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Treatments for Acute Bronchitis

Contents
  1. Acute Bronchitis: Introduction
  2. Treatment list for Acute Bronchitis
  3. Latest treatments for Acute Bronchitis
  4. Buy Products Related to Treatments for Acute Bronchitis
  5. Acute Bronchitis: Introduction

Treatments for Acute Bronchitis

The list of treatments mentioned in various sources for Acute Bronchitis includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Acute Bronchitis: Is the Diagnosis Correct?

The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for Acute Bronchitis may include:

Hidden causes of Acute Bronchitis may be incorrectly diagnosed:

Acute Bronchitis: Marketplace Products, Discounts & Offers

Products, offers and promotion categories available for Acute Bronchitis:

Acute Bronchitis: Research Doctors & Specialists

Research all specialists including ratings, affiliations, and sanctions.

Latest treatments for Acute Bronchitis:

The following are some of the latest treatments for Acute Bronchitis:

Hospital statistics for Acute Bronchitis:

These medical statistics relate to hospitals, hospitalization and Acute Bronchitis:

  • 0.017% (2,227) of hospital consultant episodes were for acute bronchitis in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 82% of hospital consultant episodes for acute bronchitis required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 52% of hospital consultant episodes for acute bronchitis were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 48% of hospital consultant episodes for acute bronchitis were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 94% of hospital consultant episodes for acute bronchitis required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • more hospital information...»

Hospitals & Medical Clinics: Acute Bronchitis

Research quality ratings and patient incidents/safety measures for hospitals and medical facilities in specialties related to Acute Bronchitis:

Hospital & Clinic quality ratings » »

Choosing the Best Treatment Hospital: More general information, not necessarily in relation to Acute Bronchitis, on hospital and medical facility performance and surgical care quality:

Buy Products Related to Treatments for Acute Bronchitis

 
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Book Excerpts: Treatment of Acute Bronchitis

Treatments of Acute Bronchitis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Acute Bronchitis.

Stridor & Wheezing: Treatment
(In a Page: Signs and Symptoms)

  • Attention to airway, breathing, and circulation
  • Administer supplemental O2
  • Asthma: Avoid triggers; bronchodilation with inhaled β 2 agonists (e.g., albuterol) and anticholinergics (e.g., ipratropium); inhaled, oral and/or IV steroids
    • Epiglottitis: Emergent airway intervention (endotracheal intubation or tracheostomy); cephalosporin antibiotics
    • Respiratory infection: Appropriate antibiotics if bacterial cause is suspected; βagonists
    • Anaphylaxis: Patients in extremis require immediate subcutaneous epinephrine injection; antihistamines (e.g., diphenhydramine); inhaled β 2 agonists (e.g., albuterol); steroids
  • Croup: Supportive care; nebulized steroids; epinephrine

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Cough - Productive: Treatment
(In a Page: Signs and Symptoms)

  • Cessation of cigarette smoking
  • Administer supplemental O2 if necessary
  • Postnasal drip: Treat underlying etiology (e.g., antibiotics for sinusitis, antihistamines and/or inhaled steroids for allergies)
  • Acute bronchitis: Inhaled β2 agonists (e.g., albuterol); since most cases are of viral origin, antibiotics are usually not indicated; increased fluid intake; antitussive
  • Pneumonia: Oral (e.g., macrolide, doxycycline, quinolone) or IV antibiotics (third-generation cephalosporin and a macrolide; or a second-generation quinolone)
  • COPD: Inhaled bronchodilator therapy with β2 agonists (e.g., albuterol) and anticholinergics (e.g., ipratropium); systemic corticosteroids; antibiotics (e.g., azithromycin, doxycycline) should be administered in severe exacerbations or secondary infections; noninvasive mechanical ventilation by CPAP or BiPAP may be necessary

    • >

    » READ BOOK EXCERPT ONLINE »

    Source: In a Page: Signs and Symptoms, 2004

    Cough - Nonproductive: Treatment
    (In a Page: Signs and Symptoms)

