RSV/Bronchiolitis

question

A nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions would the nurse include in the plan of care? Select all that apply. 1. Place the infant in a private room. 2. Ensure that the infant’s head is in a flexed position. 3. Wear a mask at all times when in contact with the infant. 4. Place the infant in a tent that delivers warm humidified air. 5. Position the infant side-lying, with the head lower than the chest. 6. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.
answer

1. Place the infant in a private room. 6. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.
question

A client who develops acute respiratory distress syndrome (ARDS) is exhibiting hypoxemia that is unresponsive to oxygen therapy. In explaining the client’s condition to the family, the nurse would incorporate which of the following concepts? A) There is excess surfactant production by the alveoli. B)Thick secretions block the airways. C)Blood is shunted past alveoli with no ventilation. D)The individual has difficulty expelling air trapped in the alveoli.
answer

C) Blood is shunted past alveoli with no ventilation. Rationale: One of the primary alterations occurring with ARDS is the collapse of alveoli, causing loss of ventilation in these areas. Perfusion may be normal, but gas exchange is impaired because of inadequate ventilation. Surfactant production decreases with ARDS, a factor that impairs adequate gas exchange. Air does not become trapped in hyperinflated alveoli in ARDS; instead, alveoli collapse.
question

In a client with respiratory distress, which finding by the nurse most manifests a worsening clinical state? A) Increased respiratory rate B) Tachycardia C) Agitation D )Cyanosis
answer

D) Cyanois Rationale: Increased respiratory rate, tachycardia, and agitation are all early signs of respiratory distress. Cyanosis develops later in the progression of respiratory distress.
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RSV
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a pathogen that causes bronchiolitis and pneumonia and is a major cause of acute respiratory disease in children.
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Bronchiolitis
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lower respiratory tract illness ,occurs when an infecting agent causes inflammation and obstruction of the small airways.
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the most common cause of bronchiolitis
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infection with RSV
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how RSV is transmitted
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trough direct contact with respiratory secretions or indirectly through contaminated surfaces
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infants at risk for RSV
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infants under 24 mo with chronic lung disease who have required medical therapy within 6 mo. of RSV season ;those with significant congenital heart disease ;preterm infants under 35 weeks of gestation.Infants, toddlers not breast fed Secondhand smoke Socioeconomically disadvantaged Attend daycare Live in crowded conditions Prematurity Chronic lung disease Congenital heart disease Reduced immunity
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RSV is higher in infants
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who are not breastfed; are exposed to secondary cigarette smoke; attend daycare; live in crowded conditions; socioeconomically disadvantaged.
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clinical manifestations begin
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3-5 days after the exposure to the virus
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Early signs of a mild infection
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rhinorrhea,cough,irritability,and low- grade fever for 1-3 days.Copious mucous secretions, usually green
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S/S for a more serious infection(call for medical care)
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increased irritability,excessive coughing,wheezing,and observable retractions of the ribcage.Nasal flaring,rapid RR,blue skin,listlessness,periods without breathing.
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Diagnostic tests
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enzyme immunoassay techniques from a posterior nasopharyngeal specimen;viral cell culture;chest x-ray;ABG
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clinical therapy
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Isolation,humidified oxygen, IV fluids for hydration,nasal suctioning,CPAP in moderate or severe bronchiolitis.
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Nursing diagnosis
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Ineffective breathing pattern Ineffective airway clearance Impaired gas exchange Fluid and electrolytes imbalance Impaired nutrition Activity intolerance
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nursing care priority
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maintain a clear airway and promote oxygenation
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pharm therapies
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No effective therapy Isolation, cohorting patients Humidified oxygen Maintain oxygen saturation readings > 90%
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Synagis (Palivizumab)
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Prevention; Every 28 days during RSV season Specific criteria used for who needs it Expensive Given IM: powder mixed with sterile water, good for 6 hours after mixing Won’t treat RSV once it has developed

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