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Antiviral
• Prophylaxis:
<1 year: Not established
>1 year:
<15 kg: 30 mg PO QID for 10 d
>15-23 kg: 45 mg PO QID for 10 d
24-40 kg: 60 mg PO QID for 10 d
>40 kg: Administer as in adults
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CikguOnline
Antiviral
b. Zanamivir (Relenza)
• treatment: 10 mg (2 inhalations, 5
mg/inhalation) inhaled PO q12h for
5d; berries within 2 symtoms are
shown
• Prophylaxis: 10 mg (2 inhalations, 5
mg/inhalation) inhaled PO QID for 10
d; berries within 36 h of infection
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Antiviral
• Paeds: Treatment: <7 years: Not
established >7 years: Administer as
in adults Prophylaxis: <5 years: Not
established >5 years: Administer as
in adults
• Precaution: may cause
bronchospasm
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CikguOnline
Management
2. Non-pharmacology
- oxygen therapy
- cough and breathing exercise
- chest percussion and postural percussion
- suction
- increase fluid intake
- observation – vital sign and general condition
- diet
- lifestyle changes
▪ physical activities
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Oxygen Therapy
a. Supplying oxygen to body tissues
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Physiotherapy and postural drainage
Helps in removing
secretions that block
the airways
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CikguOnline
Breathing / coughing exercises
Helps in expanding
the lung area and
more effective
secretion production
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COMPLICATION
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1. Atelectasis
A condition that occurs when a blockage in the airways causes part of
the lung to malfunction (collapsed).
This is because insufficient oxygen does not reach the lung tissue
especially the farthest / lower lobes.
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2. Bronchiectasis
Prolonged bronchitis will damage the muscles of the bronchial wall
causing permanent damage to the bronchioles
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3. Emphysema
• Damage to the alveolar wall.
• Inflammatory cells present in bronchiolar tissue reduce the elasticity
of the fibres in the alveolar duct.
• This causes the alveoli and the surrounding air space to enlarge with
a loss of response to the pulmonary capillaries.
• Decreased alveolar-capillary diffusion affects gas exchange.
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NURSING INTERVENTION
FOR THE PATIENT WITH
BRONCHITIS
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Nursing intervention for the patient with
Bronchitis
a. Airway clearance ineffective related to increase production of
mucus
b. Impaired gas exchange related to airflow limitation, production
of mucus
c. Activity intolerance related to imbalance between oxygen supply
and demand
d. Knowledge deficit regarding medication regime and self-care
techniques
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1. Airway clearance ineffective related to
increase production of mucus
Goal:
• No abnormal breathing sounds (ronchi / wheezing)
• Oxygen levels are within normal levels
• The client can breathe deeply and cough to remove secretions
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CikguOnline
1. Airway clearance ineffective related to
increase production of mucus
Interventions:
• Assess respiratory status at least every 4 hours. Airway obstruction
will encourage complications to occur.
• Place the client in the fowler position. Promotes lung expansion and
facilitates secretion production.
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CikguOnline
1. Airway clearance ineffective related to
increase production of mucus
Interventions:
• Teach the client to cough effectively and deep breathing. Makes it
easy to secrete
• Perform oral suction to clear the airways.
• Encourage the client to remove that secretion to reduce the
accumulation of secretions in the airways.
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CikguOnline
1. Airway clearance ineffective related to
increase production of mucus
Interventions:
• Encourage taking plenty of fluids to dilute secretions of at least
2000ml-3000ml a day
• Refer to physiotherapy to perform postural drainage, percussion and
vibration (chest physio) to promote the movement of secretions.
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CikguOnline
1. Airway clearance ineffective related to
increase production of mucus
Interventions:
• Give bronchodilators, and other medications as prescribed by your
doctor.
• Give oxygen therapy, to promote oxygenation to the cells of the body,
as directed by the doctor.
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1. Airway clearance ineffective related to
increase production of mucus
Interventions:
• Monitor ABG values and hemoglobin levels to assess oxygenation and
ventilatory status. Report abnormal results; the value must be more
than 80%.
• Prepare for endotracheal intubation, in case conservative action fails
to maintain partial arterial oxygen (PaO2) in the normal range.
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2. Impaired gas exchange related to airflow
limitation, production of mucus
Goal:
• The client will be able to maintain adequate ventilation
• Clients can cough effectively
• The client showed normal breathing sounds
• Clients can perform ADL according to tolerance levels
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CikguOnline
2. Impaired gas exchange related to airflow
limitation, production of mucus
Interventions:
• Place the client in the fowler position.
• Change positions at least every 2 hours. Secretions can be mobilized
and allow ventilation to occur throughout the lung area
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CikguOnline
2. Impaired gas exchange related to airflow
limitation, production of mucus
Interventions:
• Perform bronchial hygiene; such as coughing, percussion, postural
drainage and suctioning. Promotes circulation and dilates the airways.
• Give medication as directed such as a bronchodilator.
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CikguOnline
2. Impaired gas exchange related to airflow
limitation, production of mucus
Interventions:
• Monitor oxygen therapy. It causes an increase in the alveolar oxygen
concentration and additional arterial blood oxygenation.
• Assist client in ADL to reduce oxygen demand in tissues.
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2. Impaired gas exchange related to airflow
limitation, production of mucus
Interventions:
• Include rest periods in the care plan to reduce oxygen demand in
body tissues.
• Monitor ABG levels and report immediately if there are any
abnormalities
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2. Impaired gas exchange related to airflow
limitation, production of mucus
Interventions:
• Teach clients relaxation techniques. Relaxation will reduce the
demand for oxygen in the tissues of the body.
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3. Activity intolerance related to imbalance
between oxygen supply and demand
Goal:
• The client will express an understanding of the importance of
maintaining a level of daily activity.
• The client's blood pressure, pulse and respiration are at normal levels
during the activity
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CikguOnline
3. Activity intolerance related to imbalance
between oxygen supply and demand
Interventions:
• Encourage the client to perform active movements with assistance
• Assist clients in performing daily activities on their own. Increasing
client involvement in self -care, which is affordable, enables self -
reliance and increases mobility.
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3. Activity intolerance related to imbalance
between oxygen supply and demand
Interventions:
• Encourage clients to get involved in planning and decision making in
daily care. Further increase the level of client cooperation in care and
treatment.
• Take the client’s vital signs while performing the activity to assess the
client’s body tolerance.
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3. Activity intolerance related to imbalance
between oxygen supply and demand
Interventions:
• Teach clients to detect signs of attack while performing activities. So
that the client knows to what level of activity he can do.
• Encourage patients to do ADL. Provide emotional support and provide
positive feedback if the client shows initiative to do so
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4. Knowledge deficit regarding medication
regime and self-care techniques
Goal:
• The patient expressed an understanding of taking medication and
avoiding the causative factors of the attack
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4. Knowledge deficit regarding medication
regime and self-care techniques
Interventions:
• Explain the disease process to the patient and his family.
• Tell the patient the symptoms of the attack and see a doctor
immediately for example when there is a respiratory tract infection.
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CikguOnline
4. Knowledge deficit regarding medication
regime and self-care techniques
Interventions:
• Give a description of the treatment
✓The name of the drug and its purpose
✓Medication dose, timing of medication and the importance of
taking medication regularly.
✓Side effects of the drug.
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CikguOnline
4. Knowledge deficit regarding medication
regime and self-care techniques
Interventions:
• Tell patients not to take medication without a doctor's prescription
• Consult a nurse or pharmacist if you have any questions about
medication
• Immediately go to the hospital if the medicine supply is almost
depleted
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