This document provides an overview of the respiratory system and common respiratory disorders in children. It describes the anatomy and physiology of the respiratory system in infants. It then discusses various upper and lower respiratory disorders like nasopharyngitis, tonsillitis, pneumonia, influenza, croup, tuberculosis and asthma. For each disorder, it covers causative agents, clinical manifestations, diagnosis, and nursing management including therapeutic interventions and prevention.
This document provides an overview of pediatric pneumonia. It begins by defining pneumonia as inflammation of the lung parenchyma that fills alveolar air spaces with exudate and inflammatory cells. It then discusses the epidemiology, risk factors, classifications, diagnosis, differential diagnosis, prevention, and management of pediatric pneumonia. Nursing care focuses on assessing respiratory status, managing secretions, positioning, encouraging coughing and deep breathing, and providing comfort measures. Complications can include pleural effusions, empyema, lung abscesses, and extra-pulmonary issues like dehydration or meningitis. Medical management depends on factors like age, severity and chest x-ray findings.
UPPER RESIRATORY TRACT INFECTIONS IN CHILDREN , ACUE PHARYGITIS , COMMON COLD , ACUTE SINUSITIS , ACUTE OTITIS MEDIA , APPROACH TO PATIENT WITH URTI , MANAGEMENT OF URTI IN CHILDREN
This document discusses several common respiratory disorders in children. It begins by noting that respiratory illnesses are frequent in young children, with most cases being mild. However, around one third of pediatric hospitalizations are due to more severe respiratory problems like asthma and pneumonia. The document then outlines different categories of respiratory disorders including acute issues like bronchitis, bronchiolitis, and pneumonia as well as chronic conditions such as tuberculosis and cystic fibrosis. Specific acute upper and lower respiratory diseases are defined and their symptoms, causes, diagnosis, and treatment are described. The document closes by focusing on apnea of prematurity, its risk factors, types, management, and typical resolution.
The document discusses pneumonia, specifically lobar pneumonia. It describes the pathogenesis, morphological features, and stages of lobar pneumonia including congestion, red hepatization, grey hepatization, and resolution. Complications of untreated lobar pneumonia are also discussed, such as organization of exudate leading to fibrosis, pleural effusions, empyema, lung abscesses, and metastatic infection.
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms. It commonly affects people of all ages worldwide. Nursing management of pneumonia includes improving airway clearance through hydration and breathing exercises, promoting rest and activity intolerance, ensuring adequate fluid and nutrition intake, and providing education on treatment and prevention. The expected outcomes are improved breathing, maintained energy levels and intake, and no developing complications.
This document discusses different types of otitis media including acute otitis media, chronic otitis media, and serous otitis media. It covers the etiology, risk factors, clinical manifestations, diagnostic evaluations, and management for each type. The main types are acute bacterial infection of the middle ear (acute otitis media), chronic infection with tissue damage (chronic otitis media), and non-infectious fluid accumulation (serous otitis media). Diagnosis involves examination, tests to check for fluid/infection, and treatment involves antibiotics, drainage procedures, and addressing underlying causes.
This document provides an overview of pediatric pneumonia. It begins by defining pneumonia as inflammation of the lung parenchyma that fills alveolar air spaces with exudate and inflammatory cells. It then discusses the epidemiology, risk factors, classifications, diagnosis, differential diagnosis, prevention, and management of pediatric pneumonia. Nursing care focuses on assessing respiratory status, managing secretions, positioning, encouraging coughing and deep breathing, and providing comfort measures. Complications can include pleural effusions, empyema, lung abscesses, and extra-pulmonary issues like dehydration or meningitis. Medical management depends on factors like age, severity and chest x-ray findings.
