Resp System Koleya
Resp System Koleya
Resp System Koleya
System :
General Objective
By the end of this session each student should understand the common respiratory diseases & nursing care of such case.
Specific Objective
By the end of this session each student will be able to:
1. Recognize factors affecting type of illness. 2. Recognize the etiology & characteristics of acute upper & lower respiratory infections. 3. Apply Ng. Process for the common types of acute upper respiratory infections e.g: nasopharyngitis, pharyngitis, tonsilitis, otitis media, & croup syndrome (acute spasmodic laryngitis).
Specific Objective
4. Apply Ng. Process for the common types of
2. Older child
Dryness & irritation of nose & throat, sneezing, & muscular aches.
Medication: Acetaminophen
2. Older child
Fever (40 c), anorexia, abdominal pain, vomiting, &
dysphagea.
Tonsillitis
Palatine tonsils
(Visible during oral examination)
Definition:
Otitis media is an inflammation of the middle ear.
Otitis media
Is middle ear effusion (MEE) of any duration that lacks the associated signs and symptoms of infection (e.g., fever, otalgia, irritability). OME usually follows an episode of AOM.
Chronic OM: is a chronic inflammation of the middle ear that persists at least 6 weeks and is associated with otorrhea through a perforated TM, an indwelling tympanostomy tube (TT).
Otitis media
Tympanostomy tube in place.
Chronic OM
Otitis media
1.
Therapeutic management:
Administration of antibiotic (Ambicillin or Amoxicillin) & anti-inflammatory (analgesic & antipyretic).
1.
Nursing care:
Apply hot water bag over the ear with the child lying on the affected side may reduce the discomfort (applied during the attack of pain). Put ice bag over the affected ear may also be beneficial to reduce edema (between pain attacks).
2.
Otitis media
Nursing care:
3. For drained ear; the external canal may be frequently cleaned using sterile cotton swabs (dry or soaked in hydrogen peroxide). 4. Excoriation of the outer ear should be prevented by frequent cleansing & application of zinc oxide to the area of oxidate. 5. Give special attention to the tympanostomy tube i.e., avoid water entering the middle ear and introducing bacteria.
Otitis media
Nursing care:
6. Educate family about care of child, & keep them
aware with the potential complications of acute otitis
1. 2. 3.
Home care:
Encourage bed rest. Provide warm, high humidity atmosphere, especially
4.
Furthermore among children the condition becomes worse due to lack of cartilaginous support of the smooth muscle which is not fully developed until the adolescent years leading to more constriction .
yellow, or greenish mucus. Generally feeling ill Anterior chest pain, that increased by cough. Fever (usually mild) = low grade fever. Shortness of breath A feeling of tightness in the chest. wheezing (a whistling or hissing sound with breathing).
Nursing care:
Provide well balanced diet. Encourage adequate fluid intake, provide small frequent amount to prevent nausea & vomiting. Ensure warm atmosphere, encourage the child to
- Therapeutic management:
Fortunately, most cases of bronchiolitis are mild and require no specific treatment. Antibiotics aren't useful because bronchiolitis is caused by a viral infection. Medication may sometimes be given to help open a child's airways e.g., bronchodilators, corticosteroids. Cough suppressants. Encourage bed rest.
4.
5.
Pneumonia
Definition: Pneumonia is an inflammation with consolidation ( ) of the lung tissue. Exudates consolidate material replaces air in the lung so the density ) (of the lung increases, and leads to increase sound heard on auscultation & dullness ) (of the lung area on percussion.
Pneumonia
Image (A): Normal chest x-ray
Pneumonia
Anatomical forms of Pneumonia: 1. Lobar Pneumonia 2. Bronchopneumonia: Begins in the terminal bronchioles which become clogged ) (with mucopurulent exudates to form consolidated patches in nearby lobules. 3. Interstitial pneumonia: in which the inflammatory process is confined within the alveolar walls, peribronchial & interlobular tissues.
Pneumonia
Pneumonia
Causative organism: Bacterial viral (RSV) others e.g: mycoplasmic pneumonia. Pathologic changes in tissue: - Pneumococci Consolidation - H. Influenza extensive destruction of the epithelium of small airway & hemorrhagic edema. - Mycoplastic pneumonia ulceration & sloughing of mucosal lining.
Pneumonia
Bacterial Pneumonia: the onset is abrupt causative organisms: e.g: pneumococci, staph , streptococcus, & H. influenza
General Signs of Pneumonia: Fever, respiratory, Behavior, & gastrointestinal. Therapeutic management: Bed rest, oral fluid intake, antipyretic, & antitussive for dry hacking cough
Pneumonia
Nursing Assessment:
Pneumonia
Nursing Management: is primarily supportive & symptomatic
Viral Pneumonia
Viral pneumonia is more common pediatric problem than bacterial pneumonia. Respiratory syncytial virus (RSV) is the most common causative organism. Many types of bacterial infection requires hospitalization, and usually accompanied with higher level of morbidity & mortality than viral infection e.g., Staphylococcus, H. Influenza.
