Acute Bronchitis: Patient Education (Nursing)

00:00 Okay so let's break that down for you. As a nurse, what do you want to educate the patient about specifically? Well, make sure any patient knows when they should contact their healthcare provider. So somebody that we think has acute bronchitis, we want them to know "Hey if you have any signs of a new onset of fever, call us. If it gets harder for you to breathe, call us. If your symptoms are lasting longer than 3-4 weeks, call us." And lastly, "Oh bloody sputum, what you're coughing up looks bloody, definitely call us." Now, don't use that alarmed face with the patient, but what I want you to recognize is no matter which patient you're interacting with, no matter what their diagnosis is, it's very important that you help them understand the symptoms and signals that mean hey, they need a healthcare professional to check this out because they might be getting into some trouble or complications. Now acute bronchitis is usually caused by virus and you'll educate them why we're not giving them the antibiotic. Why do we keep talking about it? Because it's a major patient dissatisfier. A lot of times patients live with the misconception that they didn't get the care they need, want them to understand because we think it's caused by a virus, we don't want to give you an antibiotic because that's going to make more superbugs like MRSA and VRE and we have enough of that already. So you want to reinforce with them we have paid attention to them, we have done a detailed assessment, we've ruled out pneumonia. If we're worried about them having pneumonia, we would give an antibiotic. But since we think it's bronchitis, we think it's viral, that's why they're not getting an antibiotic. Don't rush through this point. It's really important that you clearly articulate in a way that the patient can understand. Now you can talk to them about the appropriate over-the-counter medications for supportive care so we're going to kind of deal with the symptoms. They're going to have symptoms that maybe similar feel like a common cold symptom when someone has bronchitis. So you can recommend acetaminophen which they may know is Tylenol or NSAIDs. They may know like an ibuprofen or Aleve. That might help them with headache, muscle pain, or joint pain. Now, they might also consider antihistamines or decongestants. Intranasal or inhaled ones are usually much better for them. They'll help with that additional relief if it's appropriate for them. So, if they can handle a nose spray, that's usually better for an antihistamine or a decongestant. Be careful with decongestants if the patient has any cardiac history because a lot of the decongestants cause vasoconstriction.

02:47 If someone already has a cardiac history, that's not a good idea. So, make sure the patient is aware of that and the possible risk with the decongestant if they have cardiovascular disease. Now the cough. This is annoying for the patient and it's annoying for those that they live with. Why? Because the cough always seems to be worse at night. So, we want to make sure that they're getting good rest and so are the rest of the people in their family. So, we can deal with a cough with maybe some throat lozenges, warm beverages. I love ginger tea to take the ginger root and make some tea out of it. It's very soothing when it goes down. We also want them to avoid tobacco or smoke exposure. So whether they smoke or someone around them smokes, they get 2nd hand smoke, they really need to avoid that on any day but especially if they're dealing with bronchitis. Now we talked about the over-the-counter, that's what OTC means, over-the-counter drugs that they could consider and also dextromethorphan or guaifenesin. Now, dextromethorphan is in a lots of different products. That's the one that will help with cough. But guaifenesin is one that will help thin those secretions. Nice to think this was nonsense. Right? These are some brand names you might recognize as like Mucinex.

04:10 I thought that was silly. They had a killer advertising campaign is on mucus people but I didn't think it was real. I thought if you just drink water this would be fine until I got sick and tried some of this miracle drug and it worked amazing in my body. So for combination of the dextromethorphan and the guaifenesin, that's going to be really helpful to patients to actually feel better, it will make them easier to get rid of those secretions even in dealing with suppressing that cough. So, that's my personal favorite and my go to when I don't feel good.

04:46 Now bronchodilators. What we know about those, "Hey, wouldn't that be helpful in acute bronchitis?" Well if we do, we'll use a short-acting beta-2 adrenergic agonist but you only use those in patients who are really having pretty significant issues. They don't have that wheezing or we know they have some other underlying pulmonary disease. So your average patient with acute bronchitis is not going to go home with a SABA, a short-acting beta-2 adrenergic agonist. But, if the patient is wheezing or having some pretty significant respiratory problems or we know they already have some other pulmonary disease issues, they probably will make sure that they have one of these available to them.