Hi and welcome to Nursing School Explained. Today we'll go over one of the
most common pediatric respiratory disorders called bronchiolitis and what
that means is inflammation of the bronchioles. Those are the smaller
Airways that we have in our upper chest. 50% of the cases the cause RSV
Respiratory Syncytial Virus and usually small children and infants are very
prone to getting this. And usually they get it from contact with an older
sibling or a parent who might only have a very mild upper respiratory infection.
Symptoms such as a little bit of a runny nose, sore throat, cough. They might not
really think much about it but because the differences in the anatomy in small
children it can cause significant symptoms and also respiratory distress
in these very small children. And it is highly contagious so a lot of times
parents they don't know. They just think they have a very minor cold they go on
about their business they care for their child or infant as they would usually.
They kiss them they you know don't practice any particular infection
control and all of a sudden this child gets really ill with the same virus
that's not really causing any trouble in the adults or older siblings but in
small children it can cause some significant problems. So signs and
symptoms include nasal congestion that's a big one. And because we know that small
children are unable to clear their noses themselves they can't blow their nose
and also they mostly breathe through their noses so if they have a lot of
mucus buildup, lots of nasal congestion that is basically an airway obstruction
and can lead to to some really big problems. They might also be sneezing,
having a low-grade temperature and anorexia because we know that children when
they're ill they just don't want to eat. Now later signs and symptoms so in the
initial phase they might just have very mild symptoms but then later on they can
develop some signs and symptoms of acute respiratory distress such as tachypnea, tachycardia
They might have abnormal lung sounds and that's mostly going to
be rhonchi because there's all this mucous congestion that's causing the
problems and there might be underlying crackles or wheezing as well. The child
might be cyanotic or show signs of cyanosis such as starting with circumoral
or maybe the extremities are a little bit cyanotic. That certainly can progress to
some more significant whole-body cyanosis. They might have all these other
signs and symptoms of respiratory distress nasal flaring, retractions,
difficulty feeding, sucking and swallowing because they're working so
hard to breathe that feeding really comes secondary. Plus keep in mind if
they were breastfed and there are they're attempting to feed and they are
attempting to breathe the same time if the nose is congested they're not going to
be able to feed. Now diagnostic tests for bronchiolitis is a respiratory culture
to really see what virus or bacteria might be causing the trouble and the
signs and symptoms. And then maybe a chest x-ray if there is a suspicion for some
underlying atelectasis or pneumonia. So this child is just not getting any
better after several days of being here or maybe hospitalized and their O2 sat is not improving then certainly a chest x-ray will be indicated. And
treatment and nursing care so if the symptoms are mild the patient can be
treated at home with supportive care and that includes management of fever, making
sure they are staying hydrated, making sure that infection control
measures are being taken that they're eating well and all those good things
that we teach our patients. Now but if they're moderately to severe symptomatic
then they're going to may have to be hospitalized. And treatments here
because of this nasal congestion that's causing all this trouble in these
children that breathe through their nose primarily we want to make sure we get
rid of that mucus. So nasal or nasopharyngeal suctioning is going to be of the
utmost importance for these children. Cool humidified air will help moisturize
any secretions as well as deal with the inflammation of the Airways to really
help decrease the edema and open their Airways to breathe a little bit easier.
Certainly we want to elevate the head of the bed because all this congestion
might feel like they're choking so by elevating the head of the bed we'll let
things just drain naturally. They might need IV fluids for hydration and
certainly infection control measures. Now the CDC only recommends contact
precautions for RSV but most hospitals nowadays will put the patient in contact
and droplet precautions because it is so highly contagious. And therefore preemies
and children with chronic lung issues so maybe they have asthma
they've had some contain a heart defect or any kind of other chronic illnesses
there is an RSV vaccination available. In summary RSV is very common. If you've
been to pediatric clinical yet you know that children are hospitalized
frequently for this for this illness and because we have this nasal congestion
and the mucus production number one is to clear their airway. You're thinking
about your airway breathing circulation priorities so that suctioning
is going to be very important. Thank you for watching. Please also watch the other
videos on pediatric respiratory disorders to help you distinguish
between the differences and I hope to see you again soon. Thank you for
watching Nursing School Explained.