Bronchiolitis/Respiratory Syncytial Virus [RSV] (10 Questions)

1. You are the charge nurse on a pediatric unit during peak viral season. You are assigning a bed for Baby Petit, a 4-month-old admitted with confirmed RSV bronchiolitis. The unit is almost full. You have four semi-private rooms available, each with one patient currently occupying a bed.

Question:
Which roommate is the safest assignment for Baby Petit to minimize the risk of cross-infection? *
2. Baby Lemieux, 6 months old, is brought to the emergency department by his parents. They state, "He has had a cold for 3 days, but today he seems to be breathing very fast and won't take his bottle." Upon assessment, the infant is irritable. Vital signs: Rectal Temp 38.5°C, HR 160 bpm, RR 72 breaths/min, SpO2 90% on room air. You observe nasal flaring.

Question:
Which additional physical assessment finding indicates severe respiratory distress requiring immediate intervention? *
3. Baby Cloutier, 3 months old, is admitted with moderate bronchiolitis. The medical orders include: "Monitor vital signs q4h, Oxygen to keep SpO2 > 92%, Suction PRN." The mother tells you, "He hasn't had a wet diaper in 8 hours because he coughs and chokes every time I try to give him the bottle." The infant’s respiratory rate is 70 breaths/min.

Question:
What is the most appropriate nursing intervention regarding nutrition and hydration? *
4. You are caring for Baby Dubé, 5 months old, with RSV. The monitor alarm sounds, indicating an oxygen saturation of 85%. You enter the room and find the baby agitated, with visible mucus bubbling at the nares. The mother looks panicked and asks, "Does he need more oxygen?"

Question:
What is the priority nursing action? *
5. You are preparing Baby Fortin for discharge. The baby was born prematurely at 28 weeks gestation and is now 4 months old (chronological age). It is November (start of RSV season). The physician has ordered Palivizumab (Synagis). The parents ask, "Is this a vaccine? Will it cure him if he gets sick?"

Question:
What is the correct information to provide to the parents? *
6. Baby Rousseau, 7 months old, has been hospitalized for 24 hours with severe bronchiolitis. On admission, he had loud expiratory wheezing and marked subcostal retractions. During your current assessment, you note that the baby appears lethargic/drowsy. Upon auscultation, you hear very little air movement and no wheezing. His respiratory rate has dropped from 60 to 30 breaths/min.

Question:
How should the nurse interpret these findings? *
7. The physician orders a trial of Salbutamol (Ventolin) nebulizer for Baby Gagnon, 9 months old, who has bronchiolitis. There is a debate about whether it will help, as bronchiolitis is often non-responsive to bronchodilators.

Question:
Which assessment finding 20 minutes post-treatment indicates that the medication was effective and should be continued? *
8. You are caring for Baby Tessier, a 3-week-old neonate admitted with RSV. The baby has been stable on room air. While documenting, the pulse oximeter alarm sounds. You look at the baby and see he is pale/blue and not breathing. The heart rate is dropping to 80 bpm.

Question:
After stimulating the baby and clearing the airway, what specific risk associated with RSV in this age group must the nurse monitor for closely? *
9. Baby Marchand, 11 months old, is being discharged home after a 2-day stay for bronchiolitis. The parents are anxious. You are providing discharge teaching regarding when to return to the emergency department.

Question:
Which statement by the parents indicates that the teaching was effective? *
10. Baby Vachon, 18 months old, is admitted with thick, tenacious secretions due to RSV. Standard suctioning is not effective. The physician prescribes Nebulized Hypertonic Saline (3%).

Question:
What is the primary therapeutic mechanism of action for this treatment? *