Acute Bronchitis

By: Charlene Pelobello & Manilyn Quimba

Acute Bronchitis

- Is an infection of the lower respiratory tract that generally follows an upper

respiratory tract infection. As a result of this viral (most common) or bacterial
infection, the airways become inflamed and irritated, and mucus production
increases.

Assessment:

1. Fever, tachypnea, mild dyspnea, pleuritic chest pain (possible).

2. Cough with clear to purulent sputum production.
3. Diffuse rhonchi and crackles(contrast with localized crackles usually heard with
pneumonia).

Pathophysiology:

Usually bronchitis occurs after the person was infected with cold or infection. The virus
that causes the common cold can also be the virus that can cause bronchitis. Acute
bronchitis can also happen by inhaling irritants that can damage and inflame the
bronchial tubes. Cigarette smoke and other chemical fumes inhaled can significantly
damage your bronchial tubes. The inflammation causes the airway to constrict and
therefore, causes you to have difficulty in breathing. If left untreated or if you continue
inhaling irritants such as cigarette smoke, the acute bronchitis will eventually develop
into its chronic form where it can permanently damage your bronchial tubes and tissues
surrounding it.

Diagnostic Evaluation:

1. Chest X-ray may rule out pneumonia. In bronchitis, films show no evidence of
lung infiltrates or consolidation.
2. Sputum analysis.
Therapeutic Intervention:

1. Chest physiotherapy to mobilize secretions, if indicated.

2. Hydration to liquefy secretions.

Pharmacologic Interventions:

1. Inhaled bronchodilators to reduce bronchospasm and promote sputum

expectoration.
2. A course of oral antibiotics such as a macrolide may be instituted, but is
controversial.
3. Symptom management for fever and cough.

PROTUSSIVESAND ANTITUSSIVES

Because acute bronchitis is most often caused by a viral infection, usually only
symptomatic treatment is required. Treatment can focus on preventing or controlling the
cough (antitussive therapy) or on making the cough more effective (protussive therapy).

Protussive therapy is indicated when coughing should be encouraged (e.g., to clear the
airways of mucus). In randomized, double-blind, placebo-controlled studies of
protussives in patients with cough from various causes, only terbutaline (Brethine),
amiloride (Midamor), and hypertonic saline aerosols proved successful. However, the
clinical utility of these agents in patients with acute bronchitis is questionable, because
the studies examined cough resulting from other illnesses. Guaifenesin, frequently used
by physicians as an expectorant, was found to be ineffective, but only a single 100-mg
dose was evaluated. Common preparations (e.g., Duratuss) contain guaifenesin in doses
of 600 to 1,200 mg.

Antitussive therapy is indicated if cough is creating significant discomfort and if

suppressing the body's protective mechanism for airway clearance would not delay
healing. Studies have reported success rates ranging from 68 to 98 percent. Antitussive
selection is based on the cause of the cough. For example, an antihistamine would be
used to treat cough associated with allergic rhinitis, a decongestant or an antihistamine
would be selected for cough associated with postnasal drainage, and a bronchodilator
would be appropriate for cough associated with asthma exacerbations. Nonspecific
antitussives, such as hydrocodone (e.g., in Hycodan), dextromethorphan (e.g., Delsym),
codeine (e.g., in Robitussin A-C), carbetapentane (e.g., in Rynatuss), and benzonatate
(e.g., Tessalon), simply suppress cough.

Selected Nonspecific Antitussive Agents

Preparation Dosage Side effects

Hydromorphone-guaifenesin
(e.g., Hycotuss)
Dextromethorphan (e.g.,
Delsym)
Hydrocodone (e.g., in
Hycodan syrup or tablets)
Codeine (e.g., in Robitussin
A-C)
Carbetapentane (e.g., in
Rynatuss)
Benzonatate (Tessalon)
5 mg per 100 mg per 5 Sedation, nausea, vomiting,
mL (one teaspoon)* respiratory depression
30 mg every 12 hours Rarely, gastrointestinal upset or
sedation
5 mg every 4 to 6 hours Gastrointestinal upset, nausea,
drowsiness, constipation
10 to 20 mg every 4 to Gastrointestinal upset, nausea,
6 hours drowsiness, constipation
60 to 120 mg every 12 Drowsiness, gastrointestinal
hours upset
100 to 200 mg three Hypersensitivity,
times daily gastrointestinal upset, sedation
Management of Acute Bronchitis

Nursing Interventions:

1. Encourage mobilization of secretion through ambulation, coughing, and deep

breathing.
2. Ensure adequate fluid intake to liquefy secretions and prevent dehydration caused
by fever and tachypnea.
3. Encourage rest, avoidance of bronchial irritant, and a good diet to facilitate
recovery.
4. Instruct the patient to complete the full course of prescribed antibiotics and
explain the effect of meals on drug absorption.
5. Caution the patient on using over-the-counter cough suppressants, antihistamines,
and decongestants, which may cause drying and retention of secretions. However,
cough preparations containing the mucolytic guaifenesin may be appropriate.
6. Advise the patient that a dry cough may persist after bronchitis because of
irritation of airways. Suggest avoiding dry environments and using a humidifier at
bedside. Encourage smoking cessation.
7. Teach the patient to recognize and immediately report early signs and symptoms
of acute bronchitis.
 GROUP 4

Members:

Mosquera, Rachel Rose

Naluaran, Ghelo Marie

Nicar, Katherine

Pagala, Apple

Parreño, Charlyn Joy

Pelobello, Charlene

Peralta, Vanessa

Pulmones, Joni Rose

Quimba, Manilyn

Samson, Mary may

Tarrazona, Lea Grace

Submitted to:

Mrs. Emily Robite