Montano, Ma. LuVerne M. c. Provide oral hygiene after expectoration of sputum.

3. Improve ventilation.
Cajandab, Mark Norriel C. a. Position client in semi or high fowlers position
b. Instruct client to use diaphragmatic muscle to
BSN-3A3 breathe.
c. Encourage productive coughing after all
Chronic Bronchitis treatments (splint abdomen to help produce more
expulsive cough)
- describes inflammation of the bronchial tubes. The inflammation d. Employ pursed lip breathing techniques
causes swelling of the lining of these breathing tubes, narrowing the (prolonged, slowed relaxed expiration against
tubes and promoting secretion of inflammatory fluid. pursed lips)
e. Chest physiotherapy
- A disease of the airways, defined as the presence of cough and 4. Provide client teaching and discharged planning concerning.
sputum production for at least 3 months in each of 2 consecutive a. Prevention of recurrent infections
1) Avoid crowds and individuals with known infection.
years.
2) Adhere to high protein, high carbohydrates, and
increased vitamin c diet.
Causes:
3) Receive immunizations for influenza and
pneumonia.
-Viral infection (rhinovirus, influenza virus) 4) Report changes in characteristics and color of
sputum immediately.
-Bacteria (Mycoplasma, Pneumococcus, Klebsiella, Haemophilus) b. Control environment.
1) Use home humidifier at 30-50 percent humidity.
-Chemical irritants (Tobacco smoke) 2) Wear scarf over nose and mouth in cold weather
to prevent bronchospasm.
Assessment: 3) Avoid smoking and others who smoke.
4) Avoid abrupt changes in temperature.
Signs and symptoms: c. Avoidance of inhaled irritants
1) Stay indoors if pollution levels are high.
First sign of Bronchitis= Persistent Dry Cough 2) Use air conditioner with high efficiency particulate
air filter to remove particles from air.
d. Increasing activity tolerance.
Acute bronchitis:
1) Start with mild exercises such as walking and
gradually increase amounts and duration.
 Burning sensation in the chest 2) Have oxygen available as needed to assist with
activities.
 Wheezing
 Sore throat Nursing Diagnosis:
 Fever
 Fatigue  Ineffective airway clearance
 Impaired Gas exchange
 Altered Tissue Perfusion
Chronic bronchitis:
 Risk for infection
 Sleep Deprivation
 Chronic cough that produces mucus  Acute Pain
 Wheezing, shortness of breath
Medications:
 Blue tinged lips
 Ankle, feet, and leg swelling NSAIDs- to decrease fever and sore throat

Other symptoms: Decongestants- for nasal congestion

 Runny Nose Expectorants- loosen mucus and increase expulsion of sputum

 Low grade fever (101°F-102°F)
 Nasal Congestion Cough Suppressants- May be used if cough interferes with sleep
 Crackling in the chest
 Shortness of Breath Corticosteroids- Reduce inflammation

-Acute Bronchitis (with or without Sputum) Diagnostic Procedures:

-Chronic Bronchitis (Green or Yellow sputum, sometimes blood may
occur)
Planning:
 Patient will maintain airway patency as evidence of absence
of respiratory distress.
 Patient will able to maintain adequacy of gas exchange as
evidence of absence of respiratory distress.
 Patient will be free from infection.
 Patient will remain free of preventable
complications/progression of illness
Interventions:
1. Administer medication as ordered.
a. Bronchodilator: aminophylline, isoproterenol,
terbutaline, metaproterenol, isotherine; used for
treatment of bronchospasm
b. Antimicrobial: tetracycline, ampicillin ; to treat bacterial
infections
c. Cortecosteroids: prednisone
d. Decongestants: patient with nasal congestion
e. Expectorant; used to loosen mucus and increased
expulsion of mucus.
2. Facilitate removal of secretions.
a. Ensure fluid intake at least 3 liters/day.
b. Provide (and teach client) chest physical therapy,
coughing and deep breathing, and use of hand
nebulizers.
 Sputum exam: culture of multiple organism and neutropils
(yellow green color)
*early morning sputum specimen is to be collected
*rinse mouth with plain water
*use sterile container
 ABG arterial blood gas: PaO2 decreased and PaCO2
increased
*utilize a 10ml pre-heparinized syringe to prevent clotting of
specimen and container with ice to prevent hemolysis of the
specimen
*radial artery- common site
 Radiology: increased markings, hyperinflation
 Pulmonary function : residual volume increased , forced
vital capacity and forced expiratory volume decreased;
compliance and diffusion normal
 Pulse oximetry
Nursing Considerations:
Aromatherapy
Running a humidifier with an essential oil such as cedarwoord,
bergamot, eucalyptus, myrrh, sweet fennel, jasmine, lavender, tea tree,
or marjoram at night may help thin mucus and ease cough.
Natural treatments for bronchitis include honey, lemon, ginger, bay
leaf, and almonds. Each of these foods has properties that reportedly
reduce symptoms of bronchitis