UPPER RESIRATORY TRACT INFECTIONS IN CHILDREN , ACUE PHARYGITIS , COMMON COLD , ACUTE SINUSITIS , ACUTE OTITIS MEDIA , APPROACH TO PATIENT WITH URTI , MANAGEMENT OF URTI IN CHILDREN
This document discusses several common respiratory disorders in children. It begins by noting that respiratory illnesses are frequent in young children, with most cases being mild. However, around one third of pediatric hospitalizations are due to more severe respiratory problems like asthma and pneumonia. The document then outlines different categories of respiratory disorders including acute issues like bronchitis, bronchiolitis, and pneumonia as well as chronic conditions such as tuberculosis and cystic fibrosis. Specific acute upper and lower respiratory diseases are defined and their symptoms, causes, diagnosis, and treatment are described. The document closes by focusing on apnea of prematurity, its risk factors, types, management, and typical resolution.
The document discusses pneumonia, specifically lobar pneumonia. It describes the pathogenesis, morphological features, and stages of lobar pneumonia including congestion, red hepatization, grey hepatization, and resolution. Complications of untreated lobar pneumonia are also discussed, such as organization of exudate leading to fibrosis, pleural effusions, empyema, lung abscesses, and metastatic infection.
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms. It commonly affects people of all ages worldwide. Nursing management of pneumonia includes improving airway clearance through hydration and breathing exercises, promoting rest and activity intolerance, ensuring adequate fluid and nutrition intake, and providing education on treatment and prevention. The expected outcomes are improved breathing, maintained energy levels and intake, and no developing complications.
This document discusses different types of otitis media including acute otitis media, chronic otitis media, and serous otitis media. It covers the etiology, risk factors, clinical manifestations, diagnostic evaluations, and management for each type. The main types are acute bacterial infection of the middle ear (acute otitis media), chronic infection with tissue damage (chronic otitis media), and non-infectious fluid accumulation (serous otitis media). Diagnosis involves examination, tests to check for fluid/infection, and treatment involves antibiotics, drainage procedures, and addressing underlying causes.
This document discusses acute respiratory infections, including pneumonia. It defines acute respiratory infections and outlines their signs and symptoms. It then discusses the epidemiological determinants of respiratory infections like agent factors, host factors, and risk factors. It classifies and describes the management of pneumonia in infants and children. It identifies high-risk groups for pneumonia and its potential complications. The document concludes with discussing treatment and important immunizations for pneumonia prevention.
Nasopharyngitis, commonly known as the common cold, is usually caused by rhinovirus and causes symptoms like a runny nose, sore throat, cough, and fever that typically last less than a week. It spreads through contact with infected respiratory droplets. While rest and over-the-counter medications can provide relief from symptoms, there is no cure or specific treatment for the cold virus itself. Regular handwashing is advised to prevent the spread of nasopharyngitis.
Bronchiolitis is an acute viral infection that causes inflammation in the small airways of infants and young children under 2 years old. The most common cause is respiratory syncytial virus. Clinical features include nasal congestion, cough, wheezing, and respiratory distress. Diagnosis is usually based on symptoms and physical exam findings. Management involves supportive care like nasal suctioning and supplemental oxygen. Severe cases may require respiratory support such as high-flow nasal cannula or mechanical ventilation. Antibiotics are not recommended as bronchiolitis is almost always viral in origin.
This document discusses various respiratory infections including the common cold, influenza, diphtheria, pertussis, tuberculosis, and pneumonia. It provides information on the causative agents, signs and symptoms, transmission, treatment and prevention of each condition. The key points are that these are mainly infectious diseases affecting the respiratory tract, spread through droplets or direct contact, and can be prevented through vaccination, hygiene and treatment of active infections.
measles and influenza for nursing and other health department
INTRODUCTION.
DEFINITION.
ANATOMY AND PHYSIOLOGY OF LUNG,
Epidemiology,
CLINICAL MANIFESTATION
DIAGNOSTIC EVALUATION
COMPLICATION
MANAGEMENT
PREVENTION
HEALTH EDUCATION.
This document discusses lower respiratory tract infections, specifically pneumonia. It defines pneumonia as an inflammation of the lung tissue caused by infectious agents. It identifies common bacterial, viral, and other causes. It describes the pathology and pathogenesis of different types of pneumonia including bronchopneumonia and lobar pneumonia. It also discusses clinical manifestations, diagnostic methods, medical management, nursing assessments, interventions, and prevention of pneumonia.
