Acute Bronchitis

Case Introduction

Acute bronchitis is inflammation of the tubes

that carry air to the lungs (bronchial tubes).
When these tubes are inflamed, they swell and
produce mucus. Acute bronchitis usually
develops rapidly and lasts 2 to 3 weeks in
otherwise healthy people.
Is an infection of the lower respiratory tract that
generally follows an upper respiratory tract
infection. As a result of this viral (most
common) or bacterial infection, the airways
become inflamed and irritated, and mucus
production increases.

Pt. Data

Name: Jhona Jhean Rebllon

Age: 11 years old
Sex: Female
Birthdate: July 27, 2014
Status: Single
Address: Brgy. Gulang-Gulang Lucena City,
Quezon
Religion: Roman Catholic
Date of Admission: 7/16/13
Chief Complaint: Cough, Colds, Dyspnea, Fever
Diagnosis: Acute Bronchitis

Physical Assessment

July 12, 2013 ; 8am

Normal values

Outcome

Interpretation

Axillary temp

37C

36.7

Normal

Respiratory rate

12-20bpm

18bpm

Normal

Pulse rate

60-100bpm

84bpm

Normal

BP

120/80mmHg

130/60

July 12, 2013 ; 8am

Axillary temp

Normal values

Outcome

Interpretation

37C

36.7

Slightly increased due to hot

environment

Respiratory rate

12-20bpm

18bpm

Normal

Pulse rate

60-100bpm

84bpm

Normal

BP

120/80mmHg

130/60

Slightly increased due to hot

environment

Head To Toe Assessment

Head to toe Assessment

Skin
Warm to touch, dark complexion, no lesion or scar noted and
dry, presence of yellowish color on the foot.
Nails

With dirty finger nails

Head and face

Head is appropriate with the body, hair is black and oily,

face is symmetrical
Eyes

Black pupil, with pale sclera

 Nose

The septum is in the midline, no mucosal

discharged noted
Mouth

With pale lips

Neck

No mass nor lesions noted

Abdomen

With occurring no susceptive and radiating

pain on the right lumbar region going to the
epigastric region, no tenderness upon palpation,
no lesion noted

Laboratory Test

06/16/13

Result

Normal Values

Interpretation

RBC

4.0

4-6X10 12/1

Normal

Hemoglobin

131 g/l

M: 130-180 g/l
F: 120-160 g/l

Normal

Hematocrit

0.42 g/l

M: 0.40-0.54
F: 0.36-0.47

Normal

B.T (Dukes)

None

1-4 mins

Normal

C.T. (Slide)

None

2-5 mins.

Normal

Platelet

400

150-400x10 9/L

Normal

06/16/13
WBC

Result

Normal Values

Interpretation

9.0

4-11x10 9/L

Normal

Segmenters

75

50-70

There's a
presence infection

Lymphocytes

24

25-40

Slightly decrease

Monocytes

0-8

Normal

Eosinophils

0-4

Normal

Stab

None

0-3

Basophils

None

0-2

Others

None

Blood Typing

None

Differential Count

Normal Anatomy and

Physiology

Pathophysiology

Environment pollutant
Acute bronchitis
Irritate in airway
Mucous plug the airway

Hypersecretion of
mucous

Inflammation

Narrowing of bronchial
lumen

Thickened bronchial wall

Clinical Management

Drug Study

Guafenesin/Chloramphenamine
Therapeutic
Effect
Expectorant

Action

Contraindica
tion

increases the Hypersensiti

volume and vity.
reduce the
viscosity of
tenacious
sputum and
is used as an
expectorant
for
productive
cough.

Side Effects

Intervention

GI
discomfort,
nausea and
vomiting;
dizziness,
drowsiness,
headache;
rash;
decreased
uric acid
levels;
urinary
calculi (large
doses).

WARNING:
Monitor
reaction to
drug;
persistent
cough for
more than 1
wk, fever,
rash, or
persistent
headache
may indicate
a more
serious
condition.

Dosage
5ml TID

Salbutamol
Therapeutic
Effect
Antiasthmatic
and COPD
preparation

Action

Contraindicatio
n

Side Effects

It relieves nasal
congestion and
reversible
bronchospasm by
relaxing
the smooth
muscles of the
bronchioles.

Hypersensitivity
to adrenergic am
inesHypersensitivity
to fluorocarbons

1.Nervousness
2.Restlessness
3. Tremor
4. Headache
5. Insomnia6
. Chest pain
7.
Palpitations
8. Angina\
9. Arrhythmias10
Hypertension11
\S. Nausea and v
omiting
12.
Hyperglycemia
13. Hypokalemia

Intervention

Dosage
5 ml TID

Cardiac disease i
ncluding coronar
y insufficiency, a
history of stroke
, coronary artery
disease and
cardiac
arrhythmias

Therapeutic
Effect
Paracetamol
Classification
Anti-pyretic

Action

Contraindication

Decreases fever by
(1) hypothalmic
effect leading to
sweating and
vasodilation
(2) inhibits the
effects of pyrogens
on the hypothalamic
heat regulating
centers.

Renal insufficiency,
anemia, liver
failures. Clients
with cardiac or
pulmonary disease
are more susceptible
to toxicity

Side Effects

Intervention

Dosage

Contraindicated in
patients
hypersensitive to
drug.

Use liquid form for

children and patients
who have difficulty
swallowing.

Adults and children

500-1000 mg orally
every 4-6 hours.

Use cautiously in
patients with long
term alcohol use
because therapeutic
doses cause
hepatotoxicity in
these patients.

In children, dont
exceed five doses in
24 hours.

Hematologic:
hemolytic anemia,
neutropenia,
leucopenia,
pancytopenia.
Hepatic: Jaundice
Metabolic:
Hypoglycemia
Skin: rash, urticaria.

Advise patient that

drug is only for
short term use and
to consult the
physician if giving
to children for
longer than 5 days
or adults for longer
than 10 days.
Advise patient or
caregiver that many
over the counter
product contain
acetaminophen; be
aware of this when
calculating total
daily dose.

Nursing Care Plan

Assessment

Diagnosis

Planning

Intervention

Rationale

Evaluation

Subjective:
Nahihiripan ako
huminga as
verbalized by the
patient

Ineffective airway
clearance related
to obstruction by
secretion due to
excessive
production

After 8 hours of
nursing
intervention the
patient will
maintain airway
patency

Monitor Vital signs

Serves as baseline
data

After 8 hours of
nursing
intervention the
patient maintained
airway patency

Objective:
Positive
productive cough
Positive
crackles
Positive of
difficulty of
breathing
Slightly in
distress
Restless
irritable

Place the pt. in

fowlers or semifowlers position

To facilitate
maximum lung
expansion

Avoid exposure to
irritants such as
cigarette smoke,
aerosol and fumes

To avoid allergic
reaction

Auscultate breath
sounds

To as certain status
and note progress

Increase fluid intake

Helps liquefy
secretions

Suction as ordered
To clear airway
Provide oxygen
inhalation as ordered
Administer
medication as ordered
Encourage the
opportunities for rest;
limit activities to
level of respiratory
tolerance

Provide adequate
amount of oxygen
Will help loosen
secretions for easy
expulsion.
Prevents or reduces
fatigue