    • Cessation of cigarette smoking and/or ACE inhibitors
    • Postnasal drip: Treat underlying etiology (e.g., antibiotics for sinusitis, antihistamines and/or nasal steroids for allergies)
    • GERD: Lifestyle modifications (e.g., weight loss, dietary changes to eliminate predisposing agents, avoid alcohol and tobacco, avoid food within 4 hours of bedtime, sleep with head of bed elevated), anti-ulcer/antacid medications (H2 blockers, proton pump inhibitors), anti-reflux surgery (fundoplication)
    • Asthma: Avoid triggers; use inhaled β2 agonists (e.g., albuterol) and anticholinergics (e.g., ipratropium), inhaled or oral steroids (delayed onset 2–6 hours), children may benefit from magnesium or cromolyn
    • Acute bronchitis: Inhaled β2 agonists (e.g., albuterol); since most cases are of viral origin, antibiotics are usually not indicated; increased fluid intake; antitussive
    • Pneumonia: Appropriate oral or IV antibiotics
    >

    » READ BOOK EXCERPT ONLINE »

    Source: In a Page: Signs and Symptoms, 2004

    Stridor: Treatment
    (In A Page: Pediatric Signs and Symptoms)

    • Treatment is frequently based on diagnosis from endoscopy
    • Immediate evaluation when respiratory distress is present
      –Observation, intubation, tracheostomy, FB removal
      • Acute stridor
        –Viral laryngotracheobronchitis: Steroids, racemic epinephrine, and supplemental O2
        –Bacterial tracheitis: Culture-directed antibiotic therapy, consider intubation
    • Chronic stridor of newborn
      –History, physical, and endoscopy (fiberoptic or direct) confirmation of laryngomalacia
      –Consider treatment for reflux
      –Repeat endoscopy and possible supraglottoplasty if persistent stridor and failure to thrive

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Wheezing: Treatment
    (In A Page: Pediatric Signs and Symptoms)

    • Asthma is treated with layered therapy for acute symptom control (“rescue” medicine) and prevention of disease (“controller” medicine)
      –Rescue medicines are inhaled β-agonists (immediate) or steroids (rapid)
      –Controller medicines include ICS, leukotriene modifiers, anti-inflammatory agents, and long-acting bronchodilators
    • Bronchomalacia is treated with atrovent and/or ICS
    • Treat/eliminate underlying triggers

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Cough – Acute: Treatment
    (In A Page: Pediatric Signs and Symptoms)

    • Treatment is often empiric and based on history
    • Cough suppression is usually avoided, but may assist with sleep; other OTC therapies of little value
    • An empiric “diagnostic trial” of medication may treat asthma, GER, or bacterial infections
    • Treatment of “habit component” may help with psychogenic cough or other chronic conditions (e.g., postinfectious bronchitis)
    • Speech therapy is very helpful for VCD or habit cough (i.e., using cold water “hard swallow,” benzocaine throat lozenges, breathing exercises)
    • Serious psychiatric disease may be associated with VCD but referral to mental health specialists is rarely needed

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Cough – Chronic: Treatment
    (In A Page: Pediatric Signs and Symptoms)

    • Treatment is often empiric and based on history
    • An empiric “diagnostic trial” of medication may treat asthma, GER, or bacterial infections. Treatment of “habit component” may help with other chronic conditions (e.g., postinfectious bronchitis)
    • Speech therapy is helpful for VCD or habit cough (i.e., using cold water “hard swallow,” benzocaine throat lozenges, breathing exercises)
    • Serious psychiatric disease may be associated with VCD, but referral to mental health specialist is rarely needed
    • Other treatments first require accurate diagnosis (e.g., TB, CF, FB)
    • Cough suppression may be of use at night to achieve sleep, but is generally avoided

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Cough, barking: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    Quickly evaluate the child's respiratory status, and then take his vital signs. Be particularly alert for tachycardia and signs of hypoxemia. Also, check for a decreased level of consciousness. Try to determine if the child has been playing with any small object that he may have aspirated.

    Check for cyanosis in the lips and nail beds. Observe the patient for sternal or intercostal retractions or nasal flaring. Next, note the depth and rate of his respirations; they may become increasingly shallow as respiratory distress increases. Observe the child's body position. Is he sitting up, leaning forward, and struggling to breathe? Observe his activity level and facial expression. As respiratory distress increases from airway edema, the child will become restless and have a frightened, wide-eyed expression. As air hunger continues, the child will become lethargic and difficult to arouse.

