Nursing Care of Infants and Children With Bronchiolitis

Hala Mohamed Assem*

Nursing Care of Infants and Children With Bronchiolitis.

Bronchiolitis is the most common cause of lower respiratory infection in the first year of life. It is a leading cause of acute illness and hospitalization for infants and young children worldwide. Previous studies have demonstrated that at least 1% of children younger than 24 months of age are hospitalized for bronchiolitis. The primary treatment of bronchiolitis remains largely supportive with administration of fluids and supplementary oxygen, observation and mechanical ventilation if needed. Other types of treatment remain controversial. Successful treatment of this diagnosis requires coordination of care of a multidisciplinary team.

Infants become fussy and have difficulty with feeding. They are present with low grade fever, hypothermia in younger infants, running nose, and irritating cough.7,8 Concomitant otitis media is common.8 Apnea may occur particularly in low-birth weight and preterm babies.

Severe cases may progress over 2 to 5 days to the following signs and symptoms due to spread of virus to lower respiratory tract:10 Cough, dyspnea, nasal flaring, tachypnea, tachycardia, irritability, fever, retractions, prolonged expiration, fine crackles (47%), diffuse fine wheezing, hypoxia and over expanded chest.

It enhances mucociliary clearance by decreasing mucus viscosity. Evidence showed that it may decrease LOS by 25% and decrease admission.9,29 In addition, Zhang, et al.30 found that
nebulized hypertonic saline in conjunction with bronchodilator may be effective in treatment and is better than 0.9% saline.

Several studies have shown improved respiratory distress scores in patients breathing Heliox and have suggested that combined Heliox with nasal CPAP may render intubation unnecessary.47 Helium has lower density than air so improve gas flow through high-resistance airways.

Pediatr Neonatal Nurs Open J. 2015; 2(1): 43-49. doi: 10.17140/PNNOJ-2-108