Congestion and inflammation of the small airways of the lungs (bronchioles) lead to the generation of Bronchiolitis. It is a kind of lung infection caused via the viral attack [respiratory syncytial virus (RSV) or penumovirus]. Since the infants have underdeveloped immune system or are immune compromised they are most vulnerable group of getting affected with Bronchiolitis (Hasegawa, Tsugawa, Brown, Mansbach & Camargo, 2013). The primary symptoms of Bronchiolitis are characterised via coughing, sneezing runny nose and rise in body temperature. Such symptoms are often confused with common cold. However, as the disease progress, the conditions become more severe with symptoms manifested like uncontrollable coughing bouts that cause coughing spasms, breathlessness and even vomiting. Runny nose is associated with mucus secretion along with respiratory wheeze (Hasegawa et al., 2013). Paediatric bronchiolitis is further characterised via high body temperature and threats of coma due to breathless, at times skin turn pale to blue due to the lack of oxygen supply (Hasegawa et al., 2013). The following essay is based on the case study of paediatric bronchiolitis and how it affects the activities of living and subsequent assessment and treatment plan in order to overcome the same.
The AoL is mainly hampered by high body temperature during bronchiolitis. Paediatric bronchiolitis is frequently associated with high fever which is characterised by high body temperature (Ringer, 2013). According to the case study, Bree, 18-month old girl was admitted to paediatric unit of the hospitals for bronchiolitis and main symptoms include high body temperature (38.2 degree Celsius, cough, runny nose with oozing clear mucous, shortness of breath and expiratory wheeze. Thus analysis of the symptoms clearly indicates that body temperature of Bree is high than the normal (normal limit: 36.5 to 37.5 degree Celsius). High body temperature in viral infection like bronchiolitis might turn into shivering (Houdas & Ring, 2013). Purssell (2014) is of the opinion that high body temperature among infants has defined via the medical term, Pyrexia. Pyrexia signifies high body temperature but also encompass dehydration, Lathergy and hyperalgesia. Lathery and dehydration further hamper AoL and hence high body temperature must be adequately accessed and treated,
Breathing is inevitable activity of AoL. However, in bronchiolitis, this involuntary AoL is hampered due to mucus accumulation in pulmonary airway, blockage of nose, vomiting, chocking and breathlessness (Pham, O’malley, Mayfield, Martin & Schibler, 2015). The expiratory wheeze along with the presence of mucus nasal discharge clearly indicated that Bree might have symptoms like laboured breathing. If breathless continues for a prolong period of time then it might lead to coma or brain haemorrhage as due to breathless the oxygen supply within the brain is decreased or ceased. This breathless affects the overall AoL (Mayfield, Bogossian, O’Malley & Schibler, 2014).
Body temperature is the equilibrium between the heat loss and heat generated. The body temperature is lowest during early morning and gradually rises during noon or early evening. However, Bree’s body temperature of two notches above the normal level and in order to access this body temperature proper documentation of temperature per hour is important. van den Anker (2013) highlighted that use of medicines or analgesic immediately decreases body temperature and leads to the formation of sweat. This sweat further heightened cough, cough and dehydration, making condition more severe. Dehydration in turn makes the skin scaly and at time can lead to coma (Momtaz, Sabzehei, Rasuli & Torabian, 2014). The level of dehydration if any can be monitored via tabulating the amount of fluid intake and output along with observation of the colour of urine (Momtaz et al., 2014). Bofang (2013) highlighted that in infant high body temperature is associated with shivering and chills which is again detrimental for health and the child could not perform normal AoL. Since Bree is only 18-month old, it is obvious that she is incapable of expressing her thoughts and discomfort thus constant monitoring of the symptoms is important. Bree’s parents or direct care givers must be educated about disease symptoms so that they can note down rate of shivering and chills when the fever is high. Fever is the main symptom of infection so in order to reduce rise in temperature, Bree’s parents must also be educated about the importance of hand hygiene and keeping Bree in isolation. Al-Tawfiq, Abed, Al-Yami & Birrer (2013) stated that keeping in isolation helps in spread of communicable disease along with increased protection to immune-compromised person. To give Bree supreme comfort loosely fitted cotton cloths are recommended. Antibiotics are not the proper choice of medication in case of Bronchiolitis as it is a viral disease. However, proper anti-viral medication in order to reduce the infection must be done under active supervision of doctors and this medication will further help to decrease high temperature (Da Dalt, Bressan, Martinolli, Perilongo & Baraldi, 2013). Additional medication must be used for pain management. This because child cannot express his or her pain and administration of pain management medication might be helpful to provide relief. In order to control dehydration arising out of fever, electrolyte balance must be maintained via increasing fluid intake, if Bree is unable to take fluid orally intravenous fluid administration must be followed.
Breathing is another important AoL. Normal breathing is an involuntary process and is effortless (Tobaldini et al., 2013). Breathing rate in infants are greater than adults however, during bronchiolitis, breathing rate is increased further and it can no longer be considered as voluntary movement but rather becomes forced or laboured breathing (Tobaldini et al., 2013). The care giver or the nursing professional needs to document the breathing rate of Bree in order to assess whether the breathing is laboured (normal rate: 22 to 28 breaths per minute) (Tobaldini et al., 2013). The effect of laboured breathing and coughing must also be monitored like accessing the chances of breathless or sudden cessation of breath and symptoms include pale or blue colouration of skin (Parshall et al., 2012). Proper semi-fowler can be used in order to provide relief from laboured breathing (Parshall et al., 2012). Suction might also be used to clear the obstruction from trachea or larynx as mucus blocking trachea might lead to asphyxia (Parshall et al., 2012). Laboured breathing may lead to decrease in the oxygen content of the body in that case, oxygen saturation must be monitored via pulse oxymetry and external supply of oxygen must be given if necessary [SO2 below 90] (Parshall et al., 2012). Parents must be educated about semi-fowler position and proper monitoring of oxygen level.
