What is bronchiolitis?
An acute inflammatory process of the bronchioles and small bronchi.
What usually causes bronchiolitis?
A viral pathogen.
What virus accounts for the majority of bronchiolitis cases?
Respiratory Syncytial Virus (RSV).
How contagious is RSV?
RSV is a highly contagious virus.
How may RSV be contracted?
Through direct contact with respiratory secretions or from particles on objects contaminated with the virus.
Why are inpatients isolated with RSV?
To decrease the risk of spread to other children.
Why is attention to hand washing important with RSV?
Droplets might enter the eyes, nose, or mouth via the hands.
What is the typical onset of illness in bronchiolitis?
Clear runny nose (sometimes profuse).
What throat symptom may occur in bronchiolitis?
Pharyngitis.
What type of fever is associated with bronchiolitis?
Low-grade fever.
When does cough typically develop in bronchiolitis?
1 to 3 days into the illness.
What respiratory symptom often follows the cough in bronchiolitis?
Wheeze shortly thereafter.
What feeding problem may occur in bronchiolitis?
Poor feeding.
What is a clinical reasoning alert regarding respiratory rate in a tachypneic infant?
Slowing of the respiratory rate does not necessarily indicate improvement; it may indicate tiring, and carbon dioxide retention may soon be followed by apnea.
What may pulse oximetry show in bronchiolitis?
Oxygen saturation might be decreased significantly.
What might a chest radiograph reveal in bronchiolitis?
Hyperinflation and patchy areas of atelectasis or infiltration.
What might blood gases show in bronchiolitis?
Carbon dioxide retention and hypoxemia.
How can RSV be positively identified?
Nasal-pharyngeal washings via enzyme-linked immunosorbent assay (ELISA) or immunofluorescent antibody (IFA) testing.
What type of treatment is used for RSV?
Supportive care.
What supportive care measures are included in RSV treatment?
Supplemental oxygen, gentle nasal or nasopharyngeal suctioning, and oral/IV hydration.
When is home care appropriate for RSV?
If illness is mild and hydration is adequate.
When should hospitalization occur for RSV?
For more severe disease or risk of rapid decline.
What findings indicate risk for rapid decline in RSV?
Tachypnea, moderate-severe retractions, poor oral intake/dehydration, lethargy, or episodes of apnea.
Why may children with RSV require hospitalization?
Because they can deteriorate quickly and progress to needing ventilatory support.
