1. The case presentation describes a 9-year-old female child diagnosed with bronchiectasis presenting with cough, fever, and dyspnea.
2. Bronchiectasis is an irreversible dilatation of the airways caused by infection, immune deficiency, or aspiration that results in a vicious cycle of impaired mucociliary clearance and recurrent infection.
3. Treatment involves controlling infections with antibiotics guided by sputum culture, improving mucus clearance with bronchodilators, chest physiotherapy and occasionally surgery for severe cases.
A detailed description of sarcoidosis, pulmonary in specific but also covering the other systems. a rare entity in india or a better way to say, often an overlooked disease.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Case presentation on bronchiectasis with community acquired pneumoniaTejashreesujay
Bronchiectasis is defined as abnormal and irreversible dilatation of the bronchi and bronchioles (greater than 2 mm in diameter) developing inflammatory weakening of the bronchial walls.
A detailed description of sarcoidosis, pulmonary in specific but also covering the other systems. a rare entity in india or a better way to say, often an overlooked disease.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Case presentation on bronchiectasis with community acquired pneumoniaTejashreesujay
Bronchiectasis is defined as abnormal and irreversible dilatation of the bronchi and bronchioles (greater than 2 mm in diameter) developing inflammatory weakening of the bronchial walls.
BRONCHIECTASIS approach and treatment by Dr.Amira TabidiAmira30013
Pulmonolgy ,it's a common respiratory air way disease with many radiogical features that's vital to learn about it so you can reach the diagnosis easily along with a solid clinical approach
Bronchiectasis is a long-term condition where the airways of the lungs become abnormally widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.
In bronchiectasis , one or more of bronchi are abnormally widened . Damage caused to the lungs by bronchiectasis is permanent.
Bronchiectasis – first described- rené Laennec (inventor – stethoscope).
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
6. PAST HISTORY OF ILLNESS
H/o PULMONARY TUBERCULOSIS
AND EXTENSIVE
BROCHOPNEUMONIA since 5 yr
MEDICATION
She take AKT upto 6 month coarse
Stop AKT as per MEDICAL ADVOICE
7. FAMILY HISTORY
HAVING A NUCLEUS FAMILY AND 5
PERSON IS THEIR
*GRANDMOTHER
*FATHER
*MOTHER
*BROTHER
8. IMMUNIZATION
TAKEN
BCG,HEP-B,’0’POLIO …NOT TAKE STAT OR
WHENEVR AT HOSPITALIZATION AT TIME OF
LABOUR …..SHE TAKE AT 21 DAYS IN
ANGANWADI
AFTER OPV1/2/3,DPT1/2/3,HEP-B1/2/3,DPT
BOOSTER ,POLIO BOOSTER,MEASCLE AND
BOOSTER ,VITAMIN 1 AND 2 TAKE AS PER
UNIVERSAL SHEDULE
VITAMIN 3 TO 9 DOSE AND DT 5 YEAR ARE
NOT TAKEN
9. ECONOMIC STATUS
TOTAL INCOME OF FAMILY IS UPTO
10,000/month FROM LABOUR IN FARM
AND CELLING GOAT,BIRDS.THEY ARE
VERY MUCH POOR AND UNHYGENIC
FAMILY.
EXPENDITURE ON HEALTH
SPEND ONLY 20%,NEARLY 2000 FOR
SHOPING VEGITABLE ,OIL,AND KITCHEN
NECESSORY MATERIAL AND SO ON FROM
WEEKLY MARKET.
THEIR HOUSE IS ‘KACCHA”.
10. DIET PLAN
THEY TAKE BOTH VEG AND NONVEG DIET.
RUPALI WANT NEARLY 1500 Kcal DAILY IN
HER DIET PLAN
SHE TAKE DIALY
MILK 300ml AT MORNING
TAKE BRAKFAST WITH 1 CHAPATI AND TEA
LUNCH BEFOUR SHOOL 2 CHAPATI ½ CUP
RISE ½ SABJI(dal) OR NONVEG LIKE EGG
LUNCH IN SCHOOL TAKE ½ CUP KHICHADI
DINNER 2 CHAPATI ½ CUP DAL OR
NONVEG ATEMS LIKE BIRDS,FISH,CHIKEN etc
11. CHILD PERSONAL DATA
PRENATAL HISTORY
MOTHER OF CHILD HAVING TAKE ALL
TRATMENT AS PER GOI WITH RESPECTIVE
NEARER P.H.C
NO.ANY COMPLICATION REGARDING FTND
AT HOME DELIVERY BY TRAIN DAI.
13. POSTNATAL
IN NEONATAL AND INFANT PERIOD
PROVIDED EXCLUSIVE BREAST FEEDING
UPTO 6 MONTH AND WEANING FOOD
STARTD FROM THEM
14. GROWTH AND DEVELOPMENT
S
R
ANTHRO. IN
BOOK
IN
PATIE
NT
INTER
ACTIO
N
1 HEIGHT 133 132 1 cm less
2 WEIGHT 28 18 VERY LESS
3 H.C - - -
4 C.C - - -
15. Developm
ant
IN BOOK IN PATIENT
Gross
motor
Enjoying all
physical
activity
LESS Enjoying
physical activity
Fights may
Occur
Fights
Occur in patient
Continues to
collection
eg hobbies
Continues to
collection ALSO
eg hobbies
30. CONGENITAL CAUSES
2Kartagener syndrome
2 primary immunodeficiencies
2 Williams-Campbell syndrome and Marfan’s
syndrome.
