Bronchiolitis (ch.14)

Question 1

What is brionchiolitis?

Answer 1

An acute inflammatory disease of the lower resp. tract resulting in obstruction of the bronchioles

Question 2

What is the cause of bronchiolitis? (5)

Answer 2

Caused by viral pathogens like RSV, Influenza, Parainfluenza viruses, Human metapneumovirus, and Adenovirus
(presence of 2 viral pathogens makes it more severe)

Question 3

90% of children are infected with RSV in the first ___ years of life (highly contagious)

Answer 3

2

Question 4

Bronchiolitis is spread through

Answer 4

droplets

Question 5

Within 24 hours of bronchiolitis infections, _______ of respt. epithelium triggers what?

Answer 5

Necrosis; triggers inflammatory response (bronchial obstruction and airway restriction (edema of airways) and leaks exudate (fluid that leaks out of blood vessels into nearby tissues, typically as a result of inflammation or injury)

Question 6

Bronchial obstruction and airflow restriction are mostly noticeable on ? (expiration/inhlation)

Answer 6

expiration

Question 7

Complete obstruction can lead to….?

Answer 7

Absorption atelectasis (when alveoli collapse because the air inside them gets sucked into your blood, and there’s no new air coming in to keep them open) and increased V/Q mismatch

Question 8

How can you detect bronchiolitis? (3)

Answer 8

• tachypnea, tachycardia, fever
• diffuse fine expiratory wheezing on chest auscultation
• CXRs show hyperinflation, peribronchial thickening and patchy atelectasis

Question 9

Bronchiolitis clinically presents as… (5)

Answer 9

• Presents with cold-like symptoms; but as disease progresses pt presents with coughing, wheezing, and dyspnea
• Fussy w lack of appetite
• Hypothermia in children younger than 1 month
• Paradoxical breathing/ Seesaw breathing -> correlates with degree of airway obstruction
• Non-respiratory manifestations → otitis media (inflammation of ear), myocarditis (inflammation of heart muscle), and supraventricular and ventricular dysrhythmias

Question 10

T/F: Bronchodilators, ribavirin, and corticosteroids should NOT be used routinely

Answer 10

TRUE

Question 11

T/F: Only use nebulized hypertonic saline if patient is admitted into hospital (NOT in ER)

Answer 11

TRUE

Question 12

If it a patient SPO2 falls below 90% what do you do?

Answer 12

administer supplemental oxygen

Question 13

Name the antibody injection that helps prevent RSV

Answer 13

Palivizumab Prophylaxis (only given to selected infants and children w/ chronic lung disease, shows a history of prematurity (fewer than 35 weeks GA), or congenital heart disease.)