# PEDS – BRONC – CL

1. Dispo
[checklist name="variable_1" value="- Sating well on room air|- Not requiring DEEP suctioning|- Able to maintain adequate o2 saturation without respiratory support|- Afebrible or maintaining appropriate temperatures with medical intervention"]

. Bronchiolitis (RSV, Enterovirus, Rhinovirus [w/ Parapertussis])
- Afebrile over past 24hr
- Sat wnl on RA
- Continue to monitor 
- Azithromycin 68mg PO QD
- Q4 Vitals; Q8 BP; Assess for ability to maintain adequate oxygenation without respiratory support 
- Patient is breathing at an adequate rate 
 
2. Dehydration 
- Maintaining adequate output 
- Adjust fluids as needed 
- Encourage breastfeeding 
 
3. Supportive Care 
- Afebrile for the past 24 hours 
- Continue to monitor 
- Tylenol as needed to fever 
 
4. Dispo 
- Must be able to maintain adequate oxygenation while resting without medical intervention 
- Must be able to maintain adequate hydration without IV fluids 
- Must be afebrile or maintaining adequate temperatures with supportive therapy


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1. SSSS
- Clindamycin — Treat Infection — Day *** of 10
- Motrin — Pain Control
- Vaseline — Skin Healing & Integrity — Continue To Apply
- IV Fluids
- Changes: Nafcillin / Cephalexin 
 
2. Supportive Therapy
- Oral Intake — Encourage to promote adequate hydration and nutritional status
 
3. Barriers To Discharge
- Must be tolerating PO without difficulty
- Must be tolerating pain without medications


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.1. - PHARYNGITIS/SORE THROAT##
- Strep screen
- treat per protocol
- treat regardless of throat culture results due to CENTOR criteria
- throat culture obtained: POS 
- Rapid Strep W/ Culture: POST
- Symptomatic relief discussed
- Mono-type illness cautions discussed. To avoid all contact risk activities and sports until cleared to return. discussed potential complications and advised immediate evaluation if any develop.
- Strep pharyngitis considered contagious until treated for 24 hours
- Medications and side effects discussed: Penicillin 500 mg three times daily for 10 days
 
4.2. - DEHYDRATION
- IV Fluids
- Tolerate PO
 
4.3. - GOALS TO DISCHARGE 
- Needs to be able to tolerate oral intake
- Needs to not require intravenous fluids
- Needs to take adequate pain control
- Needs to be afebrile and hemodynamically stable