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Running Head: BRONCHIOLITIS

Nursing Interventions For Ineffective Breathing Pattern


In A Bronchiolitis Pediatric Client
Oladapo Olowoyeye
Humber College
NURS 209
Janet Jeffery
November 19, 2015

BRONCHIOLITIS

NURSING INTERVENTIONS FOR INEFFECTIVE BREATHING PATTERN


IN A BRONCHIOLITIS PEDIATRIC CLIENT
Bronchiolitis is one of the most common infectious diseases of lower airways in infants.
It is an acute viral infection, and it mainly affects the bronchiolar level. It usually affects children
less than two years of age, and the highest incidence is in the winter (Perry, Lowdermilk &
Hockenberry, 2013). Respiratory syncytial virus (RSV) is the main cause of bronchiolitis. Risk
factors include: maternal smoking during pregnancy; being in daycare or having siblings in
daycare; overcrowding. The clinical manifestation of bronchiolitis includes: pharyngitis,
coughing, wheezing, dyspnea, fever, cyanosis, and poor air exchange (Potter & Perry, 2014).
This paper will focus mainly on the nursing diagnosis of ineffective breathing pattern and
its priority nursing interventions. The priority nursing interventions includes: oxygen therapy,
administration of bronchodilator, and suctioning nasopharyngeal airway (Perry, Lowdermilk &
Hockenberry, 2013). It is important these interventions are done as soon as possible. There are
consequences when these interventions are not addressed immediately. These consequences
include: hypoxia, increasing dyspnea, apnea, long term wheezing problem, and death.
Administration of humidified oxygen in concentration sufficient is important to maintain
adequate oxygenation. The oxygenation is adequate when the oxygen saturation (SpO2) is at or
above 90% when measured by pulse oximetry (Perry, Lowdermilk & Hockenberry, 2013).
Suctioning of the nasopharynx periodically is important to remove the mucus and secretions. It is
also important to administer bronchodilator to open the airway. It is very important to carry out
these nursing interventions as soon as possible because there are consequences if these nursing
interventions are not addressed.

BRONCHIOLITIS

One of the consequences of not addressing these interventions is hypoxia. Hypoxia is


when the tissues in the body are deprived of adequate amount of oxygen supply. Administration
of oxygen therapy is protective against hypoxia in bronchiolitis (Bennett et al, 2007). This means
that if oxygen is not administered, hypoxia may develop in a bronchiolitis patient. It is important
to administer humidified oxygen to maintain SpO2 at or above 90%. When there is ineffective
breathing pattern due to bronchoconstriction and mucus, the patient will have difficulty
breathing, and it will be hard for the tissues of the patient to receive adequate oxygenation due to
constriction of the airway. This is why administering humidified oxygen is very important for a
bronchiolitis patient. When oxygen therapy is addressed, this will enable the tissues of the patient
to receive adequate oxygenation and there will be no consequence of hypoxia.
Furthermore, it is also very important to do nasopharyngeal suction of the patient, and
administration of bronchodilator to prevent the child from consequences like increasing dyspnea,
apnea, long term wheezing problem, and death. Nasopharyngeal suction helps to remove
secretions and mucus in the airways, and bronchodilator helps to open the airways of the patient
(Perry & Potter, 2014). When oxygen therapy, nasopharyngeal suction, and administration of
bronchodilators are addressed, it prevents the consequences mentioned earlier from happening to
the pediatric client. As stated by Moore & Tina (2003), if there is accumulation of secretions over
time, the secretions may damage the airway or interfere with mucus production. Suctioning is a
necessary procedure when managing open airways. This means that too many secretions in the
airway can lead to shortness of breath, apnea and also death of the child. Suctioning through
nasopharynx enable a child to breathe comfortably, especially when there is increased secretion,

