Question

An infant with bronchiolitis is being treated with ribavirin (Virazole). The nurse is aware that: A. The medication is only effective if given within 24 hours of developing symptoms. B. The medication is administered for 30 minutes, three times a day. C. The medication can be used with other aerosol therapy to produce bronchodilation. D. The medication requires the nurse to use protective goggles and respirator mask

Short answer

Answer: D) The medication requires the nurse to use protective goggles and respirator mask. Explanation: Ribavirin is an antiviral medication used to treat bronchiolitis in young children and infants. As an aerosolized medication, it can cause eye and respiratory irritation in individuals exposed to the mist. To avoid potential harm, nurses administering ribavirin should wear personal protective equipment, including goggles and a mask.

Step-by-step solution

Understand the question and choices

First, let's understand bronchiolitis and the provided answer choices. Bronchiolitis is a common lung infection in young children and infants. Ribavirin (Virazole) is an antiviral medication used to treat bronchiolitis. We are given four answer choices regarding the administration of ribavirin, and our task is to determine the correct statement.

Analyze the answer choices

Look at each answer choice and determine if it is accurate. A) The medication is only effective if given within 24 hours of developing symptoms. B) The medication is administered for 30 minutes, three times a day. C) The medication can be used with other aerosol therapy to produce bronchodilation. D) The medication requires the nurse to use protective goggles and respirator mask.

Research and Eliminate Incorrect Choices

Research or use prior knowledge to eliminate incorrect choices. A) It's not entirely correct that ribavirin is only effective if given within the first 24 hours. Studies have shown that early administration may improve outcomes, but there is no definitive 24-hour cutoff for its effectiveness. B) The medication is usually administered continuously for 12-18 hours per day for 3-7 days, not 30 minutes, three times a day. C) Ribavirin can sometimes be used with other aerosol therapies, such as bronchodilators like albuterol, but only if the compatibility has been checked.

Determine the Correct Answer

Based on the elimination of other choices and accurate information, the correct answer is: D) The medication requires the nurse to use protective goggles and respirator mask. Ribavirin is an aerosolized medication and can cause eye and respiratory irritation in individuals exposed to the mist. Therefore, nurses administering the medication should wear personal protective equipment, including goggles and a mask, to avoid potential harm.

Key concepts

Ribavirin Administration

Ribavirin is a critical antiviral medication used in the treatment of bronchiolitis, especially in severe cases or when the patient has underlying conditions. It is important to understand that ribavirin is usually administered via aerosol, and to achieve the desired therapeutic effects, it needs to be given continuously over a prolonged period.

Contrary to the often-misunderstood notion, this medication is not limited to a strict initial 24-hour window but rather can be efficacious if administered earlier in the course of the illness. The current treatment protocols usually involve multiple hours of administration daily, typically spanning 12-18 hours. This method ensures adequate drug delivery to the bronchioles, where the inflammation and infection are most profound.

To protect against potential risks associated with ribavirin aerosol, especially recognizing that the drug can be teratogenic, healthcare providers should adhere strictly to the recommended safety guidelines and use appropriate protective equipment.

Pediatric Nursing Care

Caring for a pediatric patient requires a unique approach that is sensitive to the developmental and emotional needs of children. In the case of infants with bronchiolitis, the role of pediatric nursing goes beyond administering medications. Nurses must monitor the child's respiratory status vigilantly, watching for signs of respiratory distress like increased work of breathing, wheezing, and decreased oxygen saturation.

Supportive care is essential, as there is no specific cure for bronchiolitis. This includes providing adequate hydration, ensuring proper nutrition, and monitoring vital signs. Nurses also play a key role in educating families about the condition, how to manage symptoms at home, and when to seek further medical attention.

Moreover, pediatric nurses should provide comforting measures for the child, such as pain relief, fever management, and oxygen therapy when needed. They also need to be aware of each child's psychological needs, aiming to reduce the stress of hospitalization.

Personal Protective Equipment in Nursing

The use of personal protective equipment (PPE) is paramount in nursing to prevent the spread of infection and protect healthcare professionals from exposure to harmful substances. When administering aerosolized medications like ribavirin, PPE becomes essential.

As per the guidelines, nurses should wear protective goggles and a respirator mask to prevent eye irritation and inhalation of the medicated mist. Additionally, gloves and gowns are advised to avoid skin contact with the drug. Nurses should be trained in the proper donning and doffing of PPE to minimize the risk of contamination.

It’s also crucial for healthcare facilities to maintain an adequate supply of PPE and to ensure that the equipment is accessible where and when it is needed. Regular checks and staff training reinforce the proper and consistent usage of PPE.

Bronchiolitis Management

Managing bronchiolitis primarily focuses on supportive care, as antibiotics do not treat this viral infection, and therapies such as ribavirin are reserved for severe cases. The mainstay of bronchiolitis treatment is ensuring that the child maintains adequate oxygenation and hydration.

Interventions may include supplemental oxygen to maintain oxygen saturation above a certain threshold, usually around 90%. Hydration can be managed orally or intravenously if the child is unable to drink or is too tachypneic. Suctioning of nasal secretions can help to clear the airways and promote better breathing and feeding.

Bronchodilators and Steroids

While bronchodilators like albuterol are sometimes used, their effectiveness in bronchiolitis is not well-supported by evidence. Systemic steroids are also not routinely recommended for the treatment of bronchiolitis.

The management also involves careful monitoring for signs of worsening, such as apnea, marked tachypnea, lethargy, and poor feeding. In such cases, escalation of care, including potential hospitalization, may be needed.