Nonpharmacologic Management Essay Assignment Paper

Know presentation, DX and Management

Diagnoses List

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Acute bronchitis-

DESCRIPTION

Acute cough due to inflammation of the bronchioles, bronchi, and trachea; usually follows an upper respiratory infection or exposure to a chemical irritant.

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

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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

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