This document discusses respiratory disorders that are common causes of admission for neonatal and intensive care patients. It defines acute respiratory infections as infections of the respiratory tract, including the sinuses, middle ear and pleural cavity. Respiratory disorders are classified as either upper respiratory infections, which include the common cold, pharyngitis and tonsillitis, or lower respiratory infections such as bronchitis, bronchiolitis and pneumonia. Common symptoms, causes, diagnostic evaluations and nursing care are outlined for various respiratory conditions like the common cold, pharyngitis, tonsillitis, bronchitis and bronchiolitis.

2. INTRODUCTION
• Respiratory disorder are the most frequent
causes of admission for neonatal and intensive in
both term and preterm infant.
• It includes all infections of less than 30 days
duration, except the infection of the ear lasting
less than 14 days.
• A wide variety of pathologic lesions may be
responsible for respiratory disturbances including
pulmonary airway, cardiovascular, central
nervous and other disorder.

3. DEFINITION
• An acute respiratory infection is an acute
infection of any part of the respiratory tract
and related structure including paranasal
sinuses, middle ear and pleural cavity.

4. CLASSIFICATION
 Acute upper respiratory infection which
includes common cold, pharyngitis, tonsillitis.
Acute lower respiratory infection which
includes bronchitis, bronchiolitis and
pneumonia.

6. COMMON COLD
• The common cold is an infection of upper
respiratory tract caused by large number of
viruses like adeno virus, influenza virus, para
influenza virus. It is one of the common illness
during childhood period.
• Incubation period: 2 to 3 days up to weeks
• Clinical presentation: fever up to 104 degree F,
sneezing, rhinorrhoea, breathing difficulty,
difficulty in sucking and malaise.

7. PHARYNGITIS
• It is an inflammation of pharynx caused by
different type of viruses. Common virus are
adeno virus, entero virus and para influenza
virus.
• Clinical presentation: Redness in throat,
swelling and enlarged tonsil, swallowing
difficulty, refuse to take food and fever are
common presentation.

8. TONSILLITIS
• It is the inflammatory condition of tonsil.
Tonsillitis often occurs with pharyngitis. The
causative agent may be viral or bacterial.
• Clinical presentation: difficulty swallowing and
breathing.

10. BRONCHITIS
• Bronchitis is an inflammation of the air
passages between nose and the lungs,
including the windpipe and the larger air
tubes in the lungs that bring air in from the
trachea.
• There are two types of bronchitis:
Acute bronchitis
Chronic bronchitis

11. Clinical presentation of bronchitis:
• Running nose
• Dry hacking
• Unproductive cough
• Chest pain
• Shortness of breath
• Wheezing
• Fever
• Fatigue and malaise

12. BRONCHIOLITIS
• It is the infection of the small air passage of
the lungs called the bronchioles.
• Causative organisms are para influenza virus,
adeno virus, influenza virus and M.
pneumoniae.
• Clinical presentation: runny nose, cough,
production of mucus, fatigue, shortness of
breath, slight fever and chills.

13. DIAGNOSTIC EVALUATION
• History taking
• Physical examination
• Chest X ray
• CBC
• Blood culture
• Sputum culture
• Measurement of blood gases

14. THERAPEUTIC MANAGEMENT
• Drugs therapy:
Bronchodilator
Corticosteroids
• Chest physiotherapy
Breathing exercise
Purse lip breathing
• Oxygen therapy continuously
• Maintain fluid and electrolyte balance
• Avoid sedatives that may suppress the patients respiratory
drive

16. NURSING DIAGNOSIS
1. Ineffective breathing pattern related to inflammatory process in
the respiratory tract.
Goal: child will initiate normal and effective breathing and increase
supply oxygen to lungs.
Intervention:
• Observe vital sign, presence of cyanosis as well as pattern depth
of breathing.
• to provide a comfortable position and prevent aspiration.
• Provide well ventilated room for sufficient air humidity.
• Encourage the family to bring clothes looser thinner and absorb
sweat.
• Give oxygen and nebulization in accordance in the doctors
instruction.

17. 2. Altered body temperature related to inflammatory
process and pain
Goal: temperature will be reduced to normal.
Intervention:
• Assess vital sign and general condition of the child.
• Maintain well ventilation of room.
• Remove extra clothing from the body and perform
cold sponging.
• Advice for plenty of water.
• Administer analgesic as prescribed by the doctor.

18. 3. Imbalance nutrition level less than body requirement
related to disease condition.
Goal: child will maintain normal nutrition level.
Intervention:
• Assess body weight and dietary intake.
• Encourage mother for oral care.
• Emphasize mother for breast feeding.
• Advice mother to give supplementary food like sarbottam
pitho with daal soup and vegetables.
• Give smaller more frequent meals to decrease possibility of
emesis with coughing spells.
• Monitor intake and output.

19. 4. Anxiety related to acute illness and need for unplanned
hospitalization.
Goal: anxiety level of child as well as family will reduce and actively
involve in caring for children.
Intervention:
• Observe the level of anxiety experienced by families.
• Provide sufficient information to parent including prognosis care
and treatment of child.
• Encourage the family to ask if they see thing that are less
understood or not clear.
• Provide well orientation of hospital rules, policy, ward information,
laboratory and pharmacy.
• Promote parent involvement in the care of patient.
• Arrange as appropriate play activities.

20. PREVENTION
• Timely immunization of child.
• Promoting the nutritional status of the child.
• Keeping the child warm adequately, avoiding exposure
to cold, damp environment.
• Prevent exposure to different house hold, tobacco and
other environmental smoke.
• Proper treatment and management of condition like
measles, malnutrition, diarrhoea, vomiting which can
lead to secondary respiratory complication.
• Careful caring of the child to prevent accidents like
aspiration of fluid, chemical or other foreign bodies to
the respiratory tract.

21. REFERENCES
• Nelson textbook of pediatrics 19th editon,
volume 2nd, elsevier publicaion.
• Essentials of pediatric nursing, 8th edition,
elsevier publication.
• Shrestha T. Essential of child health nursing, 1st
edition, medhavi publication
• Upreti K. Child health nursing 1st edition.