Bronchiolitis is a viral infection of the bronchial inflammation, which causes acute airway obstruction and decreased gas exchange in the alveoli. More often caused by respiratory syncytial virus (RSV), this disorder usually occurs in children aged 2 to 12 months, especially during winter and early spring.
Infection characterized by mucosal edema, increased mucus secretion, bronchial obstruction, and excessive stretching of the alveoli. Possible complications of this disorder include chronic lung penyakt and even cause death.
• Nasal flaring
• Breathing shallow
• Reduced breath sounds
• Ekspirasi that extends
• Difficulty sleeping
• Difficulty eating
• Increased temperature
Impaired gas exchange related to bronchial edema and increased mucus production
Children will increase gas petukaran marked breathe easily and the skin color of a young peacock.
1. Create an environment with high humidity by placing the child in a damp tent or equipment with a cold humidifikasi.
2. Give oxygen through a face shield, kanule nose, or oxygen tent, according to the instructions.
3. Position the child with head and chest and neck slightly higher enstensi.
4. Perform chest physiotherapy every 4 hours, or as directed.
5. Give a bronchodilator as directed
6. Perform suctioning as needed gracious remove mucus secretions
7. given antiviral drugs as directed.
8. Provide adequate rest by reducing noise and lighting and provide warmth and comfort
9. Assess the child’s respiratory rate and rhythm every hour. If the child has respiratory problems, auscultatory breath sounds, perform chest physiotherapy, and inform treatment of respiratory
10. apical rate monitors in children; if it detects a tachycardia (based on age of child), report on the incident doctor
1. Cold moisture from the tent or Croupette will help thin mucus and reduce bronchial edema
2. Oxygen will help reduce the anxiety associated with respiratory distress and hypoxia
3. This position is to maintain open airway and facilitate respiration by diaphragm pressure because menurnnya
4. Chest physiotherapy to help relieve and remove the mucus that can inhibit airway smaller
5. Although often used to treat muscle spasms, bronchodilators also effectively mengobatan bronchial edema
6. Will help clear mucus bronchioles, will increase gas exchange.
7. Anti-viral medication, such as respiratory syncytial virus immune globulin (RespiGam), used to pengobati RSV, ribavirin (Virasole) is also used, although efficacy may be questionable.
8. Increasing the rest will reduce respiratory distress associated with bronchiolitis.
9. The assessment will often guarantee an adequate respiratory function.
10. Tachycardia can be caused by hypoxia or influence the use of bronchodilators.
Risk reduction in fluid volume is associated with loss of fluid through ekshalasi and a decrease in fluid intake.
1. Give intravenous fluids as directed
2. Make sure that the child adequate rest
3. monitor the child’s fluid intake and output fluid carefully
4. Assess for signs of dehydration, including weight loss, pale, poor skin turgor, dry mucous membranes, oliguria, and increased pulse frequency.
5. Increase fluid intake by mouth during an acute attack occurs.
1. Fluid via I.V. used for hydration until the child through a critical time.
2. Rest allows the frequency of the child’s breathing returned to normal limits, would reduce the amount of fluid loss through ekshalasi
3. Be careful monitoring to ensure adequate hydration. If urine output decreases, the child may be considered for addition of liquids
4. These signs indicate that the child does not receive enough fluids.
5. Liquids help thin mucus.
Hipertermi associated with infection
Children will maintain body temperature less than 100 º F (37.8 º C). (Temperature in particular depend on the method used in making temperature).
1. Maintain a cool environment through the use of strong light pajamas and a blanket and keep room temperature between 72 º and 75 º F (22 º and 24 º C).
2. Give antipyretics as directed.
3. monitor the child’s temperature every 1 to 2 hours when there was an increase in sudden
4. Give antimicrobial, if recommended
5. Give a compress on the child (98.6 º F [37 º C]) to lower fever
1. The cool environment will help lower body temperature by heat loss through radiation.
2. Antipiretika such as acetaminophen (Tyleno), effectively reducing fever
3. Increasing the temperature will suddenly cause seizures
4. Antimicrobials in accordance with the instructions in order to treat the organism causes. Antibiotics are usually not disarnkan to treat RSV.
