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Upper Respiratory Infection Pediatric Care Plan

Illustration of a man with a hand on his neck and his mouth open with nothing coming out

What is an Upper Respiratory Infection?

Commonly called a “cold,” and sometimes called viral rhinitis, upper respiratory infections (URI) are contagious viral infections of the nose and throat.

URIs are the most common infectious disease in the United States. Family members or close friends may have the same symptoms.  Most adults catch a cold from time to time, but kids can get 8-12 a year. They are the top reason kids visit the doctor and miss school. About 5 and 10% of children with a URI will also develop an ear or sinus infection.

Symptoms of an URI may include:

  • The first symptoms of a URI are often a tickle in the throat.
  • Runny or stuffy nose (nasal discharge may be clear, cloudy, yellow or green)
  • Sore throat
  • Fever can also be present (temperature >100.3)
  • At times, the child may also have a cough and hoarse voice. Sometimes, watery eyes and swollen lymph nodes in the neck also occur. Headache, muscle aches, feeling tired and lack of appetite can also be present.

What Causes Upper Respiratory Infections?

Most URIs are caused by rhinoviruses carried in invisible droplets in the air or on things we touch. These viruses can get into the protective lining of the nose and throat, setting off an immune system reaction that can cause a sore throat, headache, and trouble breathing through the nose.

Dry air — indoors or outside — can lower resistance to infection by the viruses that cause colds. So can being a smoker or being around someone who smokes. 

Despite some old wives’ tales, not wearing a jacket or sweater when it’s chilly, sitting or sleeping in a draft, and going outside while your hair’s wet do not cause colds.

How Long Do URIs Last?

URI symptoms usually appear 2 or 3 days after exposure to a source of infection. Most symptoms clear up within 1 week, but some last a bit longer.

How to Treat Upper Respiratory Infections

With each new URI, your child’s body builds up immunity to that virus. Most parents know when their child has a URI. Sometimes, they have it too or other children in school have it.

Most often, you don’t need to call or see your child’s doctor. There are no medicines to make a URI go away sooner. But, there are good ways to help many of the symptoms and provide comfort to your child.  The treatment for each symptom is different.

Here is some care advice that should help.

Some Supportive Things You Can Do: 

For a Runny Nose With Lots of Discharge: Blow the Nose

The nasal mucus and discharge is washing germs out of the nose and sinuses.

Blowing the nose is all that’s needed.

For a Blocked Nose: Help Clear Congestion

  • Use saline (salt water) nose drops or spray to loosen up the dried mucus. If you don’t have saline, you can use a few drops of bottled water or clean tap water.
  • Run a hot shower to create a steam-filled bathroom where your child can sit to help clear stuffiness
  • For children 8 years of age and older, saline sinus irrigation can provide better relief of congestion.

Keep Your Child Hydrated:

  • Try to get your child to drink lots of fluids. It will thin out the mucus discharge from the nose and loosen up any phlegm in the lungs.

Avoid Dry Air

  • If the air in your home is dry, use a humidifier. Dry air makes nasal mucus thicker.

Soothe Raw or Irritated Nose Area

If the nose is irritated from blowing, dab petroleum jelly on the skin under the nose to soothe rawness.

Soothe Sore Throat:

  • Give hard candy or cough drops to relieve sore throat (only for kids older than 6)
  • Sip warm chicken broth. 
  • Some children prefer cold foods such as popsicles or ice cream.
  • Warm salt water gargles

Relieve Aches and Pains:

  • Run a warm bath or use a heating pad to soothe aches and pains
  • Use tylenol or motrin as needed

Medication for Colds:

Many experts now believe that there’s usually no reason to give over-the-counter (OTC) decongestants and antihistamines to any child younger than 6. There’s little proof that these medicines work, and decongestants can cause hallucinations, irritability, and irregular heartbeats, particularly in infants.

Cold Medicines – NOT ADVISED

  • Reason: They can’t remove dried mucus from the nose.
  • Nasal saline works best.

Decongestants – NOT ADVISED

  • Decongestants by mouth (such as Sudafed) are not advised due to side effects.

Allergy Medicines 

  • They are not helpful, unless your child also has nasal allergies.

Antibiotics – NOT APPROPRIATE

  • Antibiotics are not helpful for viruses or colds. 
  • Antibiotics may be used if your child develops a secondary bacterial infection, for example, an ear or sinus infection, pneumonia

Medication for Fever:

For children not drinking or playing due to fever, give acetaminophen (such as Tylenol) or ibuprofen (such as Motrin or Advil).  Follow packing instructions or check in with K for Parents for specific dosing recommendations for your child. 

Never give aspirin to children or teens, as such use has been linked to Reye syndrome, a rare but serious condition that can be fatal.

Treatment for Other Symptoms:

Pain

Use acetaminophen (such as Tylenol) or ibuprofen for muscle aches or headaches.

Cough

Can give honey 1 teaspoon (5 ml) for coughing spells as often as needed. Can also use cough drops. Do not give to infants under 12 months of age due to risk of botulism, a bacteria that can cause paralysis.

Chicken soup

There’s no real proof that eating it can cure a cold, but sick people have been swearing by it for more than 800 years. Chicken soup contains a mucus-thinning amino acid called cysteine, and some research shows that chicken soup helps control congestion-causing white cells, called neutrophils.

Vapor rub

Recent studies show that children ages 2-11 years of age using vapor rub on chest and neck at bedtime provided symptomatic relief of nighttime cough, congestion and difficulty sleeping, allowing them and their parents to have a more restful night than those in the other study groups.

Check in with K if…

  • You have questions to discuss with the doctor
  • You want to know your child’s dosage for over-the-counter medications
  • Nasal discharge lasts more than 10 days
  • You want to check in with a doctor for a follow up evaluation of how your child is doing

See a doctor in person if…

  • Earache occurs
  • Fever lasts more than 5 days
  • Cough lasts more than 3 weeks
  • Shortness of breath occurs
  • Unusual lethargy/tiredness develops
  • Inability to keep food or liquids down or poor fluid intake
  • Severely painful sore throat that interferes with swallowing
  • Chest or stomach pain not relieved with Tylenol or ibuprofen
  • Swollen glands (lymph nodes) in the neck noted