BRONCHITIS

Definition: Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs.

Incidence: Most commonly occurring children age group between 2-5 years. More commonly in winter and rainy season.

TYPES

1. Acute bronchitis: is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated (coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis, whereas bacteria account for fewer than 10%.

2. Chronic bronchitis: a type of chronic obstructive pulmonary disease, is characterized by the presence of a productive cough that lasts for three months or more per year for at least two years. Chronic bronchitis most often develops due to recurrent injury to the airways caused by inhaled irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants.

Etiology:

— Viruses that infect the epithelium of the bronchi, resulting in inflammation and increased secretion of mucus.

— Upper respiratory infection (URI) such as the common cold or influenza. About 90% of cases of acute bronchitis are caused by viruses, including rhinoviruses, adenoviruses, and influenza. Bacteria, including Mycoplasma pneumonia, Chlamydophila pneumonia, Bordetella pertussis, streptococcus pneumonia, and homophiles influenza.

Pathophysiology:

Inflammation of the bronchi and trachea can lead to an increased volume of lower respiratory tract secretions and cartilaginous support of the reactive portions of the lower respiratory tract is not fuly developed until the adolescent years. The lack of cartilaginous support of the smooth muscles can result in constriction of the lower airways.

Clinical manifestation:

Children develop a dry, hacking, unproductive but frequent cough. Anterior chest pain. Whistling sounds and occasional shortness of breath. Auscultation reveals coarse and fine moist rales and high pitched bronchi. Low grade fever, coughing.

Diagnostic evaluation:

1. Physical examination

2. Blood examination.3.chest x-rays

Medical management:

1. Administration of antibiotics: azithromycin 250mg 3 days.

2. Bronchodilator: administration of bronchodilator like inj- deriphylline 2-5ml/kgwt.

3. Analgesic and antipyretic drugs such as paracetamol.

Nursing management:

Most children who developed bronchitis are required hospitalization is frequently. children's are given proper medications. Providing high humidity oxygen to children.

Anti-inflammatory medicines and glucocorticoid steroids - these are for more persistent symptoms.

Pulmonary rehabilitation program - this includes work with a respiratory therapist to help breathing.

Bronchitis is a somewhat preventable disease. Prevention methods include:

Avoiding people who are sick with colds or the flu

§ Getting a yearly flu vaccine

§ Getting a pneumonia vaccine (especially for those over 60 years of age)

§ Washing hands regularly

§ Avoiding cold, damp locations or areas with a lot of air pollution

§ Wearing a mask around people who are coughing and sneezing.

§ Provide adequate rest

§ Positioning the child-provide fowlers position to facilitate for easy breathing.

§ Maintain hydration to the child by giving adequate fluids

§ Psychological support to the child and family.

Nursing diagnosis:

1. Altered breathing pattern related to dysponea secondary to disease condition.

Objective: child maintain normal breathing pattern

Nursing intervention: assess the breathing pattern of child

Providing proper position to child eg: fowlers position

Provide breathing exercise

Administered humidified oxygen to child

Administered bronchodilator as per doctors orders.

2. Altered sleeping pattern related to dysponea secondary to disease condition.

Objective: child maintain normal sleeping pattern.

Nursing intervention: assess the sleeping pattern of child

Providing fowlers position for easy breathing

Providing calm and quiet environment

Avoid sleeping at day time more

3. Knowledge deficit of parents related to child condition, hospitalization, treatment.

Objective: parents gain knowledge regarding child condition

Nursing intervention: assess the knowledge of parents by asking question

Explain parents about hospital rules and regulation

Explain parents about treatment, child condition

Provide psychological support to parents and child.

4. Altered body temperature more than normal related to disease condition.

Objective: child maintain normal body temperature

Nursing intervention: assess the body temperature of child by thermometer

Provide cold compress and tepid sponge

Provide plenty amount of fluid to child

Administered antipyretic as per doctor’s order.

REFERENCES:

1. Achar. Textbook of Pediatrics. Saunders Publications, New Delhi.1992.

2. Doroth. R. Barbard. Textbook of pediatrics nursing. W.B. Saunders Company Philadelphia, USA.2 Nd Edi.2002.

3. Marka and David. Manual of Pediatric Care. Saunders Elsevier.USA.2^nd edi.2002.

4. Dorthy R. Marlow. Textbook of Pediatrics Nursing.8^th Edi. 2012.

Received on 18.05.2015 Modified on 26.06.2015

Int. J. Nur. Edu. and Research. 2016; 4(2):231-232.

DOI: 10.5958/2454-2660.2016.00046.6