    If the child shows signs of severe respiratory distress, try to calm him, maintain airway patency, and provide oxygen. Endotracheal intubation or a tracheotomy may be necessary.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Cough, productive: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    A patient with a productive cough can develop acute respiratory distress from thick or excessive secretions, bronchospasm, or fatigue, so examine him before you take his history. Take his vital signs and check the rate, depth, and rhythm of respirations. Keep his airway patent, and be prepared to provide supplemental oxygen if he becomes restless or confused or if his respirations become shallow, irregular, rapid, or slow. Look for stridor, wheezing, choking, or gurgling. Be alert for nasal flaring and cyanosis.

    A productive cough may signal a severe life-threatening disorder. For example, coughing due to pulmonary edema produces thin, frothy, pink sputum, and coughing due to an asthma attack produces thick, mucoid sputum. Assist the patient to clear excess mucous with tracheal suctioning if necessary.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Stridor: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    If you hear stridor, quickly check the patient’s vital signs, including oxygen saturation, and examine him for other signs of partial airway obstruction — choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)

    If you detect signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare the patient for emergency endotracheal (ET) intubation or tracheostomy and mechanical ventilation. (See Emergency endotracheal intubation.) Have equipment ready to suction aspirated vomitus or blood through the ET or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease his breathing.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Wheezing [Sibilant rhonchi]: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    Examine the degree of the patient’s respiratory distress. Is he responsive? Is he restless, confused, anxious, or afraid? Are his respirations abnormally fast, slow, shallow, or deep? Are they irregular? Can you hear wheezing through his mouth? Does he exhibit increased use of accessory muscles; increased chest wall motion; intercostal, suprasternal, or supraclavicular retractions; stridor; or nasal flaring? Take his other vital signs, noting hypotension or hypertension and decreased oxygen saturation or an irregular, weak, rapid, or slow pulse.

    Help the patient relax, administer humidified oxygen by face mask, and encourage him to take slow, deep breaths. Have endotracheal intubation and emergency resuscitation equipment readily available. Call the respiratory therapy department to supply intermittent positive-pressure breathing and nebulization treatments with bronchodilators. Insert an I.V. line for administration of drugs, such as diuretics, steroids, bronchodilators, and sedatives. Perform the abdominal thrust maneuver, as indicated, for airway obstruction.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Whooping cough: Treatment
    (Professional Guide to Diseases (Eighth Edition))

    Vigorous supportive therapy requires hospitalization of infants (commonly in the intensive care unit) and fluid and electrolyte replacement. Other measures include adequate nutrition; codeine and mild sedation to decrease coughing; oxygen therapy in apnea; and antibiotics, such as erythromycin and, possibly, ampicillin, to shorten the period of communicability and prevent secondary infections.

    Because very young infants (younger than age 1) are particularly susceptible to whooping cough, immunization — most commonly with the diphtheria-tetanus acellular-pertussis vaccine — begins at ages 2, 4, and 6 months. Boosters follow at age 18 months and at ages 4 to 6. The risk of pertussis is greater than the risk of vaccine complications such as neurologic damage. However, seizures or unusual and persistent crying may be a sign of a severe neurologic reaction, and the physician may not order the other doses. The vaccine is contraindicated in children older than age 6 because it can cause a severe fever.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Diseases (Eighth Edition), 2005

    Cough, barking: Emergency interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Quickly evaluate the child’s respiratory status. Then take his vital signs. Be particularly alert for tachycardia and signs of hypoxemia. Also, check for a decreased level of consciousness. Try to determine if the child was playing with a small object that he may have aspirated.

    Check for cyanosis in the lips and nail beds. Observe the patient for sternal or intercostal retractions or nasal flaring. Next, note the depth and rate of his respirations; they may become increasingly shallow as respiratory distress increases. Observe the child’s body position. Is he sitting up, leaning forward, and struggling to breathe? Observe his activity level and facial expression. As respiratory distress increases from airway edema, the child will become restless and have a frightened, wide-eyed expression. As air hunger continues, the child will become lethargic and difficult to arouse.

    If the child shows signs of severe respiratory distress, try to calm him, maintain airway patency, and provide oxygen. Endotracheal intubation or a tracheotomy may be necessary.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Cough, productive: Emergency interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    A patient with a productive cough can develop acute respiratory distress from thick or excessive secretions, bronchospasm, or fatigue, so examine him before you take his history. Take vital signs and check the rate, depth, and rhythm of respirations. Keep his airway patent, and be prepared to provide supplemental oxygen if he becomes restless or confused, or if his respirations become shallow, irregular, rapid, or slow. Look for stridor, wheezing, choking, or gurgling. Be alert for nasal flaring and cyanosis.

