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07.08 Pediatric Bronchiolitis Labs

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Overview

  1. Pediatric bronchiolitis
    1. Labs to consider for disease process
    2. Lab purposes
    3. Special considerations

Nursing Points

General

  1. Pediatric bronchiolitis
    1. Labs to consider for disease process
      1. Respiratory syncytial virus
      2. Influenza
      3. Complete blood count
      4. Cultures
    2. Lab purposes
      1. Respiratory syncytial virus
        1. Checks for antibodies specific to RSV
      2. Flu
        1. RSV similar to flu symptoms
        2. Rules out influenza
      3. Complete blood count
        1. Infection
        2. Inflammation
      4. Cultures
        1. Isolates pathogen
        2. Determines sensitivity of pathogen
    3. Special Considerations
      1. RSV
        1. Swab
      2. Influenza
        1. Swab
      3. CBC
        1. Lavender top
      4. Cultures
        1. Blood
          1. Aerobic/Anaerobic jars
        2. Sputum
          1. Sputum collection cup
        3. Wash
          1. Direct sample
          2. Nasopharyngeal swab

Nursing Concepts

  1. Oxygenation
  2. Lab Values

Reference Links

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Video Transcript

Okay in this lesson, we’re going to take a look at Labs that you’ll come and do for any patient that you have that has pediatric bronchiolitis.

Like some of the other lessons similar to this, our goal here is to provide you with a framework of potential labs that you may run into for patients that have particular diseases, illnesses, or injuries. This list that we put together for you is not all encompassing, but it’s the labs that we most commonly have seen with our patients, and that you will probably see with your patients that have any one of these particular illness is.

With pediatric bronchiolitis, it’s one of the most common admissions in Pediatrics. The goal here so identify the cause and rule out other pathogens because some of them are similar to the main cause of pediatric bronchiolitis. Also you want to focus on developing a plan of care for your patient and providing supportive therapy for your patient.

These are the most common test that you’re going to see with pediatric bronchiolitis. The number one cause of pediatric bronchiolitis is respiratory syncytial virus, which is why we screen for it. But it’s also important to screen for flu, and also get a complete blood count and cultures if there’s some sort of suspicion of infection

First off, the thing that you got to test for right off the bat is respiratory syncytial virus. It’s an antibody test if you’re going to do and it’s going to confirm the presence of the antibodies.

The other thing that you don’t want to test for is influenza. And the reason is because it mimics RSV. While the treatments may be similar, it’s important to know what the cause of the illness is so that you can focus on providing that optimal plan of care.

Especially in these little guys, their immune systems are already being dampened by whatever virus is going on especially RSV, so it’s important to monitor for infection. That’s why we need the CBC. It’s going to tell us if there’s some sort of infection or if there’s some information going on so that we can provide additional therapy there.

In the event that we suspect that there’s some sort of infection and we need to do some sort of culture, they’re usually three ways that we do it. First off you’re going to do a potential blood culture, which is a direct sample is going to go into this blood culture darks. Additional you may run into something called a wash, which is a nasopharyngeal swab. That goes directly to the lab and one of the culturette swabs. Now depending on the age of your patient and the ability for them to follow direction, sometimes you can get a sputum sample, but just know that this may be far less likely especially depending on how cooperative they are.

So what do you need to know about when you’re getting your lab samples?

Well first off the RSV in the influenza are both swabs. You’re going to get those swabs and send those out to the lab. They don’t always look like this picture, so just make sure that you use in the appropriate culture swab for these.

For your CBC you’re going to use a purple top two, because this got that EDTA in it. But if you’re going to do some sort of blood culture, you’ll submitted into these culture jars. If you’re doing a culture for a wash, you’ll get the direct sample from the nasopharyngeal swab and that’s enough to the lad. Also if if your patient is old enough to follow directions or they can follow directions well, you may be able to get a sputum sample. That’ll go in a sputum collection cup.

For our nursing concepts for Pediatric bronchiolitis, they focus on lab values and oxygenation since this is a primary pulmonary Illness.
Okay so let’s recap.

RSV is a high-risk respiratory disease, and we use a swab to identify that.

We want to rule out influenza, so we’ll also get an influenza swab.

If we’re concerned about a source of infection, we can do cultures on our patient and these are going to be either blood, wash, or sputum.

Lastly we can do a CBC to identify an infection, and keep an eye on any inflammation or systemic infection that may be brewing.

That’s it for a lesson for labs dealing with pediatric bronchiolitis. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!

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  • Question 1 of 2

A nurse has just received the results of a client’s complete blood count with differential. Which of the following WBC elevation would indicate a left shift?

  • Question 2 of 2

A nurse has admitted a client with an elevated WBC count. Which of the following scenarios does the nurse understand to be a potential cause of the elevated count? Select all that apply.

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