👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: RSV · respiratory syncytial virus · baby chest cold · wheezing infant
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Use this quick-reference guide to spot, treat, and prevent Bronchiolitis (RSV) on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
⚠️ Causes
RSV virus, fall–winter
Inflamed bronchioles, mucus plug
🩺 Signs
Wheezing, tachypnea, retractions
Nasal flaring, copious secretions
Poor feeding, apnea spells
✅ Do
Contact + droplet isolation
Suction nares, humidified O2
Small frequent feeds, hydrate
🧪 Meds
Palivizumab = prevention high-risk
No abx (viral), supportive care
📚 Bronchiolitis (RSV) — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Bronchiolitis is a viral infection of the lower airways, most often caused by respiratory syncytial virus (RSV), that inflames and obstructs the small bronchioles with mucus. It is the leading cause of hospitalization in infants under 1 year and is most dangerous in young, premature, or chronically ill babies. RSV is highly contagious and spreads by droplet and direct contact.
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Key points
Understand these first
Begins with cold-like symptoms (runny nose, cough, low-grade fever) that progress to wheezing and respiratory distress.
Thick copious nasal secretions, tachypnea, retractions, and nasal flaring are common.
Air trapping causes wheezing, prolonged expiration, and hyperinflated lungs.
Poor feeding and dehydration occur because nasal congestion and tachypnea interfere with sucking.
Apnea can be the first or only sign in very young or premature infants.
Diagnosis is often confirmed with a nasopharyngeal swab for RSV.
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Nursing priorities
What to do, in order
Maintain a patent airway: suction the nose and mouth (bulb or nasopharyngeal) before feeds and as needed.
Place the infant on contact and droplet precautions in a private room or cohort with other RSV patients.
Administer humidified oxygen and monitor oxygen saturation continuously.
Promote hydration with small frequent feeds or IV fluids; monitor intake, output, and weight.
Elevate the head of the bed and cluster care to allow rest and reduce energy expenditure.
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Red flags — report now
Escalate immediately
Apnea, cyanosis, or oxygen saturation that stays low despite oxygen requires immediate escalation.
Severe retractions, grunting, head bobbing, or rising respiratory rate signal worsening distress and fatigue.
Signs of dehydration (no wet diapers, sunken fontanelle, poor feeding) need prompt intervention.
Strict hand hygiene and contact precautions are mandatory to prevent unit outbreaks.
Wash hands frequently and keep infants away from sick contacts and cigarette smoke.
Suction the nose with saline drops and a bulb syringe before feeds to ease breathing and eating.
High-risk infants may receive monthly palivizumab (or nirsevimab) during RSV season for prevention.
Return for fast or labored breathing, refusal to feed, fewer wet diapers, or bluish lips.
❓ Bronchiolitis (RSV): NCLEX FAQs
What are the priority nursing interventions for Bronchiolitis (RSV)?
Maintain a patent airway: suction the nose and mouth (bulb or nasopharyngeal) before feeds and as needed. Place the infant on contact and droplet precautions in a private room or cohort with other RSV patients. Administer humidified oxygen and monitor oxygen saturation continuously. Promote hydration with small frequent feeds or IV fluids; monitor intake, output, and weight.
What are the warning signs of Bronchiolitis (RSV) a nurse must report?
Apnea, cyanosis, or oxygen saturation that stays low despite oxygen requires immediate escalation. Severe retractions, grunting, head bobbing, or rising respiratory rate signal worsening distress and fatigue. Signs of dehydration (no wet diapers, sunken fontanelle, poor feeding) need prompt intervention. Strict hand hygiene and contact precautions are mandatory to prevent unit outbreaks.
What do I need to know about Bronchiolitis (RSV) for the NCLEX?
Begins with cold-like symptoms (runny nose, cough, low-grade fever) that progress to wheezing and respiratory distress. Thick copious nasal secretions, tachypnea, retractions, and nasal flaring are common. Air trapping causes wheezing, prolonged expiration, and hyperinflated lungs. Poor feeding and dehydration occur because nasal congestion and tachypnea interfere with sucking.
What patient teaching is important for Bronchiolitis (RSV)?
Wash hands frequently and keep infants away from sick contacts and cigarette smoke. Suction the nose with saline drops and a bulb syringe before feeds to ease breathing and eating. High-risk infants may receive monthly palivizumab (or nirsevimab) during RSV season for prevention. Return for fast or labored breathing, refusal to feed, fewer wet diapers, or bluish lips.
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Quick Tip
Begins with cold-like symptoms (runny nose, cough, low-grade fever) that progress to wheezing and respiratory distress.