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Acute Bronchitis Nursing Care Plan & Management

Notes

Description
  • Is an contamination of the inferior respiratory hope that generally follows an better respiratory hope contamination. As a product of this viral (most despicable) or bacterial contamination, the airways beseem inflamed and austere, and mucus genesis growths.
Causes
  • Acute bronchitis is accustomedly exercised by viruses. Established dispose factors grasp a narrative of smoking, occupational scyllas, air defilement, frugal lung administration, and neardity. Children of parents who steam are at excellent dispose for pulmonary contaminations that may bring to bronchitis.
Assessment:
  • Fever, tachypnea, gentle dyspnea, pleuritic chest abstinence (possible).
  • Cough forthcoming a period transparent to corrupt sputum genesis.
  • Diffuse rhonchi and crackles(dissimilarity forthcoming a period localized crackles accustomedly heard forthcoming a period pneumonia).
Diagnostic Evaluation:
  • Chest X-ray may government out pneumonia. In bronchitis, films pretext no indication of lung infiltrates or junction.
Primary Nursing Idiosyncrasy
  • Impaired gas diversify allied to compulsory airways
Medical Management:
  • Chest physiotherapy to mobilize secretions, if implied.
  • Hydration to dissolve secretions.
Pharmacologic Interventions:
  • Inhaled bronchodilators to attenuate bronchospasm and elevate sputum expectoration.
  • A round of unwritten antibiotics such as a macrolide may be instituted, but is controversial.
  • Symptom superintendence for fervor and cough.
Nursing Interventions:
  • Encourage mobilization of secretion through ambulation, coughing, and subterranean vivacious.
  • Entrusting diffuse melting inassume to dissolve secretions and checkmate dehydration exercised by fervor and tachypnea.
  • Encourage repose, nonintention of bronchial irritant, and a good-tempered-tempered regimen to dispose replacement.
  • Instruct the resigned to total the generous round of prescribed antibiotics and expound the movables of meals on offal aridity.
  • Caution the resigned on using balance-the-counter cough suppressants, antihistamines, and decongestants, which may exercise arefexercise and claim of secretions. However, cough preparations containing the mucolytic guaifenesin may be misapply.
  • Advise the resigned that a dry cough may adnear forthcoming bronchitis beexercise of womanishness of airways. Suggest forsakeing dry environments and using a humidifier at bedside. Suffer smoking respite.
  • Teach the resigned to allow and instantly description introduce signs and indications of intelligent bronchitis.
Documentation Guidelines
  • Respiratory foundation of the resigned: Respiratory reprimand, inspiration sounds, use of oxygen, tint of nail beds and lips; hush any respiratory trouble
  • Response to motive: Class of nonproduction of inspiration forthcoming a period any toil,class of tire
  • Comfort, collection atmosphere
  • Response to medications, oxygen,and vivacious entertainments
  • Need for influence forthcoming a period activities of daily influence
  • Response to regimen and growthd caloric intake, daily weights
Discharge and Home Healthcaution Guidelines
  1. Medications. Be trusting that the resigned understands all medications, including the dosage, path, exercise, and impertinent movabless. Patients on aminophylline should accept blood planes drawn as ordered by the physician. Before entity untrammelledd from the hospital, the resigned should demon- streprimand the personal use of metered-dose inhalers.
  2. Complications. Instruct resigneds to declare their principal healthcaution collectr of any veer in the tint or closeness of their secretions. Green-colored secretions may point-out the pres- ence of a respiratory contamination. Patients should also description agreeing, continueed periods of dyspnea that are unrelieved by medications.
  3. Follow-up. Consider that resigneds forthcoming a period strict complaint may deficiency influence forthcoming a period activities of daily influence forthcoming untrammelled. Hush any referrals to collective services. Send resigneds home forthcoming a period a regimen, granted by the regimenitian and reinforced by the entertain, which collects a high-caloric intake. Suffer the resigned to unite the aspect forthcoming a period a scarf if he or she goes out-of-doors in the wane. If the resigned continues to steam,collect the overcome of a smoking respite program or a influence order. Suffer the resigned to forsake irritants in the air.
Sources: ADAM for Images Marilyn Sawyer Sommers, RN, PhD, FAAN , Susan A. Johnson, RN, PhD, Theresa A. Beery, PhD, RN , DISEASES AND DISORDERS A Nursing Therapeutics Manual, 2007 3rd ed Lippincott Review Series

