Nursing Case Study on Bronchiolitis: Affect on Activities of Life

Running head: NURSING CASE STUDY
Nursing Case Study
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NURSING CASE STUDY
Introduction
Bronchiolitis is a kind of ling infection that leads to the formation of congestion and
subsequent inflammation in the bronchioles (small airways) in the lungs. The main causative
micro-organism is respiratory syncytial virus (RSV) or penumovirus (Ricci et al., 2015, pp:
350). The most vulnerable population getting affected with bronchiolities are the new born
babies and children. The immune system of the infants is weak in comparison to the adults
and thereby making them vulnerable towards viral infection (Meissner, 2016, pp: 62-72). The
primary symptoms of bronchiolitis include runny nose, sneezing and coughing along with
mild rise in body temperature, this symptoms coincides with the symptoms of common cold
and thus the bronchiolitis is confused with common cold at its initial stages (Ricci et al.,
2015, pp: 350). However, as the disease progress, the condition becomes more severe with
symptoms like traumatic coughing bouts leading to breathless or shortness of breath. The
accumulation of mucus in the pulmonary airways further complicates the overall pathological
condition along with the increase in the respiratory rate, causing laboured breathing
(Meissner, 2016, pp: 62-72). The following essay aims of analyse bronchiolitis and its affect
of activities of life (AoL) based on the case study of a 18-month old baby girl, Bree. The AoL
that with be emphasized in this essay include breathing and rise in body temperature. At the
end, the essay will postulate nursing care plan for Bree.
Activities of Life (AoL)
The manifestation of Bronchiolitis in paediatric population occurs through increase in
body temperature. The increase in body temperature leads to fever (Meissner, 2016, pp: 62-
72). According to the case study, 18-month old Bree was admitted to the paediatric ward with
bronchiolitis and she was showing like expiratory wheeze, shortness of breath, runny nose
with clear mucus secretion, coughing bouts and body temperature of 38.2 degree Celsius. Via

NURSING CASE STUDY
examining these symptoms, it can be clearly gauzed that body temperature of Bree is few
notches higher in comparison to the normal body temperature (normal range: 37 to 37.5
degree Celsius). High body temperature is an indicator of inflammation or infection with the
body and in majority of the cases associated with shivering (Morrison, 2016, pp: 30 to 35).
This high body temperature (above 38 degree Celsius) generates threat for the paediatric
population as it give rise of Pyrexia. Pyrexia is again associated with several complications
like dehydration, lethargy and hyperalgesia (Morrison, 2016, pp: 30 to 35). Lathery and
dehydration further hampers the health and well-being of the child and therefore rise in the
body temperature must be handled with utmost care (Donna & Chris, 2013, pp: 1-74).
Breathing is another important AoL which is important for sustaining. In
bronchiolitis, coughing is associated with bouts of cough mixed with mucus which at times
lead to vomiting, breathless and even chocking (Philipson, et al., 2013, pp: 573-579). In case
of Bree, expiratory wheeze indicates the presence of mucus within the airways and this
creating obstruction in breathing. If such conditions sustains for few days, it may lead to
breathless, nausea, disturbances in sleep and thus further hampering the quality of life of
Bree.
AoL assessment and treatment plan
The temperature of the body is defined as the ratio of total heat generated in the body
and total heat loss of the body. In paediatric population, the preliminary manifestation of
inflammation or infection within the body is fever or high body temperature (Houdas & Ring,
2013, pp: 15 to 16). The rise in body temperature as indicated by the thermometer increases
discomfort among the infants (Houdas & Ring, 2013, pp: 15 to 16). According to the case
study, Bree’s body temperature at the time of admission is 38.2 degree Celsius. This high
body temperature above the normal might at tome accompanied with shivering and
subsequent drop in the body temperature under the effect of analgesic can cause profuse

NURSING CASE STUDY
sweating. This sweating in turn can further increase the discomfort level of Bree along with
increase in the tendency of dehydration. Moreover, congestion in the pulmonary cavity
mainly in the trachea and the larynx creates difficulty in swallowing which further limits the
fluid intake and thereby increasing the chances of dehydration (Corrard et al., 2013, p:6).
Common symptoms of dehydration include dry mouth, dry skin, and lack of proper discharge
of urine, pale of yellow colouration of urine and in extreme cases might lead to drowsiness
(Bell & Acarregui, 2014,pp: 10 to 12). As Bree is only 18-month old, she is incapable of
expressing her discomfort arising out of dehydration. It is the duty of the healthcare provider
to access the level of discomfort of Bree via tabulating the amount of fluid intake and
subsequent fluid output. This will further help the nursing professional to frame the care plan
accordingly. The monitoring of the nature of urine can be regarded as another hallmark in
accessing the level of dehydration (Bell & Acarregui, 2014,pp: 10 to 12). Since fever
indicates heightened response of infection, Bree must be kept in isolation. According to
Ricciet al. (2015), bronchiolitis is highly contagious and make infants immune-compromised
and thus increasing further chances of additional infection. So in order to check the chances
of rise in body temperature, apart from keeping Bree in isolation, proper dosage of analgesic
and proper maintenance of sterile condition is extremely important. Here the parents, the
direct caregivers of Bree are required to be educated about the importance of maintain aseptic
condition while handling Bree. Fernandeset al. (2014) stated that proper parent education is
the domain of contagious disease is important to maintain the health and well-being of the
infant. Meissner (2016) reported proper antiviral medication with dosage adjusted for the
infants on the basis of health and weight is also important for controlling the body
temperature and further spread of infection. In order to give comfort from sweating, light
fitted cotton clothes are suitable for Bree and diet plan of Bree will mainly strength over