*NURSING > STUDY GUIDE > NR 661 Week 4 VISE Assessment, Familiarize Yourself with Know presentation, DX and Management (All)
Diagnoses List 1. Acute bronchitisDESCRIPTION Acute cough due to inflammation of the bronchioles, bronchi, and trachea; usually follows an upper respiratory infection or exposure to a chemical irri... tant. ETIOLOGY Adenovirus Rhinovirus Influenza A and B Parainfluenza RISK FACTORS Upper respiratory infection Air pollutants Smoking and/or secondary exposure Reflux esophagitis Allergy Chronic obstructive pulmonary disease Acute and chronic sinusitis Infants Older adults Immunosuppression ASSESSMENT FINDINGS Cough: dry and nonproductive, then productive; may be purulent URI symptoms Fatigue Fever due to bacterial infection; more common in smokers and patients with COPD Fever due to viral cause (unusual after first few days) Burning sensation in chest Crackles, wheezes Chest wall pain DIFFERENTIAL DIAGNOSIS Pneumonia Tuberculosis Asthma DIAGNOSTIC STUDIES Decision criteria for chest radiographs: tachypnea, hypoxia, fever, abnormal lung exam Only consider chest X-ray if high index of suspicion for pneumonia or superimposed heart failure Consider PPD: expect negative results PREVENTION Smoking cessation Avoid known respiratory irritants Treat underlying conditions that contribute to risk (asthma, gastroesophageal reflux disease, etc.) Influenza immunization for high-risk populations NONPHARMACOLOGIC MANAGEMENT Increase fluid intake Use humidifier Rest Smoking cessation Consider honey in children older than 1 year Patient education about disease, treatment, expected cause of cough, and emergency actions PHARMACOLOGIC MANAGEMENT Cough suppressants for nighttime relief Avoid antihistamines Antibiotics if organism is bacterial Antivirals if influenza diagnosed Decongestants and antihistamines are ineffective unless sinusitis or allergy is underlying Bronchodilators if wheezing or prior history of asthma [Show More]
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