BRONCHIOLITIS

it helps to prevent patient airway from being compromised (Walsh et al, 2011). This is why it is
very important to suction the patient to remove the secretions in the airways.
The three collaborative care providers for this pediatric client are respiratory therapist,
pharmacist, and physician. The respiratory therapist will help to manage the oxygen need of the
patient, provide maintenance of ventilation, care of airways, around the clock care for the patient,
and make sure the patient gets the right amount of oxygen needed. The respiratory therapist will
also ensure the patient is suctioned effectively, appropriately, and safely with minimal side
effects. The pharmacist will recommend the correct dosage of bronchodilator, and make sure the
patient gets the right type of bronchodilator. It will be more effective when the patient gets the
right type of bronchodilator and the right dose. It will help the patient to widen the airway by
relaxing the bronchial muscle (Perry & Potter, 2014). The physician prescribes and writes the
order for the suctioning of the patient. The physician will make sure the suctioning is initiated in
a timely manner. The physician will make sure the suctioning which is an invasive procedure is
not carried out unnecessarily. The physician will also help to facilitate the patient and family
understanding and cooperation of the procedure. The respiratory therapist, the pharmacist, and
the physician will communicate with each other to address the interventions needed by the
pediatric patient; and to prevent any of the consequences mentioned earlier from occurring.
The three community resources that would benefit this pediatric patient are Brampton
civic hospital, peel pediatrics after hour clinic, and peel childrens centre. In Brampton civic
hospital, the respiratory therapist will communicate with the physician and other care providers
to provide care; assess the patient, auscultate the breath sounds, check vital signs, pulmonary

BRONCHIOLITIS

function studies, administer oxygen, and suction the patient. In peel pediatrics after hour clinic,
the nurses will be able to provide oxygen therapy for the patient, also suctioning of the patient,
immunization from other infectious diseases, prescribed injections, and answer health questions
and concerns relating to the pediatric client. In peel childrens centre, the child will be able to
develop socially and emotionally; engage in sensory activities; develop body awareness; develop
verbal language skills; and gross motor-muscle development. This will really benefit the growth
and development of the child. It is important that while the child is getting the interventions to
maintain airway and improve breathing pattern, the child also develop socially and emotionally.
In conclusion, the priority nursing interventions for ineffective breathing pattern related
to bronchoconstriction and mucus in a pediatric client are oxygen therapy, nasopharyngeal
suctioning, and administration of bronchodilator. The consequences that will occur if these
nursing interventions are not addressed immediately include: hypoxia, increasing dyspnea,
apnea, long term wheezing problem and death of the pediatric client. The three collaborative care
providers that will help to address the earlier mentioned nursing interventions are respiratory
therapist, pharmacist, and physician. The respiratory therapist will help to manage the oxygen
need of the patient, provide maintenance of ventilation and care of airways. The pharmacist will
help to recommend the correct dosage of bronchodilator, and make sure the patient gets the right
type of bronchodilator. The physician prescribes and writes the order for the suctioning of the
patient. The three community resources that would benefit the client are Brampton civic hospital,
peel pediatrics after hour clinic, and peel children centre. The writer belief that the interventions
mentioned above will help to effectively manage the breathing pattern of the bronchiolitis
pediatric patient.

BRONCHIOLITIS

6
References

Bennett, Berkeley L; Garofalo, Roberto P; Cron, Stanley G. Immunopathogenesis of Respiratory


Syncytial Virus Bronchiolitis. The Journal of Infectious Diseases, 05/2007, Volume 195,
Issue 10.
Moore, Tina. Suctioning techniques for the removal of respiratory secretions. Nursing standard
(Royal College of Nursing (Great Britain): 1987), 11/2003, Volume 18, Issue 9.
Perry, S. E., Lowdermilk, D. L., and Hockenberry, M.J. (2013). Maternal Child Nursing Care in
Canada (2013). Toronto: Mosby Elsevier.
Potter, P., & Perry, A.G., (2014). In Ross-Kerr, J., Wood, M., Astle, B., & Duggleby, W.
(Eds),Canadian fundamentals of nursing (2014). Toronto: Mosby.
Walsh BK, Hood K, Merritt G (2011) Pediatric airway maintenance and clearance in the acute
care setting: How to stay out of trouble. Respiratory Care 56 (9): 1424-1444.

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