Pulmonary Complications in pediatric population.pptxSaima Mustafa
This document discusses several common respiratory disorders that affect children, including the common cold, pneumonia, bronchitis, asthma, and sinusitis. It provides details on the causes, symptoms, diagnosis, and treatment of each disorder. The common cold is usually caused by rhinoviruses and can be treated with rest, hydration, and over-the-counter medications. Pneumonia often requires antibiotics and can have serious complications. Bronchitis is usually acute and viral in children and treated with supportive care. Asthma is a chronic inflammatory lung disease treated with inhalers and medications. Sinusitis causes nasal congestion and pain and its causes include viral infections, allergies, and anatomical abnormalities.
Questions to ask to elicit a diagnosis.
Give your differential diagnosis.
Give management plan of most probable diagnosis.
Differentiate between viral upper respiratory tract infection from bacterial pharyngitis / tonsillitis.
Discuss the criteria to prescribe antibiotics for URTI.
Write prescription for viral URTI.
A sore throat is pain or irritation of the throat that often worsens when you swallow.
Fever is the temporary increase in the body's temperature in response to a disease or illness.
There are many clinical scenarios where sore throat is associated with fever. E.g. pharyngitis, tonsilitis, influenza, laryngitis.
.
The child presents with a common cold characterized by nasal congestion, headache, fever, runny nose, and impaired sleep. A physical exam reveals additional symptoms of sore throat, sneezing, and coughing. The diagnosis is an impaired sleep pattern due to nasal congestion from a common cold virus. The plan is to monitor for fever relief and reduced nasal congestion over 3 days with rest, hydration, analgesics, and antihistamines. Education focuses on prevention of spread and reassurance that colds are common in childhood.
Here are the definitions and explanation requested:
Croup syndrome is a respiratory illness characterized by inspiratory stridor, cough, and hoarseness caused by inflammation and obstruction of the larynx, trachea, and major bronchi.
Pleurisy is defined as inflammation of the pleura, the thin membrane that lines the chest cavity and covers the lungs. It is also called pleuritis.
The causes of pleurisy include:
- Respiratory infections like pneumonia, tuberculosis, and other bacterial or viral infections that can cause inflammation of the pleura.
- Immune disorders such as systemic lupus erythematosus and rheumatoid arthritis where excess fluid builds up in the pleural space
This document discusses noisy breathing in children. It defines noisy breathing as hearable breathing due to obstruction of the upper or lower airways. The document outlines the anatomy of the respiratory system and describes three main types of noisy breathing: stridor, wheeze, and grunting. It discusses common causes, clinical presentation, diagnosis, and treatment of conditions that can cause noisy breathing such as croup, bronchiolitis, asthma, pneumonia, and epiglottitis.
This document discusses noisy breathing in children. It defines noisy breathing as hearable breathing due to obstruction of the upper or lower airways. The document outlines the anatomy of the respiratory system and describes three main types of noisy breathing: stridor, wheeze, and grunting. It then discusses various causes, clinical presentations, diagnostic approaches, and treatment options for different conditions that can cause noisy breathing in children such as croup, bronchiolitis, asthma, pneumonia, and epiglottitis.
This document provides information on respiratory disorders in children. It discusses how to assess the respiratory system and identifies signs of respiratory distress. Specific respiratory conditions covered include respiratory distress syndrome, croup, epiglottitis, bronchitis, bronchiolitis, bronchopulmonary dysplasia, otitis media, tonsillitis, and asthma. For each condition, the document describes the etiology, pathophysiology, clinical manifestations, diagnosis, and treatment/management. Nursing interventions are provided for various respiratory disorders. The respiratory anatomy of children is also reviewed, noting how it differs from adults.
Adenoids
Definition
The adenoids are enlarged and hypertrophied nasopharyngeal tonsils, sufficient to produce symptoms
It is disease of infancy and childhood.
Adenoids are subjected to physiological enlargement in childhood hence nasopharyngeal tonsils are commonly called Adenoids.
