Bronchiolitis

Bronchiolitis

1. Airway Maintenance

   • Rationale: To maintain proper oxygenation to the body
   • Cause: Lower respiratory infection related to the respiratory syncytial virus
   • Interventions: 1) Ensure patient gets her albuterol when scheduled 2) Two person turn with the ventilator to decrease the risk of a vagal response 3) Suction secretions 4) Ensure the bag/mask is within reach for apnic states
   • Outcome: The patient will maintain a proper oxygen saturation throughout care.

2. Cirulation

   • Rationale: To maintain oxygen and nutrients to lower left extremity
   • Cause: Thrombus formation in the patient's common femoral and external iliac artery
   • Interventions: 1) Monitor right lower extremity pedal pulses via Doppler 2) Begin a Heparin drip 3) Monitor PTT and platelets
   • Outcome: The patient will maintain full circulation to all extremities

3. Infection Maintenance

   • Rationale: Bronchiolitis is a highly contagious infection which can be easily transmitted without proper precaution. Also to decrease the risk of the patient gaining another infection.
   • Cause: RSV positive; MRSA positive in nares; Patients father has the flu; Patient's mother is hospitalized with the flu and pnumonia
     • Lewis, S. L., Dirksen, S. R., Hitkemper, M. M., & Bucher, L. (2014). Medical-Surgical Nursing: Assessment of Clinical Problems. St. Louis, Missouri: Elsevier.
   • Interventions: 1) Suction to decrease risk of ventilator associated pneumonia 2) Maintain contact precautions and Cluster care 3) Administer antibiotics 4) Strict hand washing in between patient's rooms 5) Instruct family to wear masks around the patient
   • Outcome: Reduce the risk of the patient receiving another infection and treating the current infection