Acute Bronchitis

• Is an infection of the lower respiratory tract that generally follows an upper respiratory tract infection. As a result of this viral (most common) or bacterial infection, the airways become inflamed and irritated, and mucus production increases.

Assessment:

1. Fever, tachypnea, mild dyspnea, pleuritic chest pain (possible).
2. Cough with clear to purulent sputum production.
3. Diffuse rhonchi and crackles(contrast with localized crackles usually heard with pneumonia).

Diagnostic Evaluation:

1. Chest X-ray may rule out pneumonia. In bronchitis, films show no evidence of lung infiltrates or consolidation.

Therapeutic Intervention:

1. Chest physiotherapy to mobilize secretions, if indicated.
2. Hydration to liquefy secretions.

Pharmacologic Interventions:

1. Inhaled bronchodilators to reduce bronchospasm and promote sputum expectoration.
2. A course of oral antibiotics such as a macrolide may be instituted, but is controversial.
3. Symptom management for fever and cough.

Nursing Interventions:

1. Encourage mobilization of secretion through ambulation, coughing, and deep breathing.
2. Ensure adequate fluid intake to liquefy secretions and prevent dehydration caused by fever and tachypnea.
3. Encourage rest, avoidance of bronchial irritant, and a good diet to facilitate recovery.
4. Instruct the patient to complete the full course of prescribed antibiotics and explain the effect of meals on drug absorption.
5. Caution the patient on using over-the-counter cough suppressants, antihistamines, and decongestants, which may cause drying and retention of secretions. However, cough preparations containing the mucolytic guaifenesin may be appropriate.
6. Advise the patient that a dry cough may persist after bronchitis because of irritation of airways. Suggest avoiding dry environments and using a humidifier at bedside. Encourage smoking cessation.
7. Teach the patient to recognize and immediately report early signs and symptoms of acute bronchitis.

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