5. Compress effective water causes the body to cool through conduction event.
Social isolation associated with isolation precautions
Children will maintain social contact even though she is isolated from the respiratory condition
1. Explain to the child (if necessary) and parental goals and insulating properties, including details about the things around that are less familiar and use a mask and apron.
2. Introduce yourself when entering into the child’s room.
3. Teach parents and children (if necessary) how to use the call system.
4. Assess the child every hour to know that terkadi change in the child’s condition
5. If necessary, provide a variety of activities, such as games, read books, television, and music. If the child is receiving oxygen, avoiding the game that can cause electrical spark (ie a variety of games that use electronic)
6. Encourage parents to participate and take part in child care.
1. Explanation is required in order to avoid the fear in children
2. Children and parents often had difficulty distinguishing the officer because of the use of clothing insulation.
3. Call system allows families to communicate to ask for help
4. Children’s needs for strict monitoring to detect changes need to be a lot of rethinking in the isolation room
5. Activities are varied allows children stimulated and interested during isolated. Games with electronic equipment and cause a fire hazard
6. Parents are the primary sources of socialization in children who were isolated.
Fatigue associated with respiratory disorders
Children will isitirahat at least 1 hour in the morning and afternoon
1. Helps reduce fatigue in children, give regular breaks every 2 hours. Also change the sheets when children bathe, and perform neurological assessments during the visit in order to prevent a disturbed rest.
2. Create lngkungan quiet.
1. Child needs adequate rest to prevent fatigue due to increased respiratory symptoms
2. Unwanted noise and activity that causes fatigue in children will increase the occurrence of respiratory disorders
Nutritional deficiencies: lack of demand associated with increased metabolic demand.
Children will increase nutritional intake of children eating is characterized by at least 80% at every meal
1. Give meals a little, but often the food that is acceptable child.
2. Provide a diet high in calories and protein.
1. Eat little but often requires less energy expenditure and the use of breathing. Children eat a lot at every meal including his favorite foods.
2. Diets high in protein, high calorie needs of children to increase the metabolic demand.
Anxiety (children and parents) are associated with lack of knowledge about the condition of the child.
Children and parents will be less marked express concern about the condition of the child pemahamannnya.
1. Assess the knowledge of parents and (if necessary) the child about the child’s condition and treatment programs provided.
2. Encourage parents to stay with the child
3. Explain all procedures in accordance with the child’s development
4. Provide emotional support to parents during the hospital stay.
1. Assessment as a basis to start teaching.
2. Living together with children allows parents to provide support and help to reduce anxiety on both the child and parents.
3. Provide an explanation before the procedure and during their stay in hospital will reduce anxiety due to improper understanding and knowledge kuirangnya.
4. Hospitalitation created a crisis situation. Listen to the attention of parents and perasannnya will help him to handle the crisis experienced
Lack of knowledge related to home care.
The parents will express his understanding of home care directions.
1. Teach parents and children (if necessary) how and when providing treatment, including description of dosage and its reaction.
2. Describe signs and symptoms of respiratory distress and infection, including fever, dyspnea, Tachypnoea, changes in sputum color, and the presence of wheezing.
3. Explain the importance of adequate rest in children.
4. Teach the need for adequate nutrition and hydration, stressing the need for adequate fluid and high-calorie diet.
5. Teach the need to create a moist and cool environment.
1. Understanding necessary to sustain treatment programs that teraur that can help parents be with children during treatment. Knowing the result of continued treatment of the elderly is expected to soon ask bantua regarding to needs.
2. Precise knowledge on the parents will give attention to doctor’s advice when needed
3. After infection, the child will isitirahat regularly is a tool to recover and prevent recurrence of infection.
4. Giving fluids will thin the mucus. High-calorie diet will help restore the calories needed in the fight against disease.
5. Moist air that helps thin the mucus. Uidara a damp and cool which comes from the tent mounted on a child will ensure the evaporation and the warm air, which can cause a fire.
Documentation check list
During his stay in the hospital, notes:
Current status and assessment of children admitted to hospital
Child status change
Associated with laboratory tests and diagnostic tests
Fluid intake and output
Response of children to treatment
The reaction of children and parents of sick and staying patient
Guidelines for teaching patients and families
Guidelines for follow-up plan.