COMMON COLD

CHAPTER ONE

INTRODUCTION

What is common cold?

The common cold is the most frequent infectious disease in children—in fact, toddlers have

an average of 10 to 12 colds a year. School-age children and adolescents have as many as

four or five yearly. The incubation period is typically 2 to 3 days.

DEFINTION

Common cold can also be called acute viral nasopharyngittis which is the inflammation of the

mucous membranes. It is the most frequent infection in the generally population but mostly

affects children because they are not fully protected. Common cold is a upper respiratory

infection that is self limited.

CAUSES

The illness is of viral origin such as rhinoviruses,Coxsackie virus, respiratory syncytial virus

(RSV), influenza virus, parainfluenza virus, or adenovirus. Although currently more than 200

viruses can cause a common cold, the rhinovirus is the most common culprit.

PATOPHYSIOLOGY

The symptoms of the common cold are believed to be primarily related to the immune

response to the virus.[14] The mechanism of this immune response is virus specific. For

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example, the rhinovirus is typically acquired by direct contact; it binds to humans via ICAM-

1 receptors and the CDHR3 receptor through unknown mechanisms to trigger the release of

inflammatory mediators.[14] These inflammatory mediators then produce the symptoms.[14]

It does not generally cause damage to the nasal epithelium.[

CLINCAL MANIFESTATION

The child older than age 3 months usually develops fever early in the course of the infection,

often as high as 102F to 104F (38.9C–40C). Younger infants usually are a febrile. The child

sneezes and becomes irritable and restless. The congested nasal passages can interfere with

nursing, increasing the infant’s irritability. Because the older child can mouth breathe, nasal

congestion is not as great a concern as in the infant. The child might have vomiting or

diarrhoea, which might be caused by mucous drainage into the digestive system.

MEDICAL MANAGEMENT

There is no specific treatment for a common cold. Although many parents ask to have

antibiotics prescribed, because colds are caused by a virus, antibiotics are not effective unless

a secondary bacterial invasion has occurred. If a child has a fever, it can be controlled by an

antipyretic such as acetaminophen (Tylenol) or children’s ibuprofen (Motrin). Help parents

understand that these drugs are effective only in controlling fever symptoms; they do not

reduce congestion or “cure” the cold. Therefore, they should not be given unless the child has

a fever, generally defined as an oral temperature over 101° F (38.4° C). You may need to

remind parents that children younger than 18 years should not be given acetylsalicylic acid

(aspirin) because this is associated with the development of Reye syndrome, a potentially

fatal neurologic disorder (see Chapter 49). If infants have difficulty nursing because of nasal

congestion, saline nose drops or nasal spray may be prescribed to liquefy nasal secretions and

help them drain. Removing nasal mucus via a bulb syringe before feedings also allows

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infants to breathe more freely and be able to suck more efficiently. Caution parents that if

they use a bulb syringe, they must compress the bulb first, and then insert it into the child’s

nostril. If they insert the bulb syringe first, and then depress the bulb, they will actually push

secretions further back into the nose, causing increased obstruction. There is little proof that

oral decongestants relieve congestion to an appreciable degree with the common cold. Cough

suppressants are not necessary either as coughing raises secretions, preventing pooling of

secretions and the danger of consequent lower respiratory infection. Guaifenesin is an

example of a drug that loosens secretions but does not suppress a cough so is safe to use.

Parents may use a cool mist vaporizer to help loosen nasal secretions if they wish. The

efficiency of home vaporizers is questionable, however, and safe use of a vaporizer, including

proper cleaning, must be stressed or it can serve as a reservoir for microorganisms

NURSING MANAGEMENT

The nurse should educate the parents on the importance of frequent hand hygiene and proper

diet in the child. The nurse should also advise the mother on types of clothes’ to wear during

different seasons of the year since cold can be gotten as a result to cold weather.

COMPLICATION

 Acute ear infection

 Pneumonia

 Bronchiolitis

 Sore throat

PREVENTION

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The only useful ways to reduce the spread of cold viruses are physical measures such as using

correct hand washing technique and face masks. Regular hand washing appears to be

effective in reducing the transmission of cold viruses, especially among children.

INVESTIGATIONS

Throat culture: A throat culture remains the standard for diagnosis, though results can take

as long as 48 hours; throat culture results are highly sensitive and specific for group A beta-

haemolytic streptococci (GABHS), but results can vary according to technique, sampling, and

culture media.

Rapid testing: Most institutions and clinics have rapid testing, which is useful when

immediate therapy is desired; rapid testing can be highly reliable when used in conjunction

with throat cultures; several rapid diagnostic tests are available; compared with throat culture,

such tests are 70-90% sensitive and 95-100% specific.

Testing for viral causes: If Epstein-Barr virus (EBV) is considered, obtain a complete blood

count (CBC) to detect atypical cells in the white blood cell (WBC) differential, along with a

Monospot test (or another rapid heterophile antibody test).

Radiography: Imaging studies are usually not necessary unless a retropharyngeal, par

pharyngeal or peritonsillar abscess is suspected; in such cases, a plain lateral neck film can be

used as an initial screening tool.

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REFRENCES

Brunner, L. S., Suddarth, D. S., Smeltzer, S. C. O., & Bare, B. G. (2004). Brunner &

Suddarth's textbook of medical-surgical nursing (10th ed.). Philadelphia: Lippincott Williams

& Wilkins.

Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., & Harding, M.M. (2017).

Medical-Surgical Nursing: Assessment and Management of Clinical Problems (10th ed.). St.

Louis: Elsevier.