Bacterial Pneumonia
Empyema:
It is an accumulation of infected
purulent exudates (pus) in the pleural cavity.
Thoracentesis
Before thoracentesis: a) Equipment preparation: (sterile equipment Such as silicon tube, bottle, scalp, local anesthesia, syringe, sterile gloves, culture media, & test tube). b) prepare the child for procedure: - Psychologically. - Physically: positioning (infant: semi erecting on the unaffected side) or older child: sitting position with the arms & trunk bent forward over a pillow). Restrain as necessary.
Thoracentesis
During the thoracentesis: - Provide emotional support. - Observe for changes in respiration, HR, & SaO2. . After the thoracentesis: - Comfortable position. - Continue to observe respiration, HR, & SaO2.
- Record & inform the physician (description of the pleural fluid obtained esp. any abnormality).
- Sent the obtained specimens to the lab for culture.
Tuberculosis
Introduction:
Tuberculosis
Primary infection:
it occurs when the causative organism
enters the lung tissue the invaded tissue react
Tuberculosis
The disease process may spread to other parts inside the lung & to the GIT because of swallowed infected sputum. NB: when wide spread infection occurs, the child is said to have miliary tuberculosis. Later because of lowered resistance, the latent lesion may again become active.
Tuberculosis
Chest X-ray film.
Presence of numerous miliary
opacities to middle
and upper field of right and to middle
Tuberculosis
Secondary infection:
Usually occurs during adolescence
from the original focus (becomes active) or re-
infection.
Secondary infection may include extensive
Tuberculosis
Nursing assessment (S & S):
Many times the affected
child appears a symptomatic or has a broad range of symptoms (see).
Tuberculosis
Diagnostic evaluation:
- Mantoux test = skin test is the most important test to
diagnose TB. - About 6 weeks after infection an antigen = ( Purified Protein Derivative) is injected intracutaneously. The presence of allergy or hypersensitivity to tuberculo-protein is observed within 48 to 72 hrs and then interpreted in relation to induration not erythema (redness) in centimeters.
Tuberculosis
Interpretation: - A reaction of less than 5cm in diameter is considered ve. - Induration of 5 to 9cm is considered doubtful and should be repeated. - A lesion of 10cm or more is considered +ve.
Mantoux test
Negative reaction
Tuberculosis
Therapeutic management: - With +ve mantoux test; the nurse is responsible for making sure that the entire family is screened.
- If a child has a +ve test but no sign of tuberculosis, we recommend that you take preventive medicine now (N.I.H), before your TB infection becomes active TB disease. This medicine, taken every day for six or nine months, & will kill the TB germs in your body so that you will not develop active TB disease.
Tuberculosis
- Children with active disease can be cared at home taking the required precautions. - With appropriate antituberculosis therapy:
Tuberculosis
Outcome:
- Most of cases are usually recover from primary TB.
Tuberculosis
Prevention:
Bronchial Asthma
(Long term respiratory dysfunction) Definition: A chronic inflammatory disorder of the airway (trachea, bronchi, & bronchioles) characterized by attacks of wheezy breathlessness, sometimes on exertion,
Bronchial Asthma
Etiology:
Triggers factors tend to participate and/or aggravate asthma exacerbation.
1. 2. 3. 4. 5. 6. Allergens e.g: pollens,air pollution, dust. Irritants e.g: Tobacco smoke, sprays. Exercise. Temperature or weather changes. Exposure to infection. Animals: e.g: cats, dogs, rodents, horses.
Bronchial Asthma
7. Strong emotions: e.g: fear, laughing. 8. Food: e.g: Nuts, chocolate, milk.
Bronchial Asthma
Pathophysiology: Asthma trigger
- Inflammation & edema of the mucous membranes. - Accumulation of tenacious secretions from mucous glands. - Spasm of the smooth muscle of the bronchi & bronchioles decreases the caliber of the bronchioles.
Bronchial Asthma
Bronchial Asthma
Clinical manifestations:
A) General manifestations:
1. The classical manifestations are: dyspnea,
Bronchial Asthma
Bronchial Asthma
Barrel chest
Bronchial Asthma
Diagnostic evaluation:
examination, & Lab tests.
2. Radiographic examination.
3. Pulmonary function tests provide an objective method of evaluating the degree of lung disease.
Bronchial Asthma
Therapeutic management:
Allergic control to prevent attacks.
Drug therapy:
preparations + chest physiotherapy (only in
between attacks).
Thank you