upper respiratory refresh for nursing.pptx

For nursing

1. Upper respiratory tract infection 2/3/2020 1

2. introduction Respiratory disorder are among the most common causes of illness and hospitalization in children. Overall dysfunction in tends to be more serious than in adults because the lumens in a child's respiratory tract are smaller and therefore more likely to become obstructed 2/3/2020 2

3. Respiratory Infection Infections of the respiratory tract are described according to anatomical area of involvement. The upper respiratory tract consist of: Pharynx, larynx, and upper part of the trachea. The lower respiratory tract consist of: Lower trachea, bronchi, bronchioles, and the alveoli. 2/3/2020 3

4. Respiratory System Nasal Cavity Nose Mouth Bronchus Bronchiole Alveolus Diaphragm Throat (pharynx) Windpipe (Trachea) Left lungs Ribs 2/3/2020 4

5. Describing the differences between adult and pedi client Differences between the very young child and the older child Tongue is larger in proportion to mouth Airway has larger soft tissue than adult Cricoid cartilage encircles airway until middle school age Larynx is 2-3 cervical vertebrae higher Lungs have fewer alveoli at birth than at one year Mucous membranes lining are more loosely attached Chest wall is less rigid and more soft 2/3/2020 5

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7. Trachea Position In children, trachea is shorter and the angle of the right bronchus at the bifurcation is more acute than in the adult. 2/3/2020 7

8. The diameter of an infant’s airway is approximately 4 mm, in contrast to an adult’s airway diameter of 20 mm. An inflammatory process in the airway causes swelling that narrows the airway, and airway resistance increases . Note that swelling of 1 mm reduces the infant’s airway diameter to 2 mm, but the adult’s airway diameter is only narrowed to 18 mm . Air must move more quickly in the infant’s narrowed airway to get the same amount of air to the lungs. 2/3/2020 8

9. Etiology and factors leading to RI 1. Infectious Agents Virus Streptococci, Staphylococci, Haemophilus Influenza, Chlamydia Trachomatis, Pneumococci. 2. Age Infant younger than age 3 months have lower infectious rate (protected from maternal antibodies). The infection rate increases from 3 to 6 months of age . The viral infection rate increase during (toddler, and preschool years). 2/3/2020 9

10. 3. Size The diameter of the airway is smaller in young children, the organism may move rapidly. 4. Resistance The ability to resist depending on several factors: Deficiency of immune system Malnutrition Anemia Fatigue Allergies Asthma Cardiac anomalies 5. Seasonal variations . 2/3/2020 10

11. Acute Upper Respiratory Tract Infections in Children: Most URTIs are caused by viruses & are self-limited. Acute naso -pharyngitis & pharyngitis (including tonsillitis) are extremely common in pediatric age groups. 2/3/2020 11

12. 2. Tonsillitis What is tonsillitis? Tonsillitis is a viral or bacterial infection in the throat that causes inflammation of the tonsils. Tonsils are small glands (lymphoid tissue) in the pharyngeal cavity. In the first six months of life tonsils provide a useful defense against infections. Tonsillitis is one of the most common ailments in pre-school children, but it can also occur at any age. Tonsils are masses of lymphoid tissue located in the pharyngeal cavity. Etiology Tonsillitis often occurs with Pharyngitis. Viral or bacterial 2/3/2020 12

13. “Kissing tonsils” occur when the tonsils are so enlarged they touch each other. 2/3/2020 13

14. : Children are most often affected from around the age of three or four, when they start nursery or school and come into contact with many new infections. A child may have tonsillitis if he/she has a sore throat, a fever and is off food. Pharyngitis : = Sore throat including tonsils. Uncommon in children under 1 yr. The peak incidence occurring between 4 & 7 yrs of age. Causative organism: viruses or bacterial (group A beta-hemolytic streptococcus). 2/3/2020 14

15. Tonsillitis Palatine tonsils (Visible during oral examination) 2/3/2020 15

16. Encourage bed rest. Introduce soft liquid diet according to the child's preferences. Provide cool mist atmosphere to keep the mucous membranes moist during periods of mouth breathing. Warm saline gargles & Paracetamol are useful to promote comfort. If antibiotics are prescribed, counsel the child's parents regarding the necessity of completing the treatment period. Advice and treatment: 2/3/2020 16

17. Management: Therapeutic management Tonsillectomy Adenoidectomy The controversy of tonsillectomy:- Generally, tonsils should not removed before 3 or 4 yrs of age, because of the problem of excessive blood loss & the possibility of re-growth or hypertrophy of lymphoid tissue, in young children. 2/3/2020 17

18. If a child has severe tonsillitis that is recurrent, persistent and troublesome, i.e ; in cases where the child is subjected to around 4 attacks a year for two years or more, then surgery should be considered as an option. Surgery might also be considered if the tonsils were so large that they are causing breathing problems at night. Management (Tonsillectomy): 2/3/2020 18

19. Nursing considerations Provide comfort and minimizing activities that interventions that precipitate bleeding. A soft to liquid diet is preferred. Warm salt water gargles, analgesic and antipyretic drugs. Postoperative nursing care Abdomen or side lying position to facilitate drainage of secretions. 2/3/2020 19

20. Discourage from coughing, clearing their throat, blowing their nose that may aggravate the operation site. All secretions and vomitus are inspected for evidence of fresh bleeding. Analgesics may be given rectally or intravenously to avoid the oral route 2/3/2020 20

21. Food and fluids are restricted until children are fully alert and there are no signs of bleeding . Cool water, crushed ice, diluted fruit juice is given. Soft foods, cooked fruits, mashed potatoes are started on the first or second postoperative day. The nurse observe the throat directly for evidence of bleeding. 2/3/2020 21