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Acute Bronchitis Nursing Guide

Content reviewed by Ann Dietrich, MD, FAAP, FACEP.

Acute Bronchitis etiology and epidemiology 

Acute bronchitis is an infection of the lower respiratory tract that leads to coughing, which may be accompanied by phlegm, lasting up to three weeks. It is among the most frequent diagnoses made by primary care providers, with annual costs for evaluation and treatment in the U.S. ranging from $200 to $300 million. 

Contributing conditions 

Acute bronchitis can arise from various conditions. 

  • Bacterial infections: 

    • Streptococcus pneumoniae 
    • Moraxella catarrhalis 
    • Mycoplasma 
    • Haemophilus influenzae 
    • Chlamydia pneumoniae 
    • Bordetella pertussis 

  • Viral infections: 

  • Common irritants: 

    • Smoke (including secondhand smoke) 
    • Polluted air 
    • Dust 
    • Environmental pollutants 

Acute Bronchitis Diagnosis 

To diagnose acute bronchitis, the following tests and assessments may be conducted: 

  • Complete Blood Count (CBC) with Differential 
  • Blood cultures (if systemic infection is suspected) 
  • Throat culture 
  • Sputum cytology 
  • Influenza swab 
  • Chest X-ray 
  • Bronchoscopy 
  • Laryngoscopy (if needed to rule out other conditions) 

Acute Bronchitis Management 

Preventive measures 

  • Influenza vaccine: Administered between October and April to reduce the risk of viral infections that may lead to bronchitis 

Symptomatic relief 

  • Over-the-Counter medications: Educate patients on the use of OTC medications like analgesics and NSAIDs to alleviate symptoms 

Pharmacological treatment 

  • Antiviral medications: 
    • Oseltamivir phosphate 
    • Zanamivir 
    • Peramivir 
    • Baloxavir marboxil 
    • Antibiotics (only if bacterial infection is confirmed): 
      • Azithromycin (Zithromax®) 
      • Trimethoprim and sulfamethoxazole (Bactrim®) 
      • Clarithromycin (Biaxin®) 
    • Steroids: May be necessary for individuals with preexisting asthma or chronic obstructive pulmonary disease (COPD) 

Acute Bronchitis nursing care plan 

Utilizing the nursing process, a comprehensive plan of care should include the following: 

Assessment 

Evaluate the patient for common symptoms such as: 

  • Cough: Initially dry, progressing to productive with sputum. 
  • Chest discomfort: Burning sensation in the chest. 
  • Fatigue and Mild Dyspnea 
  • Fever 
  • Pleuritic chest pain 
  • Erythematous Pharynx and Mucosa 
  • Abnormal breath sounds: 
    • Wheeze 
    • Rhonchi 
    • Crackles 
  • Tachycardia and Tachypnea 

Nursing diagnoses 

  • Activity intolerance related to fatigue and respiratory difficulty 
  • Alteration in comfort due to chest pain and cough 
  • Ineffective airway clearance associated with mucus production 
  • Impaired gas exchange secondary to airway inflammation 
  • Deficient knowledge about disease management and prevention 

Interventions 

  • Rest and comfort: Encourage adequate rest and provide comfort measures for symptoms like myalgias. 
  • Medication administration: Provide prescribed analgesics, NSAIDs, or antibiotics, if necessary. 
  • Hydration: Ensure the patient maintains adequate fluid intake. 
  • Respiratory support: Recommend the use of humidifiers or steam to keep airways moist, and administer respiratory treatments as indicated. Monitor oxygenation. 
  • Patient education: 
    • Encourage the use of cough drops or hard candies for throat discomfort, and sugar-free options for diabetic patients. 
    • Stress the importance of smoking cessation and avoiding bronchial irritants. 
    • Educate on the signs of severe infection and the need for follow-up care. 

Monitoring 

  • Oxygenation status: Regularly assess oxygen saturation and respiratory rate. 
  • Sputum characteristics: Monitor for changes in color, consistency, and volume. 
  • Signs of systemic infection: Watch for early indicators of sepsis, such as increased heart rate and low blood pressure. 

Expected outcomes 

  • Symptom awareness: Patient will verbalize understanding of respiratory infection symptoms. 
  • Hydration and nutrition: Patient will maintain adequate hydration and nutritional intake throughout recovery. 
  • Smoking cessation: Patient will actively engage in smoking cessation efforts. 

Individual/caregiver education 

  • Disease and treatment plan: Develop a personalized plan that includes symptom management, proper use of medications, and infection control practices. 
  • Bronchospasm prevention: Discuss strategies to prevent bronchospasm, particularly in patients with underlying respiratory conditions. 
  • Infection control: Emphasize the importance of good hygiene and avoidance of sick contacts to prevent further respiratory infections. 
  • Follow-up care: Highlight the necessity of follow-up appointments, especially if symptoms worsen or new symptoms develop. 

ICD-10 Code for Acute Bronchitis 

  • J20.9 – Acute bronchitis, unspecified 

FAQs

Additional Information

Content Release Date 

4/1/2022

Content Expiration

12/31/2024

References 

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