NCLEX Review Guide: Bronchiolitis and Respiratory Syncytial Virus (RSV)

RSV and Bronchiolitis Basics

• Bronchiolitis is inflammation of the small airways (bronchioles) most commonly caused by Respiratory Syncytial Virus (RSV) in infants and toddlers under 2 years old.
• RSV causes bronchiolar edema, mucus production, and airway obstruction, leading to air trapping and difficulty with expiration.
• Peak incidence occurs in winter and early spring months with highest risk in infants 2-6 months old.

Assessment Findings

• Early symptoms include rhinorrhea, low-grade fever, cough, and irritability resembling a common cold.
• Progressive symptoms develop within 2-3 days: increased work of breathing, wheezing, retractions, and poor feeding.
• Severe signs include apnea (especially in infants <6 months), cyanosis, dehydration, and lethargy.

Priority Interventions

1. Maintain airway and monitor respiratory status - assess for increased work of breathing, oxygen saturation, and signs of respiratory distress.
2. Provide supportive care including humidified oxygen, adequate hydration, and nutritional support.
3. Position infant in semi-Fowler's or upright position to facilitate breathing and drainage.
4. Implement contact and droplet precautions to prevent transmission to other patients.