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Unit II


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2nd Lecture in our NCM 104 CD class.

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Unit II

  1. 1. Common ColdH1N1Influenza
  2. 2. Diptheria Pertussis PTB Pneumonia Streptococcal Sore throat AndScarlet Fever
  3. 3. An acute usually afebrile viral infectioncaused by inflammation of the upperrespiratory tract. filtrable virus Rhinovirus, Adenovirus
  4. 4. 1-4 days Airborne Droplet contact withcontaminated objects Hand to hand transmission or indirect Nasopharynx
  5. 5.  Frequent sneezing Headache,tearyeyes,watery eyes Myalgia Arthralgia Chills-early afternoon fever and accpd. By chilly sensation Scratchy throat , runny nose Hacking,non-productive cough
  6. 6.  Hacking,non-productive cough Diminished sense of taste,smell and hearing Blocked nasal passages with continuous watery discharges
  7. 7.  Sinusitis Otitis Media Bronchopneumonia Primary treatment Aspirin or Acataminophen Fluids Decongestants Sorethroat lozenges Steam inhalation
  8. 8. 1) Complete bed rest2) Administration of antibiotic/doctors order3) Health education
  9. 9.  Highly contagious infection of the respiratory tract that results from 3 types of myxovirus influenza. Affects all age group, the incidence highest in school children, severity is greatest in the very young elderly people and those with chronic diseases.
  10. 10. MOST prevalent, strikesevery year strikes annually found insmaller epidemics every 4-6 years found in sporadic cases endemic
  11. 11. through inhalation of a respiratory droplet from an infected person or by indirect contact. secretions fromupper respiratory tract . until5th day of illness 24-48 hours.
  12. 12. Invades the respiratory mucosaDamages ciliated epitheliumof the trachea bronchial tree Making it vulnerable to secondary infection Severe reactions Serosanguinous discharge Complication
  13. 13. Joint Pain Onset is sudden,  Non-productive chilly sensation, cough and hyperpyrexia occationally laryngitis Headache  Conjunctivitis Malaise  Rhinitis Myalgia  Rhinorrhea Hoarseness
  14. 14.  Pneumonia Reyes syndrome Myositis Myocarditis Blood Examination
  15. 15.  Active Immunization Educate the public and health care personnel in basic personal hygiene Client should receive the vaccine annually 1. Elderly 2. People who have poor immunity 3. Conditions such as D.M., Lung Disease, Kidney disease, Heart disease, Liver disease
  16. 16. 1. Bed rest2. Adequate fluid intake3. Aspirin or Acetaminolphen4. Guaifenesin or another expectorant Amantadine Symmetrel
  17. 17. 1) Advise the pt. to use of mouthwashes.2) Increase fluid intake3) Screen visitors4) Teach the patient proper disposal of tissue and proper handwashing technique to prevent the virus from spreading.
  18. 18. 5) Watch for s/s of developing pneumonia Such as cracks,coughing accompanied by purulent bloody sputum.
  19. 19.  acute highly contagious toxin mediated infection caused by coryne bacterium diphteriae Gram (+) rod that usually infects the respiratory primarily the tonsils, nasophayrnx, larynx usually producing a membranous pharyngitis
  20. 20. Corynebacterium Diphtheriae (Klebs Loeffler Bacillus)Contact with patient or carrier or witharticles soiled with discharges ofinfected persons. 2-5 days
  21. 21. 2-4 weeks in untreated patient 1-2 days in treated patientDischarges from the nose, pharynx eyesor lesions on other parts of the body ofinfected persons. Pseudomembrane
  22. 22. A. Nasal with serosanguinous secretions from the nose with foul smellB. Tonsilar low fatality rateC. NasopharyngealD. Wound or cutaneous diphtheria
  23. 23. 1) Feeling of fatigue2) Malaise3) Slight sorethroat and elevation of temperature usually not exceeding 380C4) Cervical Adenitis with tenderness of the glands occur5) Inflammatory reactions is initiated by the body and exudate consisting of leukocytes and RBC and necrotic tissues begins to form
  24. 24. ~ opening created by incisionNose and Throat SwabSchick Test – To determine the susceptibility or immunity in diphtheriaMoloney Test – Hypersensitivity in diphtheria
