rates.

Zobacz więcej