    A productive cough may signal a life-threatening disorder. For example, coughing due to pulmonary edema produces thin, frothy, pink sputum, and coughing due to an asthma attack produces thick, mucoid sputum.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Stridor: Emergency interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    If you hear stridor, quickly check the patient’s vital signs including oxygen saturation and examine him for other signs of partial airway obstruction—choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)

    If you detect any signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare for emergency endotracheal intubation or tracheostomy and mechanical ventilation. (See Emergency endotracheal intubation, page 734.) Have equipment ready to suction any aspirated vomitus or blood through the endotracheal or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease his breathing.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Cough, nonproductive: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Explain to the patient why nonproductive coughs should be suppressed and productive coughs encouraged. Encourage the patient to use a respirator in the presence of airway irritants such as paint fumes and dust.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Wheezing [Sibilant rhonchi]: Emergency interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Assess whether the patient is in respiratory distress. Is he responsive? Is he restless, confused, anxious, or afraid? Are his respirations abnormally fast, slow, shallow, or deep? Are they irregular? Can you hear wheezing through his mouth? Does he exhibit increased use of accessory muscles; increased chest wall motion; intercostal, suprasternal, or supraclavicular retractions; stridor; or nasal flaring? Take his other vital signs, noting hypotension or hypertension, decreased oxygen saturation, and an irregular, weak, rapid, or slow pulse.

    Help the patient relax. Administer humidified oxygen by face mask, and encourage slow, deep breathing. Have endotracheal intubation and emergency resuscitation equipment readily available. Call the respiratory therapy department to supply intermittent positive-pressure breathing and nebulization treatments with bronchodilators. Insert an I.V. line for administration of drugs, such as diuretics, steroids, bronchodilators, and sedatives. Perform the abdominal thrust maneuver, as indicated, for airway obstruction.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Cough, barking: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Don’t attempt to inspect the throat of a child with a barking cough unless intubation equipment is available. If the child isn’t in severe respiratory distress, a lateral neck X-ray may be done to visualize epiglottal edema; a negative X-ray doesn’t completely rule out epiglottal edema. A chest X-ray may also be done to rule out lower respiratory tract infection. Depending on the child’s age and degree of respiratory distress, oxygen may be administered. Rapid-acting epinephrine (racemic epinephrine) and a steroid should be considered.

    Be sure to observe the child frequently, and monitor the oxygen level if used. Provide the child with periods of rest with minimal interruptions. Maintain a calm, quiet environment and offer reassurance. Encourage the parents to stay with the child to help alleviate stress.

    Patient teaching

    Teach the parents how to evaluate and treat recurrent episodes of croup syndrome. For example, creating steam by running hot water in a sink or shower and sitting with the child in the closed bathroom may help relieve subsequent attacks. The child may also benefit from being brought outdoors (properly dressed) to breathe cold night air.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Cough, productive: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Obtain the patient’s vital signs and note signs of infection. Assess the respiratory system frequently, noting signs of respiratory distress. Avoid taking measures to suppress a productive cough because retention of sputum may interfere with alveolar aeration or impair pulmonary resistance to infection. Expect to give a mucolytic and an expectorant, and increase the patient’s intake of oral fluids to thin his secretions and increase their flow. In addition, you may give a bronchodilator to relieve bronchospasms and open airways. An antibiotic may be ordered to treat underlying infection.

    Humidify the air around the patient; this will relieve mucous membrane inflammation and also help loosen dried secretions. Provide pulmonary physiotherapy, such as postural drainage with vibration and percussion, to loosen secretions. Aerosol therapy may be necessary.

    Provide the patient with uninterrupted rest periods. If bed rest is ordered, change the position often to promote the drainage of secretions.

    Prepare the patient for diagnostic tests, such as chest X-ray, bronchoscopy, lung scan, and pulmonary function tests. Collect sputum samples for culture and sensitivity testing.

    Patient teaching

    Encourage the patient not to smoke because doing so can aggravate his condition. Explain that quitting even after decades of use is helpful. Teach the patient how to breathe deeply, to cough effectively and, if appropriate, to splint his incision when he coughs. Teach the patient and his family how to use chest percussion to loosen secretions.

