Exam #3 - NRSG 2500 (Exam #3 - NRSG 2500 Units 5 and
6)
Bronchiolitis Score / Condition
Bronchiolitis scoring… from 1-9
Score __-__: normal
Score ___-_____: mild
Score ____-____: moderate
Score ____-______: sever
0-1
2-3
4-6
7-9
High flow nasal cannula (HFNC)
Size
Infant : Min-max Flow : __-___ LPM
Pediatric : Min-max Flow : __-__ LPM
Choose a cannula that occupies ___-___% of nares opening
Exceeding maximum flow may cause significant airway
moisture losses and airway cooling, which may thicken
secretions and worsen bronchospasms
,2-7
2-8
50-75
You assess a 12-month old bronchiolitis patient and find:RR
46, subcostal & intercostal retractions, crackles & rhonchi
bilaterally. The patient requires 2 LPM
What is the bronchiolitis score.
5
Know how to do a bronchiolitis score
A 2-week old bronchiolitis patient is breathing at a rate of
52, has subcostal & intercostal retractions
and crackles bilaterally.
What is the bronchiolitis score
3
After suctioning, a 9 month old displays the following:
RR 68, subcostal, intercostal & suprasternal retractions,
crackles bilaterally, diminished breath sounds
in the RLL & O2 need of 1.5 LPM.
What is the bronchioloitis score
9
The doctors orders specifically use this scoring
- The Bronchiolitis scores are used to guide ________
,medications treatments
- Oxygen
- Monitoring
- Suction
- Initiation, escalation and ________ of high-flow nasal cannula
- And when to call the MD or LIP
respiratory
weaning
Medications are not as important as _______…Evidence
Based Practice shows ______ alone is better if it will work.
•The first way and easiest is BBG….(baby booger grabber)
•The second is __ (_____ ________) suction
- The highest you want to turn the suction to is _____mm hg for
peds patients
- Use the correct cath size usually an ___ French
•Remember with suction you need protection…gown mask,
goggles and gloves
suction
suction
NP
Nasal pharyngeal
100
8
, Do a baseline score
•Score + NP suction + post suction score
•Albuterol, Epinephrine, or Corticosteroids are ______ typically
used.
-____ shows that they can actually make it worse if there's too
much congestion because it opens the airways and makes all the
junk drop to the _____ airways.
-______ prolong viral shedding.
•The AAP recommends against other treatments commonly used
in the past, including nebulized ______ saline, systemic
corticosteroids, antibiotics, and chest physiotherapy.
NOT
EBP
lower
steroids
hypertonic
Bronchiolitis Physician Orders
- Diagnosis----bronchiolitis
- VS
- Monitors:Spo2 monitor, cardiorespiratory monitor, apnea,
- Oxygen
6)
Bronchiolitis Score / Condition
Bronchiolitis scoring… from 1-9
Score __-__: normal
Score ___-_____: mild
Score ____-____: moderate
Score ____-______: sever
0-1
2-3
4-6
7-9
High flow nasal cannula (HFNC)
Size
Infant : Min-max Flow : __-___ LPM
Pediatric : Min-max Flow : __-__ LPM
Choose a cannula that occupies ___-___% of nares opening
Exceeding maximum flow may cause significant airway
moisture losses and airway cooling, which may thicken
secretions and worsen bronchospasms
,2-7
2-8
50-75
You assess a 12-month old bronchiolitis patient and find:RR
46, subcostal & intercostal retractions, crackles & rhonchi
bilaterally. The patient requires 2 LPM
What is the bronchiolitis score.
5
Know how to do a bronchiolitis score
A 2-week old bronchiolitis patient is breathing at a rate of
52, has subcostal & intercostal retractions
and crackles bilaterally.
What is the bronchiolitis score
3
After suctioning, a 9 month old displays the following:
RR 68, subcostal, intercostal & suprasternal retractions,
crackles bilaterally, diminished breath sounds
in the RLL & O2 need of 1.5 LPM.
What is the bronchioloitis score
9
The doctors orders specifically use this scoring
- The Bronchiolitis scores are used to guide ________
,medications treatments
- Oxygen
- Monitoring
- Suction
- Initiation, escalation and ________ of high-flow nasal cannula
- And when to call the MD or LIP
respiratory
weaning
Medications are not as important as _______…Evidence
Based Practice shows ______ alone is better if it will work.
•The first way and easiest is BBG….(baby booger grabber)
•The second is __ (_____ ________) suction
- The highest you want to turn the suction to is _____mm hg for
peds patients
- Use the correct cath size usually an ___ French
•Remember with suction you need protection…gown mask,
goggles and gloves
suction
suction
NP
Nasal pharyngeal
100
8
, Do a baseline score
•Score + NP suction + post suction score
•Albuterol, Epinephrine, or Corticosteroids are ______ typically
used.
-____ shows that they can actually make it worse if there's too
much congestion because it opens the airways and makes all the
junk drop to the _____ airways.
-______ prolong viral shedding.
•The AAP recommends against other treatments commonly used
in the past, including nebulized ______ saline, systemic
corticosteroids, antibiotics, and chest physiotherapy.
NOT
EBP
lower
steroids
hypertonic
Bronchiolitis Physician Orders
- Diagnosis----bronchiolitis
- VS
- Monitors:Spo2 monitor, cardiorespiratory monitor, apnea,
- Oxygen
