Case Study on a Three Year Old With Bronchiolitis

Acute bronchitis is one of the most common diagnoses encountered in a primary care setting. It affects millions of individuals resulting in significant impact on health of patients and health care industry. Studies have shown that 90% of times acute bronchitis is caused by a virus, yet health care providers are failing to treat or manage these patients with appropriate therapies (Knutson & Braun, 2002). The focus of this paper is to review the guidelines for treatment of acute bronchitis after differentiating acute bronchitis from other common respiratory disease in terms of epidemiology, pathophysiology, clinical features, diagnosis, differential diagnosis, complications and patient education. Understanding the evaluation and treatment guidelines, nurse practitioners can provide evidence-based practice for patients with acute bronchitis.

Participants reaffirmed that the guidance of the nursing team at the moment of discharge were specific to the care in relation to the drug therapy or to invasive devices, such as probes and tracheostomies, without a focus on the guidance about the general care related to the chronic health conditions and the importance of following-up the child after the hospital discharge. One can say that the factors associated with the readmission of children are related to the age group of infants, with respiratory problems associated with chronic conditions, besides the lack of effectiveness in the post-discharge follow-up. Accordingly, it is relevant to reflect about the role of the nursing team in the planning of interventions capable of providing the adaptation of children and their families over the period of admission, at the moment of discharge and in the post-discharge. The combination of guidance of verbal and written strategies can help us to understand the trajectory of illness and adaptation, thereby avoiding

It is suggested by Henderson (1998) that breathlessness in the UK today is a common and complex subjective set of symptoms. A vast range of medical and lifestyle choices cause and exacerbate breathlessness, which can be a frightening and sometimes a painful experience for the patient. A nurses interaction with a patient can help alleviate and reduce these episodes and make a substantial difference to patients both in the community and hospital setting.

Bronchiolitis is a lower respiratory infection caused commonly by the respiratory syncytial virus (RSV) in the first two years of life. Nearly every child in the United States will be infected with RSV before its second birthday. The condition is a leading cause of hospital admissions among children under the age of two. The populations most frequently and severely affected by bronchiolitis include; infants less than 12 months of age, children born at a low gestational age (less than 32 weeks), and children with chronic lung disease, congenital heart disease, or immunodeficiency. Standardized and proper diagnosis and management are essential to effective treatment. The guideline established by the Academy of Pediatrics (AAP) in 2014 provides practitioners with recommendations for diagnosis, management, and prevention of bronchiolitis in children.

This essay provides a written account of the holistic assessment used when admitting a patient onto a respiratory ward. A brief outline is also included of the processes involved together with the resources used for collating information. Using the Roper, Logan and Tierney activities of daily living (ADL’s), eating and drinking, has been identified as one goal of nursing care. A short reflection has also been included based on experiences gained on a first clinical placement on the ward. For the benefit of this essay the selected patient will be referred to as Mrs P in order to maintain confidentiality.

If all methods, mentioned in the previous article about bronchitis curing, are not helpful, it is time to take meaningful steps. However, only pediatrician can prescribe all drugs. Never make experiments and self-medicate. If you see, the situation is getting worse, call for a doctor.

Checketts for adequate hydration by checking many things, but six assessments that are important are: (1) amount of urinary output or yellow urine, (2) normal blood pressure, (3) elastic skin turgor with no tenting (Kalia, 2008), (4) basic metabolic panel (BMP) to assess BUN, creatine, and electrolytes including sodium, potassium, chloride, and bicarbonate (Dehydration, 2016), (5) her level of consciousness (LOC) including confusion and lethargy, and lastly (6) seizures. Other assessments include checking if capillary refill is less than three seconds and if pulse and respirations are normal. I’m also checking to make sure mucus membranes are moist (Kalia, 2008) and if her eyes normal and not sunken in. I’d perform a urinalysis, a CBC to check hematocrit, and finally a blood/urine osmolality (Dehydration,

Based on a case study for a 76 year old female, Betty White, presenting to a medical ward with an acute exacerbation of chronic obstructive pulmonary disease (COPD), this paper will firstly outline a brief summary of COPD and discuss the associated risk factors. Secondly, the patient’s information will be summarised. From the perspective of the primary Registered Nurse, this paper will detail steps of an initial clinical assessment of the patient. In doing this, the priorities and considerations involved in order to provide best patient care for this scenario will be addressed. A discussion of information and suggested interventions will be integrated as to how the nurse shall develop a plan of care. Furthermore, it will outline

Bronchiolitis is defined by the textbook as, “a diffuse, inflammatory obstruction in the small airways or bronchioles occurring most commonly in children” (Heuther & McCance, 2012). It is an acute inflammatory disease of the lower respiratory tract that occurs most commonly in infants and is caused by infection with seasonal viruses such as respiratory synctial virus (RSV) (Zorc & Hall, 2010). Bronchiolitis often results from an obstruction of the small airways. It is the leading cause of infant hospitalization in the United States (Zorc & Hall 2010) and is arguably the most common significant medical illness of childhood, with at least “1 in 7 normal infants developing symptomatic bronchiolitis in his or her first year of

Therefore, Oxygen therapy could be one of the strategies. At the same time, nurse should conduct respiratory assessment. depends on the situation,and conduct oxygen therapy to maintain oxygen saturation(Bailey et al., 2013).

The patient manifested signs of respiratory distress precipitated by a pneumonia and bronchiolitis infection. A.D was on 0.5 liters of oxygen via nasal prongs with an oxygen saturation reading of 94%. On prior days without the supplemental oxygen, she was desaturating to below 92%, “ high flow rates generate continuous positive pressure in the airways that could help reduce the work of breathing in bronchiolitis and decrease the need for more invasive respiratory support” (Casey, 2015, p. 24). The patient had a respiratory rate of 42 breaths per minute and the normal respiratory rate for a 13month old as stated in Perry et al. (2013) ranges between 20-40 breaths per minute. Also, the patient had a heart rate of 158 beats per minute and the

treatment at the ward it is therefore important that the nurse encounter, listen to and give the child the time it needs when it is needed.(13) A dilemma for nurses is the balance of professional approach between being personal but yet not to get private with patients or relatives. By showing your personality and genuinity in caring for the child’s parent gives you a head start in a new relationship. In every encounter the child as related bystander or parent assess how reliable and genuine you are. This encounter is a major foundation towards the growth of the relationship. If the nurse comes off as bitter, detached or nonchalant the relationship suddenly gets more complicated in further care.(14) Being involved as for the child as related

receiving less than 30% oxygen at 36 weeks, in order to confirm their need for supplemental

A qualitative study was to assess the physical and psychosocial impact of bronchiectasis. A total of 32 patients had diagnosis of bronchiectasis attended four focus groups. Each focus group was videotaped and subjected to qualitative analysis using the grounded theory approach. Patients demonstrated the potential to self-manage with strategies including self-regulation of medication and airway clearance. Patients suggested that self-management could be promoted through disease-specific information and appropriate healthcare procedures. The conclusion of this study shows that the patients with bronchiectasis have their lives disrupted by this chronic condition, but are receptive to self-management. The present study has given information from

History of Present Illness: Ms. Leach is a very pleasant 85-year-old woman who was last seen by William Pease, DO for a history of bronchiectasis. Her bronchiectasis is very mild and predominantly basilar. She has had prior lobectomy secondary to multiple recurrent pneumonias and [_:30___] bronchiectasis. She has required no hospitalizations. Her symptoms are stable. She has a very minimal cough without sputum production. She does have some shortness of breath with exertion. Her dyspnea is complicated by chronic congestive heart failure.