2 Patients with alpha 1-antitrypsin deficiency
have been found to be particularly
susceptible to bronchiectasis,
32. INFECTIVE CAUSES ASSOCIATED WITH
BRONCHIECTASIS INCLUDE
2 infections caused by
the Staphylococcus,
Klebsiella, or
Bordetella pertussis,
the causative agent of
whooping cough.
33. ASPIRATION OF AMMONIA AND OTHER TOXIC
GASES,
2 pulmonary aspiration,
2alcoholism, heroin (drug use),
2 various allergies all appear to be linked
to the development of Bronchiectasis
34. 3Childhood Acquired Immune Deficiency
Syndrome (AIDS), which predisposes patients
to a variety of pulmonary ailments, such as
pneumonia and other opportunistic infections.
3 Inflammatory bowel disease, especially
ulcerative colitis.
3 A Hiatal hernia can cause Bronchiectasis when
the stomach acid that is aspirated into the
lungs causes tissue damage.
35. CLINICAL MANIFESTATION
The production of large quantities of purulent
and often foul-smelling sputum.
The volume of sputum can be used for
estimating the severity of the disease
2 Mild < 10 mL
2 Moderate 10~150 mL
2 Severe >150 mL
36. OTHER
2 Some people with bronchiectasis may
produce frequent green/yellow sputum (up to
240ml daily.
2 Bronchiectasis may also present with
hemoptysis
2 Pneumonia
2 Bad breath indicative of active infection.
2 Frequent bronchial infections and
breathlessness are two possible indicators of
37. 2. Chronic cough
3.Hemoptysis:
Frequent
More commonly in dryvariety
Usually mild (blood streaking ofpurulent
sputum)
Massive hemoptysis is usually from
dilated bronchial arteries or bronchial-
pulmonary anastomoses under systemic
pressure
41. Due to etiological factor
Inflammation of bronchial wall
causing
Loss of supporting structure
Result in
Thick sputum that obstruct the bronchi
The bronchial wall become
permanently dialated and distorted
47. INVESTIGATION
3 History and physical examination
3 Chest x-ray
3 CT (computerised tomography) scan
3 Blood tests
3 Testing of the mucus to identify any bacteria
present
3 Checking oxygen levels in the blood
3 Lung function tests (spirometry).
48. Spirometry and Arterial
Blood Gas Analysis
Supportive evidence of airway disease (Obstructive
defect) Severity assessment (Severe impairment =
poor prognosis) Bronchodilator therapy (Positive
bronchodilator response) Oxygen therapy
(Hypoxemia)
53. TREATMENT
Therapy has several major goals:
(1)Treatment of infection, particularly during acute
exacerbations
(2) Improved clearance of tracheobronchial secretions
(3) Reduction of inflammation
(4) Treatment of an identifiable underlying problem
54. TREATMENT
2 Treatment of bronchiectasis includes
2 controlling infections and bronchial
secretions,
2 relieving airway obstructions,
2 removal of affected portions of lung by
surgical removal or artery embolization
2 preventing complications.
56. 2. Antibiotic
The choice of antibiotics should be
accurately by the results of sputum
culture and drug sensitivity test.
Empirical therapy ---
antipseudomonal antibiotics.
57. ANTIBIOTICSARETHE OF BRONCHIECTASIS
MANAGEMENT
2 Antibiotics are used only during acute
episodes
2 Choice of an antibiotic should be guided by
gram's stain and culture of sputum
2 Empiric coverage (amoxicillin, co-
trimoxazole,levofloxacin) is often given
initially
58. BRONCHODILATER
Bronchodilators to improve
obstruction and aid clearance
of secretions are useful in
patients with airway
hyperreactivity and reversible
airflow obstruction
60. Surgical management is indicated
1. Recurrent and refractory clinical
symptoms are due to a focal area
of disease involvement.
2. Massive hemoptysis
Management of hemoptysis
61. NURSING MANAGEMENT:
2 History and physical examination
2 Obtain history regarding amount
and characteristics of sputum
produced, including haemoptysis.
2 Auscultate lungs for diffuse rhonchi
64. Bronchiectasis: Summary
Abnormal irreversibly dilated and often
thick-walledbronchi
Pathogenesis related to one or more
defects ofmucociliary clearance, cellular
and immunity defense mechanism or
presence of associated conditions
“The vicious cycle”and P aeruginosa
contributes progression and severity of
disease
Imaging greatly helps in diagnosis: Tram
line, honeycombing, cystic, signet ring sign
Additional test may be required in specific
clinical settings
Microbiology of the diseased
airway may aidproper
antimicrobial therapy