    Tell the patient to cover his mouth and nose with a tissue when he coughs and to dispose of contaminated tissues properly, to protect himself and others from the cough and secretions. Be sure to provide a container for tissues and sputum.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Stridor: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Continue to monitor the patient’s vital signs closely. Prepare him for diagnostic tests, such as arterial blood gas analysis and chest X-rays. Offer reassurance and calm the patient and his family. Provide ongoing assessment of the patient’s respiratory status and oxygenation.

    Patient teaching

    Instruct the patient and his family about safety measures in the home environment if the stridor is related to aspiration of a foreign object. If the stridor is related to croup, teach the parents techniques to use to manage the condition. Teach the patient and his family about signs and symptoms that require immediate attention.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Wheezing: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Prepare the patient for diagnostic tests, such as chest X-rays, arterial blood gas analysis, pulmonary function tests, and sputum culture.

    Ease the patient’s breathing by placing him in semi-Fowler’s position and repositioning him frequently. Perform pulmonary physiotherapy as necessary.

    Administer an antibiotic to treat infection, a bronchodilator to relieve bronchospasm and maintain a patent airway, a steroid to reduce inflammation, and a mucolytic or expectorant to increase the flow of secretions. Provide humidification to thin secretions.

    Patient teaching

    If appropriate, encourage increased activity to promote drainage and prevent pooling of secretions. Encourage regular deep breathing and coughing. Explain the importance of drinking fluids to liquefy secretions and prevent dehydration.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Cough, barking: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Teach the parents how to evaluate and treat recurrent episodes of croup syndrome. For example, creating steam by running hot water in a sink or shower and sitting with the child in the closed bathroom may help relieve subsequent attacks. The child may also benefit from being brought outside (properly dressed) to breathe cold night air.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Cough, productive: Emergency Actions
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    A patient with a productive cough can develop acute respiratory distress from thick or excessive secretions, bronchospasm, or fatigue, so examine him before you take his history. Take vital signs and check the rate, depth, and rhythm of respirations. Keep his airway patent, and be prepared to provide supplemental oxygen if he becomes restless or confused, or if his respirations become shallow, irregular, rapid, or slow. Look for stridor, wheezing, choking, or gurgling. Be alert for nasal flaring and cyanosis.

    A productive cough may signal a severe life-threatening disorder. For example, coughing due to pulmonary edema produces thin, frothy, pink sputum, and coughing due to an asthma attack produces thick, mucoid sputum.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Stridor: Emergency Actions
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    If you hear stridor, quickly check the patient’s vital signs including oxygen saturation and examine him for other signs of partial airway obstruction — choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)

    If you detect any signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare for emergency endotracheal intubation or tracheostomy and mechanical ventilation. Have equipment ready to suction any aspirated vomitus or blood through the endotracheal or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease breathing.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Wheezing: Emergency Actions
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Examine the degree of the patient’s respiratory distress. Is he responsive? Is he restless, confused, anxious, or afraid? Are his respirations abnormally fast, slow, shallow, or deep? Are they irregular? Can you hear wheezing through his mouth? Does he exhibit increased use of accessory muscles; increased chest wall motion; intercostal, suprasternal, or supraclavicular retractions; stridor; or nasal flaring? Take his other vital signs, noting hypotension or hypertension, decreased oxygen saturation, and an irregular, weak, rapid, or slow pulse.

    Help him relax, administer humidified oxygen by face mask, and encourage slow, deep breathing. Have endotracheal intubation and emergency resuscitation equipment readily available. Call the respiratory therapy department to supply intermittent positive-pressure breathing and nebulization treatments with bronchodilators. Insert an I.V. line for administration of drugs, such as diuretics, steroids, bronchodilators, and sedatives. Perform the abdominal thrust maneuver, as indicated, for airway obstruction.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Cough, nonproductive: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Explain to the patient why nonproductive coughs should be suppressed and productive coughs encouraged. Encourage the patient to use a respirator (protective mask) in the presence of airway irritants such as paint fumes and dust. Instruct him to use a humidifier at home. Tell him to avoid using aerosols, powders, or other respiratory irritants — especially cigarettes. Make sure that the patient receives adequate fluids and nutrition.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Cough, barking: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Don't attempt to inspect the throat of a child with a barking cough unless intubation equipment is available. (See Managing the patient with epiglottiditis.)

    ▪ If the child isn't in severe respiratory distress, a lateral neck X-ray may be done to visualize epiglottal edema.

    ▪ A chest X-ray may be done to rule out lower respiratory tract infection.