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Nursing Caution Plan

Intalented Airway Clearance
Assessment
Patient may manifest
  • Wheezes/crackles on auscultation on the BLF
  • Subcostal retraction
  • Nasal flaring
  • Presence of non-productive cough
  • Incrtranquility RR balancesection recognized range
Nursing Diagnosis
  • Intalented Airway Clearance
Outcomes
  • Patient obtain demonstreprimand movablesive transparenting of secretions.
  • Patient obtain repress movablesive airway transparentance.
Nursing Interventions
  • Position section midline forthcoming a period dissolution on misapply for age/condition
    • Rationale: To perform or repress notorious airway
  • Elevate HOB
    • Rationale: To decrtranquility prestrusting on the diaphragm and enhancing drainage
  • Observe S/Sx of contaminations
    • Rationale: To warrant corruptions process
  • Auscultate inspiration sounds & assess air mov’t
    • Rationale: To detect foundation & hush advance
  • Instruct the resigned to growth melting intake
    • Rationale: To acceleration to dissolve secretions.
  • Demonstreprimand movablesive coughing and subterranean-vivacious techniques.
    • Rationale: To maximize effort
  • Keep end dry
    • Rationale: To checkmate exalt complications
  • Turn the resigned q 2 hours
    • Rationale: To checkmate potential aspirations
  • Demonstreprimand chest physiotherapy, such as bronchial tapping when in cough, personal postural drainage.
    • Rationale: These techniques obtain checkmate potential aspirations and checkmate any unfriendly complications
  • Administer bronchodilators if prescribed.
    • Rationale: More obnoxious measures to repress airway patency.

Intalented Vivacious Pattern
Assessment
Patient may manifest
  • Wheezes/crackles on auscultation on the BLF
  • Subcostal retraction
  • Nasal flaring
  • Presence of non-productive cough
  • Incrtranquility RR balancesection recognized range
Nursing Diagnosis
  • Intalented Vivacious Sample RT Retained Secretions
Outcomes
  • Patient obtain rectify vivacious sample.
  • Patient obtain repress a respiratory reprimand forthcoming a periodin recognized words.
Nursing Interventions
  • Place resigned in semi-fowlers aspect
    • Rationale: To accept a climax lung disquisition
  • Incrtranquility melting inassume as applicable
    • Rationale: To dissolve secretions
  • Keep resigned end dry
    • Rationale: To forsake stasis of secretions and forsake exalt complication
  • Change aspect bountiful 2 hours
    • Rationale: To dispose secretion mov’t and drainage
  • Perform CPT
    • Rationale: To imperil secretion
  • Place a pillow when the client is reposeing
    • Rationale: To collect diffuse lung disquisition period reposeing.
  • Instruct  how to splint the chest deference forthcoming a period a pillow for self-approval during coughing and refinement of section balance collection as misapply
    • Rationale: To elevate physiological tranquility of maximal inspiration
  • Maintain a dubious airway, suctioning of secretions may be done as ordered
    • Rationale: To separebuke secretions that  obstructs the airway
  • Provide respiratory influence. Oxygen life is granted per doctor’s order
    • Rationale: To aid in relieving resigned from dyspnea
  • Administer prescribed cough suppressants and analgesics and be cowardly, so-far, beexercise opioids may deter respirations exalt than desired.
    • Rationale: To elevate subterraneaner respirations and cough

Impaired Gas Exchange
Assessment
Patient may manifest
  • Appearance of sky blue extremities when in cough (cyanosis), lips
  • Lethargy
  • Restlessness
  • Hypercapnea
  • Hypoxemia
  • Abrecognized reprimand, rhythm, profundity of vivacious
  • Diaphoresis
Nursing Diagnosis
  • Impaired Gas Diversify RT Altered Oxygen Balance
Outcomes
  • Patient obtain rectify balm and diffuse oxygenation of tissues
  • Patient obtain minimize or altogether be untrammelled of indications of respiratory trouble.
Nursing Interventions
  • Monitor plane of sensation or supernatural foundation
    • Rationale: Restlessness,anxiety, confusion, somnolence are despiccontributive reason of hypoxia and hypoxemia.
  • Assist the client into the High-Fowlers aspect
    • Rationale: The upfair aspect allows generous lung journey and enhances air diversify
  • Incrtranquility resigned’s melting intake
    • Rationale: To acceleration dissolve secretions
  • Encourage expectoration
    • Rationale: To cast-out muddy, obstinate, profuse secretions which subscribe for the impairment of gas diversify.
  • Encourage beggarly aspect veers
    • Rationale: To elevate drainage of secretions
  • Encourage diffuse repose & word activities to forthcoming a periodin client tolerance
    • Rationale: Helps word oxygen needs/consumption
  • Promote calm/restful environments
    • Rationale: To punish/rectify material deficiencies
  • Administer supplesupernatural oxygen judiciously as implied
    • Rationale: May punish or checkmate worsening of hypoxia.
  • Administer meds as implied such as bronchodilators
    • Rationale: To entertain the underlying condition

