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:
- Fever, tachypnea, mild dyspnea, pleuritic chest pain (possible).
- Cough with clear to purulent sputum production.
- Diffuse rhonchi and crackles(contrast with localized crackles usually heard with pneumonia).
Diagnostic Evaluation:
- Chest X-ray may rule out pneumonia. In bronchitis, films show no evidence of lung infiltrates or consolidation.
Therapeutic Intervention:
- Chest physiotherapy to mobilize secretions, if indicated.
- Hydration to liquefy secretions.
Pharmacologic Interventions:
- Inhaled bronchodilators to reduce bronchospasm and promote sputum expectoration.
- A course of oral antibiotics such as a macrolide may be instituted, but is controversial.
- Symptom management for fever and cough.
Nursing Interventions:
- Encourage mobilization of secretion through ambulation, coughing, and deep breathing.
- Ensure adequate fluid intake to liquefy secretions and prevent dehydration caused by fever and tachypnea.
- Encourage rest, avoidance of bronchial irritant, and a good diet to facilitate recovery.
- Instruct the patient to complete the full course of prescribed antibiotics and explain the effect of meals on drug absorption.
- 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.
- 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.
- Teach the patient to recognize and immediately report early signs and symptoms of acute bronchitis.
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
