Bronchitis

Bronchitis

The right and left bronchi, secondary bronchi, and bronchioles are all included in the bronchial tree, which is inflamed in bronchitis. It may be localized or widespread, acute or chronic.

Types:

• Acute Bronchitis.
• Chronic Bronchitis.

Acute Bronchitis

One of the most frequent illnesses affecting children in preschool and school age is acute bronchitis, which is an acute inflammation of the bronchi that is most frequently caused by a respiratory tract infection (influenza). It happens more frequently throughout the winter and more frequently in male children.

Causes:

• Virus: common virus is Respiratory syncytial virus, rhino virus, influenza virus, measles virus.
• Other irritation fumes like tobacco, smoke, dust or pollutes the air.
• Bacteria: streptococci, pneumonia, H.influenza, staphylococcal.

Pathophysiology:

This usually starts with an upper respiratory infection to the larynx and then goes into the trachea up to the bronchi and causes inflammatory changes in these structures. Due to inflammation and infection child will develop following clinical manifestation:

• Running nose
• Dry hacking unproductive cough that is changed in greenish-yellow sputum.
• Sore throat
• Pain or upper retrosternal discomfort
• Fever up to 102 d with chills.
• Wheezing after a cough
• Chest pain
• Fatigue
• Dyspnea
• Malaise

Diagnosis:

• History taking
• Physical examination
• Sputum cultures to detect bacterial infection

Treatment:

• Advice for drinking of plenty of hot fluids, adequate rest, avoid smoking, increasing moisture in the air with a cool moist humidifier and taking acetaminophen for pain and malaise.
• Cough suppressant if a cough is a dry and no sputum.
• Administer antibiotics if a secondary bacterial infection is present: antibiotics-Amoxicillin
• Bronchial dilators with inhaler if a cough is persistent.
• Smoking cessation/avoid from passive smoking.

Chronic Bronchitis

Chronic bronchitis is defined as a persistent cough that produces sputum and mucus, for at least 3 months in 2 consecutive years. It is a sign of serious lung diseases that may be slowed down but cannot be cured.

Clinical Presentation:

• Expectorating cough
• Shortness of breath
• Wheezing
• Chest pain
• Fever
• fatigue
• Malaise

Diagnosis:

• History taking
• Physical examination
• Chest x-ray
• Sputum test
• Blood test

Treatment:

• Administration of antibiotic such as amoxicillin/clavulanic acid, cephalosporin, and quinolones.
• Bronchodilators
• Corticosteroids
  • Smoking cessation.

Nursing Care of a Child with Bronchitis:

• Provide bed rest.
• Plenty of hot drinks.
  • Encourage for continue breastfeeding if a child is very young.
• Avoid exposure to the cold, foggy and dusty environment.
• Proper management of a cough.
• Administer medicine as prescribed.
  • Give health education to parents on:
  • Prevention of recurrent attack of cold and cough
  • Nutritional care of children at home
  • About risk factors
  • Immunization
  • Maintain general hygiene

Prevention:

• Adequate nutrition and rest during cold and flu
• Proper hand washing
• Avoiding chemical and environmental irritants
• Immunization
• Stop smoking
• Give vitamin A, C, E
• Avoid dairy products
• Avoid sugar and eggs as they may increase the tendency to form mucus in lungs.