Nasopharyngeal Tonsil
Single pyramidal mass of sub-epithelial lymphoid tissue, present in nasopharynx at the junction of its roof and posterior wall.
The pharyngeal tonsil is composed of vertical ridges of lymphoid tissues separated by deep cleft and covered by Pseudostraitified ciliated columinar epithelium.
The free surface has 6 folds
It has no capsule
These lymphoid tissues consits of T and B lymphocytes.
It forms roof of waledeyer’s ring.
Can't normally see them because they are above and behind the uvula.
Arterial Supply
Ascending branch of facial artery
Ascending pharyngeal branch of external carotid
Pharyngeal branch of third part of maxillary artery.
Ascending cervical branch of inferior thyroid artery of thyrocervial trunk
Development
Adenoids begin forming in 3rd month of fetal development
Glandular primordia on posterior pharynx are infiltrated by lymphocytes.
Covered by pseudostratified ciliated epithelium
Fully formed by 7 month
Growth
They are not visible on X-ray in infants under age of one month.
50% of cases, it is visible at 6 month.
At the age of 2 years undergo hypertrophy and hyperplasia.
Can become nearly the size of a Table Tennis ball
Hypertrophy continues up to puberty (12 years)
Then, undergoes atrophy after puberty
Finally disappears in adults
Why does adenoid physiologically enlarge?
Poorly develop at birth.
Grows rapidly during childhood.
Generalized lymphoid hyperplasia occurs in children
Among the first aggregative lymphoid tissues in respiratory tract.
Physiology
Part of secondary immune system
No afferent lymphatics
Exposed to inspired antigens passed through the epithelial layer
Membrane cells and antigen presenting cells are involved in transport of antigen from the surface to the lymphoid follicle
Antigen is presented to T-helper cells
T-helper cells induce B cells in germinal center to produce antibody
Secretory IgA is primary antibody produced
Involved in local immunity
Etiology
Age : 3 -12 years
Season: winter
Food: Cold, sour, oily food
General lymphoid hyperplasia
Infection in tonsils alone or associated with
Rhinitis, Sinusitis, Tonsillitis
(esp. chronic maxillary sinusitis)
Recurrent attacks of rhinitis, sinusitis or tonsillitis may causes chronic adenoid infection
Allergy of respiratory tract.
Clinical features
Symptoms occur most commonly between ages of
3-7 years.
Depending on size of adenoid mass and space
3 types
Nasal symptoms
Aural symptoms
General symptoms
Nasal symptoms
Bilateral Nasal obstruction
Mouth breathing
interfere
Dry cough is one of the most common symptoms prompting patients to seek medical care. A systematic diagnostic approach is recommended to determine the underlying cause. Common causes of acute dry cough include upper respiratory infections, while chronic dry cough may be due to asthma, COPD, GERD, or postnasal drip. A careful history and physical exam can provide clues to the etiology, and initial tests may include a chest x-ray, spirometry, and trial treatments targeting suspected conditions. Management involves treating the identified cause through lifestyle changes, medications, or other therapies.
Approach to patient with uper and lower airway diseasesTigreentertainment
The document outlines the approach to patients presenting with upper and lower airway diseases. For cough, it discusses the definition, epidemiology, pathophysiology, differential diagnosis, approach, history questions, physical exam findings, and diagnostic tests. For dyspnea, it lists the differential diagnosis which includes congenital causes, infections, toxic/environmental exposures, tumors/cysts, allergy, pulmonary issues, cardiac causes, and renal failure. The document provides a thorough review of evaluating and diagnosing patients with cough or dyspnea.
This document discusses acute respiratory infections (ARIs) in India. It notes that ARIs affect over 700 million people annually in India and cause over 52 million cases of pneumonia. Mortality from ARIs ranges from 3,200 to 6,900 deaths annually. Risk factors for ARIs include low literacy, suboptimal breastfeeding, malnutrition, and unsatisfactory immunization coverage. Common types of ARIs discussed include the common cold, croup, bronchiolitis, and pneumonia. Diagnosis, treatment, and prevention strategies for ARIs are also outlined.
