Briefly about common cold or nasopharyngitis in children.... Paediatric nursing..

1. COMMON COLD OR
NASOPHARYNGITIS
IN CHILDREN
By NK

2. Goals
 Introduction
 Etiology
 Pathophysiology
 Clinical manifestations
 Diagnostic evaluation
 Complications
 Differential diagnosis
 Medical Management
 Nursing assessment, diagnosis &
management
 Prevention

3. Introduction
 Frequent illness in childhood.
 More frequent in winters
 Lasts for three days
 Cough may persist up to two weeks.

4. Etiology
Infections of upper respiratory tract with :-
 Adenoviruses, influenza, rhinovirus,
parainfluenza or respiratory syncytial
viruses.
Predisposing factors :-
 Chilling, sudden exposure to cold air &
overcrowding.
 Rhinitis could also be due to allergy.
Spread by :- droplet infection.

5. Pathophysiology
 Due to direct contact with the person
with nasopharyngitis, virus can stay in
unhygienic hands for hours.
 Enter into naso pharynx – binds to
ICAM-1 (Intracellular Adhesion Molecule
1) protein (protein present n leukocytes)
 Through unknown mechanism trigger
inflammatory mediators – signs and
symptoms.

6. Clinical
manifestations
 Fever, nasal irritability, sore throat, fatigue, watery eyes.
 Thin nasal discharge- purulent if secondarily infected
especially younger children, not necessarily as it can result
from shedding of epithelial inflammatory cells results from
viral infection.
 Cervical lymph nodes may enlarge
 Nasopharyngeal congestion – nasal obstruction &
respiratory distress (more pronounced in young infants)
 Eustachian tube opening may blocked – serous otitis media
& congestion of tympanic membrane.
 Allergic rhinitis – clear mucoid discharge with sneezing.
 Narrowing of airway & pharyngeal irritation – dry hacking
cough.
 Blocked lacrimal ducts in nose - Excessive lacrimation.

8. Diagnostic
evaluation
 History taking
 Physical examination of eyes, ears,
throat & chest.

9. Complications
 Otitis media
 Laryngitis
 Sinusitis
 Bronchiolitis
 Exacerbation of asthma
 bronchopneumonia

10. Differential
diagnosis
 Presence of foreign body which presents with
unilateral serosanguineous or purulent discharge
from nostril.
 Intermittent use of rifampicin – flu-like syndrome
in some children
 Drugs like reserpine & prochlorperazine – nasal
stuffiness
 Clear mucoid discharge from nose in first few
weeks of life – snuffles.
 Snuffles of congenital syphilis – severe rhinitis
with bilateral serosanguineous discharge
commonly excoriating upper lip & leaving fine
scars.
 Nasal strictures may ulcerate leaving a flat nasal
bridge.

11. Medical
management
Relieve nasal congestion :-
 If anterior nares are tickled by tip of handkerchief -
Babies sneeze & blow out nasal discharge.
 Nasal drops of saline – symptomatic relief.
 Nasal decongestants (ephedrine, xylometozoline) –
rebound congestion, should not use routinely, use only
in refractory cases for limited duration.
 Antihistamines – best avoided in first six months of
life but give symptomatic relief by drying up thin
secretions & relieving sneezing.
 Non sedating agents, e.g. loratidine & citrizine – in
allergic rhinitis.
 Terfenadine should not prescribe in children –
potential cardiotoxicity.

12. Cont..
Fever :-
 Antipyretics such as paracetamol
(acetaminophen).
 Cough syrups should not be given
 If cough is suppressed in infants & young
children- mucoid secretions may retain in
bronchi & may predispose to spasmodic
cough, sneezing, atelectasis &
suppuration.

13. Cont..
Antibiotics :-
 Little value in viral infections.
 Used if secretions become purulent, fever
continues to rise & children develops
bronchopneumonia.
 No evidence that large doses of vitamin C
are helpful.
 Children should be protected from sudden
exposure to chills &kept warm during winter
months.

14. Nursing
assessment
 Asses the child with common cold for :-
 History of exposure to known carriers,
fever, sore throat and other clinical
features.
 History of oral intake & hydration status
should also be taken.

15. Nursing
diagnosis
 Ineffective breathing pattern related to
inflammatory process in respiratory tract
 Ineffective airway clearance related to
mechanical obstruction of airway
secretions & increased production of
secretions.
 Anxiety related to disease

16. Nursing
management
Promoting comfort :-
 Relieve Nasal congestion:-
1. Normal saline nose drops, followed by bulb
syringe suctioning in infants & toddlers.
Older children may use a NS nose spray to
mobilize secretions.
2. Cool mist humidifier.
3. Promote adequate oral fluid intake

17. Cont..
 Adequate rest.
 Position – provide the child a semi-fowlers position
for lung expansion.
 Carrying the child in cool fresh air can aid breathing.
 Administer medications as prescribed.
Providing family education :-
 Encourage parents & families to give a healthy diet.
 Educate parents to keep the child calm and make
comfortable.
 Educate parents about the medications, their use and
effects.
 Educate parents how to use nasal drops and about
suctioning also.

18. Prevention
 Frequent hand
washing decrease
the spread of
viruses.
 Cough or sneeze
into arm or tissue.
 Avoid second-hand
smoke and crowded
areas, especially
during winter.
 Avoid close contact
with individuals
having cold.

19. Thank you
for the
attention!