Info

Antipyretics

Varies with drug

Acetaminophen

Reduces fever

Other Therapy: Corticosteroids are used only as a last resort; the use of bronchodila-tors is controversial.

Independent

Ongoing, continuous observation of the patency of the child's airway is essential to identify impending obstruction. Prop infants up on pillows or place them in an infant seat; older children should have the head of the bed elevated so that they are in Fowler's position. Usually, seriously and critically ill infants are hospitalized because their care at home is difficult. Hospitalized infants are usually elevated to a sitting position at 30 to 40 degrees with the neck extended at the same 30- to 40-degree angle.

Children should be allowed to rest as much as possible to conserve their energy; organize your interventions to limit disturbances. Provide age-appropriate activities. Crying increases the child's difficulty in breathing and should be limited if possible by comfort measures and the presence of the parents; parents should be allowed to hold and comfort the child as much as possible. If the child is in a cool mist tent, parents may need to be enclosed with the child, or the child may need to be held by the parents with the mist directed toward them. Children sense anxiety from their parents; if you support the parents in dealing with their anxiety and fear, the children are less fearful. Careful explanation of all procedures and allowing the parents to participate in the care of the child as much as possible help relieve the anxiety of both child and parents.

Provide adequate hydration to liquefy secretions and to replace fluid loss from increased sensible loss (increased respirations and fever). The child might also have a decreased fluid intake during the illness. Apply lubricant or ointment around the child's mouth and lips to decrease the irritation from secretions and mouth breathing.

158 Bronchitis

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