Sleep Sample Disturbance
Assessment
Patient may manifest
  • Irritability
  • Restlessness
  • Lethargy
  • Changes in posture
  • Difficulty of vivacious which worsens at night
Nursing Diagnosis
  • Sleep Sample Disturbance RT Awkwardness of Breathing
Outcomes
  • Patient obtain warrant individually misapply interventions to elevate repose.
  • Patient obtain be contributive to description rectifyments in repose/repose sample.
Nursing Interventions
  • Monitor plane of sensation or supernatural foundation
    • Rationale: Restlessness, preservationfulness,confusion, somnolence are despiccontributive reason of hypoxia and hypoxemia.
  • Promote self-approval measures such as end rub and veer in aspect as necessary
    • Rationale: To collect non pharmacologic superintendence
  • Observe food of melting influence
    • Rationale: Lack of notice and gists, relationships may beget tone. Interfering forthcoming a period repose routines viled on adult schedules may not unite child’s deficiencys.
  • Provide hush environment.
    • Rationale: To elevate an environment contributive to repose.
  • Incrtranquility resigned’s melting intake
    • Rationale: To acceleration dissolve secretions
  • Encourage expectoration
    • Rationale: To cast-out muddy, obstinate, profuse secretions which subscribe for the DOB
  • Limit the melting inassume in plaining if nocturia is a gist
    • Rationale: To attenuate deficiency for nightduration elimination
  • Obtain feedend from SO touching accustomed bedtime, rituals/routines
    • Rationale: To mention accustomed repose samples & collect relatively vileline
  • Provide insurance for resigned repose duration insurance
    • Rationale: To elevate self-approval/safety
  • Recommend mid early nap if one required
    • Rationale: Napping esp. in the forthcomingnoon can dismember recognized repose sample
  • Administer abstinence medication as ordered.
    • Rationale: To help disself-approval and assume climax custom of allaying movables

Risk for Distribute of Infection
Assessment
Patient may manifest
  • Body atmosphere balancesection recognized range
  • Dehydration
  • Incrtranquility WBC count
  • Presence of growth mucus genesis
Nursing Diagnosis
  • Risk for Distribute of Contamination RT Stasis of Secretions & Decreased Ciliary Action
Outcomes
  • Patient obtain warrant interventions  to checkmate and/or attenuate the dispose of contamination
  • Patient obtain accept minimize or altogether be untrammelled from the dispose of contamination.
Nursing Interventions
  • Review weight of vivacious exercises, movablesive cough, beggarly aspect veers, and diffuse melting intake
    • Rationale: These activities elevate mobilization and expectoration of secretions to attenuate the dispose of enucleateing pulmonary contamination.
  • Turn the resigned q 2 hours
    • Rationale: To dispose secretion mov’t and drainage
  • Encourage growth melting intake
    • Rationale: To dissolve secretions
  • Stress the weight of handwashing to SO’s
    • Rationale: Handwashing is the principal resistance over the distribute of contamination
  • Teach the SO’s how to caution for and upright respiratory equipment
    • Rationale: Water in respiratory equipment is a despiccontributive origin of bacterial growth
  • Teach the SO’s the reasons of pulmonary contaminations (veer in tint of sputum, fervor, chills) , self-caution and when to overcome the physician
    • Rationale: Early confession of reasons can bring to a quick idiosyncrasy.
  • Recommend rinsing perforation forthcoming a period water
    • Rationale: To checkmate dispose of unwritten candidiasis.
  • Administer antimicrobial such as cefuroxime as implied.
    • Rationale: Given prophylactically to attenuate any potential complications

Other Potential Nursing Caution Plans
  • High dispose for suffocation
  • High dispose for aspiration
  • Anxiety RT intelligent vivacious difficulties
  • Activity Pharisaism RT indiffuse oxygenation
  • Imbalanced Nutrition: Less than collection requirements RT frugal propensity and dyspnea (for emphysema)

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