  25. 25. – inflammation of the heart muscle– paralysis of the soft palateparalysis of ciliary muscles of theeye,pharynx,larynx or extremities – respiratory failure esp. laryngealtype reactions tends to stagnatedue to paralysis of the diaphragm
  26. 26. Neutralization of Toxin DAT ADSFractional desensitising dosesFractional doses are given in positivecases with the following cases: 0.05 ml (1:20 dilution) SQ 0.05 ml (1:10 Dilution) 0.10 ml undiluted SQ
  27. 27. Neutralization of Toxin DAT ADSFractional desensitising dosesFractional doses are given in positivecases with the following cases: 0.20 ml undiluted SQ 0.50 ml undiluted IM 0.10 mil undiluted IV
  28. 28.  Destruction of Microorganism Giving of Penicillin Erythromycin 40 mg/kg BW in 4 doses x 7-10 days
  29. 29. a) Maintenance of Adequate nutritionb) Maintenance of adequate fluid and electrolyte balancec) Bed restd) Oxygen inhalation
  30. 30. 1) Bed rest for at least 2 weeks patient not permitted to bathe2) Diet soft diet small frequent feeding is advised3) Fruit Juices rich vit.C to maintain the alkalinity of the blood4) Ice collar applied to the neck
  31. 31. ImmunizationMandatory DPT immunization of babies ORAL HYGIENE
  32. 32. Is a highly contagious respiratoryinfection usually caused by the non-motile gram (–) negative coccobacillus Bacterial infection Bordetella pertussis
  33. 33.  7-14 days 7-10 days – direct and indirect contact – secretions from the nose and throat of infected person contain the causative organism.
  34. 34. 1. Catarrhal stage or Invasive Period Coryza, sneezing lacrimation and dry bronchial cough Cough becomes an irritating, hacking and nocturnal becoming more severe This stage last for about 1-2 weeks
  35. 35. 2. Paroxysmal Stage  7th -14th day Cough becomes spasmodic and recurrent with excessive explosive outburst in series of rapid cough in one expiration Each cough characteristically ends in a loud crowing inspiratory whoop and chocking on mucus that causes vomiting
  36. 36. 2. Paroxysmal Stage •Nose bleed •increase venous pressure •periorbitaledema •conjunctival haemorrhage •Rectal prolapse
  37. 37. 3. Convalescent stage Paroxysmal coughing and vomiting gradually subside •Pneumonia •Atelectasis •Convulsions •Bronchopneumonia – most dangerous complication
  38. 38. 3. Convalescent stage Paroxysmal coughing and vomiting gradually subside •Severe malnutrition – due to persistent vomiting.
  39. 39.  Nasopharyngeal swabs Sputum culture Fluorescent Antibody screening of nasopharyngeal smears provides quicker result than cultures but it is less reliable WBC usually increased in children older than 6 months
  40. 40. 1) Supportive Therapy  Fluid and electrolytes replacement  Adequate nutrition  Oxygen Therapy in apnea2) Antibiotic Erthromycin, Ampicillin to eliminate infection3) Hyperimmune Convalescent serum gamma globulin are found effective
  41. 41.  Isolation and Medical asepsis should be carried out During paroxysm the patient should NOT BE LEFT ALONE Suctioning equipment should be ready at all times for emergency use to avoid obstruction of airway. Sunshine and fresh air are important but the patient should be protected
  42. 42.  The child shld. be kept as quiet as possible since activity and excitement Provide warm baths , keep the bed dry and free from soiled linens I and O shld be monitored Abdominal binder
  43. 43. Immunization DPT Active
  44. 44.  Koch’sdisease, Phthisis, Consumption disease  Acute chronic infection caused by mycobacterium tuberculosis – Mycobacterium Tuberculosis
  45. 45. – 2 -10 weeks– The patient is capable of discharchingthe organism all throughout life if heremains untreated highly communicableduring its active phase – Direct and indirect contact
  46. 46. – sputum ,blood from hemoptysis, nasal discharges and salivaHuman inhalation – gains entrance inthe body by inhaled through respiratorytractBovine – ingestion enters the body viaGIT by the swallowing of the bacteria
  47. 47. ○ Slight lesion without demonstrable excavation confined to a small part of one or both lungs○ 1 or both lungs may be involved○ Lesions more extensive than moderate
