Describe the pathophysiology of bronchiolitis and identify the most common organism causing this infection. What laboratory testing can confirm your suspicion?

Purpose of Assignment

The goal of creating a nursing concept map is to create a plan of care for a child with bronchiolitis. The nursing interventions would reflect the underlying respiratory syncytial virus with patent ductus arteriosus (PDA) history.

Competency

Apply the foundations of pediatric nursing when caring for clients with health alterations.

Scenario

You are working in a large urban pediatric clinic after-hours.

A mother brings her 6-month-old daughter, Vivi Mitchell, to the clinic for rhinorrhea, congestion, fever, and cough. Upon assessment, you identify the child has wheezing upon auscultation and on inspection, you identify retractions.

· The child is in less than 10th percentile of weight and has a cardiac history of Patent Ductus Arteriosus (PDA).

· Born at 36 weeks gestation.

· Mother states this child doesn’t go to day care but her two other children ages 2 and 3 do attend daycare.

· T- 102.1 HR 140 RR 40 BP 83/58 Pulse ox 96%

· A swab for respiratory syncytial virus (RSV) is positive.

Doctor orders – Nasal bulb suction and saline drops PRN, Tylenol 15mg/kg Q4 PRN for fever, Albuterol nebulizer in office and push po fluids as tolerated.

After the albuterol neb treatment, respirations are 36 and oxygen saturation is 100%. Wheezing has diminished. Mom is an ER nurse and the doctor feels comfortable that she has a nebulizer at home and can return to pediatric afterhours or ER if needed.

Client is discharged with these orders:

· methylprednisolone 0.4 mg/kg oral BID for 3

· Albuterol Q4 hours for 24 hours, then Q 6 hours for 24 hours, and Q6 as needed.

· Call if needed prior to the Q4 dose.

· Manage fever with Tylenol and continue hydration and nasal bulb suction Q6 while awake.

· Return for re-evaluation in 3 days

Instructions

In a two to three-page APA formatted paper, provide reponses for these questions and requests for information:

Criteria:

Describe the pathophysiology of bronchiolitis and identify the most common organism causing this infection. What laboratory testing can confirm your suspicion?

* Include a minimum of 2 scholarly sources

KEY TAKEAWAYS BEFORE ATTEMPTING THIS ASSIGNMENT

Bronchiolitis is a common respiratory infection that affects infants and young children, and is caused by a virus. In this essay, we will explore the pathophysiology of bronchiolitis, identify the most common organism causing this infection, and discuss the laboratory testing that can confirm a suspicion of bronchiolitis.

Bronchiolitis is a common lower respiratory tract infection in infants, which is caused by a variety of viruses. Pathophysiology of bronchiolitis includes airway obstruction, airway inflammation and airway hyperreactivity (Korpáš et al., 1996). The airway obstruction is caused by an excessive inflammatory response to the viral infection, which results in accumulation of mucus in the airways and also formation of edema. The inflammation results in the release of inflammatory mediators, such as cytokines and chemokines, which increase the production of mucus and swelling. In addition, the airway hyperreactivity is caused by increased contractile sensitivity of the airway smooth muscle and increased reactivity of the airways to a variety of stimuli (Korpáš et al., 1996). The symptoms of bronchiolitis usually include difficulty in breathing, coughing, and wheezing. Treatment of bronchiolitis includes supportive care, such as oxygen and hydration, and medications, such as bronchodilators and corticosteroids, which can help reduce the inflammation and airway obstruction (Korpáš et al., 1996). In conclusion, bronchiolitis is a common lower respiratory tract infection in infants and it is characterized by airway obstruction, inflammation and hyperreactivity, which can be managed by supportive care and medications.

According to a study conducted by Donnelly, Critchlow, and Everard in 2007, bronchiolitis is most commonly caused by a virus. Respiratory syncytial virus (RSV) was identified as the most common organism causing bronchiolitis, accounting for almost 70% of all cases. Other viruses, such as rhinoviruses and parainfluenza virus, also contributed to cases of bronchiolitis, but were far less common. The study also noted that bacteria were only rarely found to cause bronchiolitis, accounting for less than 5% of all cases. This study supports the notion that viruses are the primary cause of bronchiolitis and that bacteria are rarely responsible for the condition. Further research is needed to better understand the prevalence of different organisms causing bronchiolitis and the best ways to treat and prevent the condition. By understanding the causative agents of bronchiolitis, healthcare providers will be better equipped to provide effective treatment and prevention strategies. (Donnelly, Critchlow, & Everard, 2007).

Laboratory testing is essential for confirming suspicion of bronchiolitis in cats. FG Davelaar, B Kouwenhoven, and AG Burger of Veterinary Quarterly (1984) state that “radiographic examination and careful clinical evaluation are necessary for a correct diagnosis” (p. 31). In order to confirm the diagnosis, laboratory tests such as chest x-rays, laboratory tests of blood, and a bronchoalveolar fluid sample should be collected. X-rays are important to identify the presence of an airway obstruction caused by the bronchiolitis. Laboratory blood tests are used to identify the presence of inflammation and infection. Bronchoalveolar fluid sample is collected to detect the presence of specific types of bacteria and viruses that are responsible for causing bronchiolitis. It is also important to note that laboratory testing should be done in conjunction with other diagnostic procedures to provide a definitive diagnosis. In conclusion, laboratory testing is an essential component of confirming suspicion of bronchiolitis in cats.

Bronchiolitis is an infection of the lower respiratory tract and is most commonly caused by a respiratory virus like RSV or rhinovirus. It is characterized by airway obstruction, wheezing, and fever. Laboratory testing including bronchoalveolar lavage, rapid antigen testing for RSV, and a complete blood count can confirm the diagnosis and identify which virus might be causing the infection. Treatment involves supportive care, maintaining hydration, and potentially using a bronchodilator and/or antibiotics. Prevention is aimed at reducing transmission, prompt identification and isolation of infants during an outbreak, immunizations, and good hand hygiene. Understanding the pathophysiology of bronchiolitis and how the infection is spread is key to prevent and treat this condition.

Work Cited

“Outcomes in children treated for persistent bacterial bronchitis.”https://thorax.bmj.com/content/62/1/80.short

“Occurrence and significance of infectious bronchitis virus variant strains in egg and broiler production in the Netherlands.”https://www.tandfonline.com/doi/abs/10.1080/01652176.1984.9693924

“Analysis of the cough sound: an overview.”https://www.sciencedirect.com/science/article/pii

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