    ▪ Depending on the child's age and degree of respiratory distress, oxygen may be administered.

    ▪ Rapid-acting epinephrine and a steroid may be administered.

    ▪ Observe the child frequently, and monitor pulse oximetry.

    ▪ Provide the child with periods of rest with minimal interruptions.

    ▪ Maintain a calm, quiet environment and offer reassurance.

    ▪ Encourage the parents to stay with the child to help alleviate stress.

    Patient teaching

    ▪ Teach the parents how to evaluate and treat recurrent episodes of croup syndrome.

    ▪ Teach parents how to administer prescribed medications.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Cough, productive: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Avoid taking measures to suppress a productive cough because retention of sputum may interfere with alveolar aeration or impair pulmonary resistance to infection.

    ▪ Expect to give a mucolytic and an expectorant.

    ▪ Increase the patient's intake of oral fluids to thin his secretions and increase their flow.

    ▪ Give a bronchodilator to relieve bronchospasms and open airways.

    ▪ Administer an antibiotic to treat any underlying infection.

    ▪ Humidify the air around the patient to relieve mucous membrane inflammation and help loosen dried secretions.

    ▪ Provide pulmonary physiotherapy, such as postural drainage with vibration and percussion, to loosen secretions.

    ▪ Administer aerosol therapy if necessary.

    ▪ Provide the patient with uninterrupted rest periods.

    ▪ If the patient is on bed rest, change his position often to promote the drainage of secretions.

    ▪ Prepare the patient for diagnostic tests, such as chest X-ray, imaging studies, bronchoscopy, a lung scan, and PFTs.

    ▪ Collect sputum samples for culture and sensitivity testing.

    Patient teaching

    ▪ Encourage the patient to stop smoking and provide him with written resources and contact information for support groups.

    ▪ Teach him how to perform cough and deep-breathing exercises.

    ▪ Discuss ways to avoid respiratory irritants.

    ▪ Explain infection control techniques.

    ▪ Teach the patient and family how to use chest percussion to loosen secretions.

    ▪ Explain to the patient his diagnosis and the treatment plan.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Stridor: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Monitor the patient's vital signs closely.

    ▪ Prepare him for diagnostic tests, such as arterial blood gas analysis and chest X-rays.

    ▪ Administer oxygen and monitor airway and ventilation.

    ▪ Provide emotional support.

    Patient teaching

    ▪ Explain the underlying disorder and treatment.

    ▪ Explain to the patient all procedures and treatments.

    ▪ Stay with the patient and talk to him in a calm voice to reduce anxiety.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Cough, nonproductive: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ A nonproductive, paroxysmal cough may induce life-threatening bronchospasm; the patient may need a bronchodilator to relieve his bronchospasm and open his airways.

    ▪ Unless he has chronic obstructive pulmonary disease, you may have to give the patient an antitussive and a sedative to suppress the cough.

    ▪ To relieve mucous membrane inflammation and dryness, humidify the air in the patient's room.

    ▪ Prepare the patient for diagnostic tests, such as X-rays, a lung scan, bronchoscopy, and PFTs.

    Patient teaching

    ▪ Teach the patient to use a humidifier if his home is dry.

    ▪ Tell him to avoid using aerosols, powders, or other respiratory irritants—especially cigarettes.

    ▪ If the patient smokes, stress the importance of smoking cessation, and refer him to appropriate resources, support groups, and information to help him quit smoking.

    ▪ Explain the importance of adequate fluids and nutrition.

    ▪ Explain to the patient the cause of his cough and the treatment plan.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Wheezing [Sibilant rhonchi]: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Prepare the patient for diagnostic tests, such as chest X-rays, arterial blood gas analysis, pulmonary function tests, and sputum culture.

    ▪ Ease the patient's breathing by placing him in a semi-Fowler's position.

    ▪ Perform pulmonary physiotherapy as necessary.

    ▪ Administer an antibiotic, bronchodilator, steroid, and mucolytic or expectorant, as ordered.

    ▪ Provide humidification to thin secretions.

    Patient teaching

    ▪ Explain to the patient the underlying cause of wheezing and its treatment.

    ▪ Teach the patient how to promote drainage and prevent pooling of secretions.

    ▪ Explain deep-breathing and coughing techniques.

    ▪ Explain the importance of increasing fluid intake, if appropriate.

    ▪ Teach the patient how to take prescribed drugs correctly.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007



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