Conclusion
Thus from the above discussion, it can be concluded that AoL are essential for survival. In this paediatric case study, focus was provided over two AoL and this include fever of body temperature and breathing. In case of paediatric care plan special attention are required to be undertaken as infants are unable to express their concerns or discomfort. Rise in body temperature and labored breathing is detrimental for child’s health as it may lead to coma or brain damage in extreme cases. Proper education of the parents or direct care givers must be done to continuous support and for the reduction of unwanted apprehension and panic attacks. Clear communication, periodic documentation and monitoring are optimal for promoting patient’s health and well-being. Moreover, a nursing professional must document body temperature, respiratory rate, fluid intake and mucus secretion in order to device the care plan accordingly. It is also the duty of the nursing professional to take into consideration of the comfort of the infants while actively monitoring them.
References
Al-Tawfiq, J. A., Abed, M. S., Al-Yami, N., & Birrer, R. B. (2013). Promoting and sustaining a hospital-wide, multifaceted hand hygiene program resulted in significant reduction in health care-associated infections. American journal of infection control, 41(6), 482-486. https://doi.org/10.1016/j.ajic.2012.08.009
Berman, A. J., & Snyder, S. (2013). Kozier & Erb’s fundamentals of nursing. Pearson Education UK. Retrieved from: https://dlvqj9fdw01.storage.googleapis.com/MDEzMTcxNDY4Ng==01.pdf
Bofang, Z. (2013). Thermal stresses and temperature control of mass concrete. Butterworth-Heinemann.
Da Dalt, L., Bressan, S., Martinolli, F., Perilongo, G., & Baraldi, E. (2013). Treatment of bronchiolitis: state of the art. Early human development, 89, S31-S36. https://doi.org/10.1016/S0378-3782(13)70011-2
Hasegawa, K., Tsugawa, Y., Brown, D. F., Mansbach, J. M., & Camargo, C. A. (2013). Trends in bronchiolitis hospitalizations in the United States, 2000–2009. Pediatrics, peds-2012. Retrieved from: https://pediatrics.aappublications.org/content/early/2013/05/29/peds.2012-3877.short
Houdas, Y., & Ring, E. F. J. (2013). Human body temperature: its measurement and regulation. Springer Science & Business Media.
Mayfield, S., Bogossian, F., O’Malley, L., & Schibler, A. (2014). High?flow nasal cannula oxygen therapy for infants with bronchiolitis: pilot study. Journal of paediatrics and child health, 50(5), 373-378. https://doi.org/10.1111/jpc.12509
Meyer, M. P., Hou, D., Ishrar, N. N., Dito, I., & te Pas, A. B. (2015). Initial respiratory support with cold, dry gas versus heated humidified gas and admission temperature of preterm infants. The Journal of pediatrics, 166(2), 245-250. https://doi.org/10.1016/j.jpeds.2014.09.049
Momtaz, H. E., Sabzehei, M. K., Rasuli, B., & Torabian, S. (2014). The main etiologies of acute kidney injury in the newborns hospitalized in the neonatal intensive care unit. Journal of clinical neonatology, 3(2), 99. doi: 10.4103/2249-4847.134691
Parshall, M. B., Schwartzstein, R. M., Adams, L., Banzett, R. B., Manning, H. L., Bourbeau, J., … & Mahler, D. A. (2012). An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. American journal of respiratory and critical care medicine, 185(4), 435-452. Retrieved from: https://www.frontiersin.org/articles/10.3389/fphys.2013.00294/full
Pham, T. M., O’malley, L., Mayfield, S., Martin, S., & Schibler, A. (2015). The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis. Pediatric pulmonology, 50(7), 713-720. https://doi.org/10.1002/ppul.23060
Purssell, E. (2014). Fever in children–a concept analysis. Journal of clinical nursing, 23(23-24), 3575-3582. https://doi.org/10.1111/jocn.12347
Ringer, S. A. (2013). Core concepts: thermoregulation in the newborn, part II: prevention of aberrant body temperature. NeoReviews, 14(5), e221-e226. Retrieved from: https://neoreviews.aappublications.org/content/14/5/e221.short
Tobaldini, E., Nobili, L., Strada, S., Casali, K. R., Braghiroli, A., & Montano, N. (2013). Heart rate variability in normal and pathological sleep. Frontiers in physiology, 4, 294.
van den Anker, J. N. (2013). Optimising the management of fever and pain in children. International Journal of Clinical Practice, 67, 26-32. https://doi.org/10.1111/ijcp.12056
Essay Writing Service Features
Our Experience
No matter how complex your assignment is, we can find the right professional for your specific task. Contact Essay is an essay writing company that hires only the smartest minds to help you with your projects. Our expertise allows us to provide students with high-quality academic writing, editing & proofreading services.
Free Features
Free revision policy
$10Free bibliography & reference
$8Free title page
$8Free formatting
$8How Our Essay Writing Service Works
First, you will need to complete an order form. It's not difficult but, in case there is anything you find not to be clear, you may always call us so that we can guide you through it. On the order form, you will need to include some basic information concerning your order: subject, topic, number of pages, etc. We also encourage our clients to upload any relevant information or sources that will help.
Complete the order form
Once we have all the information and instructions that we need, we select the most suitable writer for your assignment. While everything seems to be clear, the writer, who has complete knowledge of the subject, may need clarification from you. It is at that point that you would receive a call or email from us.
Writer’s assignment
As soon as the writer has finished, it will be delivered both to the website and to your email address so that you will not miss it. If your deadline is close at hand, we will place a call to you to make sure that you receive the paper on time.
Completing the order and download