  48. 48.  Tuberculin Test is positive X-ray of chest generally progressive Symptoms of TB are absent Sputum is absent for tuberclebacilli after repeated examination No evidence of cavity on chest X-ray
  49. 49.  Afternoon rise in temperature High sweating Body malaise and weight loss Cough dry to productive Dyspnea- hoarseness of voice Hemoptysis – considered pathognomonic to the disease Occasional chest pains Sputum positive for AFB
  50. 50.  Chest X-Ray Sputum Exam for Acid Fast Bacilli Tuberculin Testing Mantoux test – PPD intradermal Tine Test
  51. 51. – 6 months INH, Isoniazid, Rifampicin, PZA, Ethambutol – 2 monthsRifampicin 450 mg 1 hr before mealINH 300 mgPZA 1,000- 1,500 mg / hr after break fast
  52. 52. – 1 yearStreptomycin SO4INH tablet
  53. 53. A. IsolationB. Administer medicine as orderedC. Check sputum always for blood or purulent expectorationD. Encourage questions conversation to air their feelingsE. Teach or educate patient all about TBF. Encourage to stop smokingG. Proper disposal of sputumH. Plenty of rest and eat balanced meals
  54. 54.  Submit allbabies for BCG immunization Avoid overcrowding Chest X-ray , tuberculin Test
  55. 55. acute infection of the lung parenchyma Streptococcal pneumonia Staphylococcus Aureus Hemophillus influenza Klibsiela pneumonia
  56. 56. 1-3 days with sudden onset of shakingchills rapidly rising fever and stabbingchest pains aggravated by coughing andrespirationDroplet infection from mouth, nose of aninfected personIndirect contact contaminated objects
  57. 57.  CAP – Community Acquired Pneumonia – acquired in the course of Daily life Hospital Acquired Pneumonia Aspiration Pneumonia – Foreign matter is inhaled ( aspirated) into the lungs Pneumonia caused by Opportunistic organism immune system
  58. 58.  Broncho Pneumonia – Lobular or Catarrhal Pneumonia Lobar pneumonia (croupous Pneumonia) Consolidation of the entire lobe manifested by chills, chest pain on breathing, cough with blood streaked sputum
  59. 59.  Primary atypical pneumonia (Virus pneumonia) Solidification of the lung that comes in patches Cough is often delayed in appearing greenish to whitish secretions
  60. 60. 1) Stage of Lung Engorgement2) Red Hepatization3) GrayHepatization4) Stage of Resolution ○ Infammatory exudates is either absorbed by the blood stream or expectorated
  61. 61.  Chest X – Ray Sputum Analysis Blood Serologic Exam
  62. 62. Antimicrobial Therapy varies withthe causative agentSupportive Management  Humidified oxygen therapy for hypoxia  Mechanical ventilation respiratory failure  High caloric diet and adequate fluid intake  Analgesic to relieve pleuritic pain chest  Expectorant
  63. 63. 1) Maintain a patent airway2) Adequate oxygenation3) Deep breathing Excercises  Turning the patient from side to side  Change wet clothing
  64. 64. Penicillin, Erythromycin
  65. 65. Is an infection caused by GROUP A BETA HEMOLYTIC streptococcus bacteriaGroup A Beta Hemolytic Streptococcus
  66. 66. Direct and Indirect Contact – 2-5 days or 1 week
  67. 67. Fever and sorethroat rashes start to appearalready because Group A Beta Hemolyticreleases toxins Erythrogenic Toxin Pastia Line – are minute red spot on skin fold Trunk entire body involves the extremities
  68. 68. Fever and sorethroat rashes start to appearalready because Group A Beta Hemolyticreleases toxins Tongue also exhibits specific characteristics sign 2 days it will have a white coating through which red and edematous
  69. 69. Fever and sorethroat rashes start to appearalready because Group A Beta Hemolyticreleases toxins White strawberry tongue after 2 days the tongue desquamate red strawberry tongue later raspberry tongue
  70. 70. Fever and sorethroat rashes start to appearalready because Group A Beta Hemolyticreleases toxins
  71. 71.  Throat Swab Dicks Test – test to determine the susceptibility to scarlet fever Charlton Test – Hypersensitivity of the individual to scarlet fever antitoxin
  72. 72. STREPTOCOCCAL SORETHROAT – ErythromycinSCARLET FEVER – Penicillin
  73. 73. 1) Oral Hygiene Use oral Antiseptic2) Skin C are – Finger nails shld be short and clean3) Do not apply alcohol4) Avoid use of laundry soap