1. Bronchiolitis is most commonly caused by respiratory syncytial virus (RSV) in infants and young children, causing inflammation in the small airways.
2. It typically presents with cough, wheezing, nasal congestion and difficulty breathing. Chest radiographs may show hyperinflation of the lungs.
3. Treatment is supportive with oxygen and monitoring since most cases resolve on their own. Hospitalization is needed for moderate to severe distress, hypoxemia or apnea. While recurrence is common, bronchiolitis often improves within a week.
1. Diabetic ketoacidosis is caused by a lack of insulin and results in hyperglycemia, dehydration, and acidosis. It can be prevented by never skipping insulin doses and monitoring blood glucose and ketone levels.
2. Hyperglycemic hyperosmolar non-ketotic syndrome is characterized by extreme hyperglycemia without ketosis or acidosis. Both conditions require treatment of hyperglycemia, fluid replacement, and insulin administration to reverse the process.
3. The document provides details on the pathophysiology, clinical presentation, diagnostic assessment, and management of diabetic ketoacidosis and hyperglycemic hyperosmolar non-ketotic syndrome.
This document discusses stroke, also known as cerebrovascular accident. It defines stroke as the onset of neurological dysfunction lasting over 24 hours due to disrupted blood flow to the brain. Strokes are classified as either ischemic, caused by occlusion of cerebral blood vessels, or hemorrhagic, caused by leakage of blood into brain tissue. Signs and symptoms vary depending on the affected brain region but may include weakness, sensory changes, speech problems, and altered consciousness. Treatment involves stabilizing vital functions, reperfusion therapies if given early, managing blood pressure, and long term prevention strategies like anticoagulants or surgery. Nursing care focuses on prevention of injuries, management of deficits, communication support, and education to promote recovery.
This document discusses acute respiratory infections, including pneumonia. It defines acute respiratory infections and outlines their signs and symptoms. It then discusses the epidemiological determinants of respiratory infections like agent factors, host factors, and risk factors. It classifies and describes the management of pneumonia in infants and children. It identifies high-risk groups for pneumonia and its potential complications. The document concludes with discussing treatment and important immunizations for pneumonia prevention.
Nasopharyngitis, commonly known as the common cold, is usually caused by rhinovirus and causes symptoms like a runny nose, sore throat, cough, and fever that typically last less than a week. It spreads through contact with infected respiratory droplets. While rest and over-the-counter medications can provide relief from symptoms, there is no cure or specific treatment for the cold virus itself. Regular handwashing is advised to prevent the spread of nasopharyngitis.
Bronchiolitis is an acute viral infection that causes inflammation in the small airways of infants and young children under 2 years old. The most common cause is respiratory syncytial virus. Clinical features include nasal congestion, cough, wheezing, and respiratory distress. Diagnosis is usually based on symptoms and physical exam findings. Management involves supportive care like nasal suctioning and supplemental oxygen. Severe cases may require respiratory support such as high-flow nasal cannula or mechanical ventilation. Antibiotics are not recommended as bronchiolitis is almost always viral in origin.
This document discusses various respiratory infections including the common cold, influenza, diphtheria, pertussis, tuberculosis, and pneumonia. It provides information on the causative agents, signs and symptoms, transmission, treatment and prevention of each condition. The key points are that these are mainly infectious diseases affecting the respiratory tract, spread through droplets or direct contact, and can be prevented through vaccination, hygiene and treatment of active infections.
measles and influenza for nursing and other health department
INTRODUCTION.
DEFINITION.
ANATOMY AND PHYSIOLOGY OF LUNG,
Epidemiology,
CLINICAL MANIFESTATION
DIAGNOSTIC EVALUATION
COMPLICATION
MANAGEMENT
PREVENTION
HEALTH EDUCATION.
This document discusses lower respiratory tract infections, specifically pneumonia. It defines pneumonia as an inflammation of the lung tissue caused by infectious agents. It identifies common bacterial, viral, and other causes. It describes the pathology and pathogenesis of different types of pneumonia including bronchopneumonia and lobar pneumonia. It also discusses clinical manifestations, diagnostic methods, medical management, nursing assessments, interventions, and prevention of pneumonia.
Pulmonary Complications in pediatric population.pptxSaima Mustafa
This document discusses several common respiratory disorders that affect children, including the common cold, pneumonia, bronchitis, asthma, and sinusitis. It provides details on the causes, symptoms, diagnosis, and treatment of each disorder. The common cold is usually caused by rhinoviruses and can be treated with rest, hydration, and over-the-counter medications. Pneumonia often requires antibiotics and can have serious complications. Bronchitis is usually acute and viral in children and treated with supportive care. Asthma is a chronic inflammatory lung disease treated with inhalers and medications. Sinusitis causes nasal congestion and pain and its causes include viral infections, allergies, and anatomical abnormalities.
Questions to ask to elicit a diagnosis.
Give your differential diagnosis.
Give management plan of most probable diagnosis.
Differentiate between viral upper respiratory tract infection from bacterial pharyngitis / tonsillitis.
Discuss the criteria to prescribe antibiotics for URTI.
Write prescription for viral URTI.
A sore throat is pain or irritation of the throat that often worsens when you swallow.
Fever is the temporary increase in the body's temperature in response to a disease or illness.
There are many clinical scenarios where sore throat is associated with fever. E.g. pharyngitis, tonsilitis, influenza, laryngitis.
.
The child presents with a common cold characterized by nasal congestion, headache, fever, runny nose, and impaired sleep. A physical exam reveals additional symptoms of sore throat, sneezing, and coughing. The diagnosis is an impaired sleep pattern due to nasal congestion from a common cold virus. The plan is to monitor for fever relief and reduced nasal congestion over 3 days with rest, hydration, analgesics, and antihistamines. Education focuses on prevention of spread and reassurance that colds are common in childhood.
Here are the definitions and explanation requested:
Croup syndrome is a respiratory illness characterized by inspiratory stridor, cough, and hoarseness caused by inflammation and obstruction of the larynx, trachea, and major bronchi.
Pleurisy is defined as inflammation of the pleura, the thin membrane that lines the chest cavity and covers the lungs. It is also called pleuritis.
The causes of pleurisy include:
- Respiratory infections like pneumonia, tuberculosis, and other bacterial or viral infections that can cause inflammation of the pleura.
- Immune disorders such as systemic lupus erythematosus and rheumatoid arthritis where excess fluid builds up in the pleural space
This document discusses noisy breathing in children. It defines noisy breathing as hearable breathing due to obstruction of the upper or lower airways. The document outlines the anatomy of the respiratory system and describes three main types of noisy breathing: stridor, wheeze, and grunting. It discusses common causes, clinical presentation, diagnosis, and treatment of conditions that can cause noisy breathing such as croup, bronchiolitis, asthma, pneumonia, and epiglottitis.
This document discusses noisy breathing in children. It defines noisy breathing as hearable breathing due to obstruction of the upper or lower airways. The document outlines the anatomy of the respiratory system and describes three main types of noisy breathing: stridor, wheeze, and grunting. It then discusses various causes, clinical presentations, diagnostic approaches, and treatment options for different conditions that can cause noisy breathing in children such as croup, bronchiolitis, asthma, pneumonia, and epiglottitis.
This document provides information on respiratory disorders in children. It discusses how to assess the respiratory system and identifies signs of respiratory distress. Specific respiratory conditions covered include respiratory distress syndrome, croup, epiglottitis, bronchitis, bronchiolitis, bronchopulmonary dysplasia, otitis media, tonsillitis, and asthma. For each condition, the document describes the etiology, pathophysiology, clinical manifestations, diagnosis, and treatment/management. Nursing interventions are provided for various respiratory disorders. The respiratory anatomy of children is also reviewed, noting how it differs from adults.
Adenoids
Definition
The adenoids are enlarged and hypertrophied nasopharyngeal tonsils, sufficient to produce symptoms
It is disease of infancy and childhood.
Adenoids are subjected to physiological enlargement in childhood hence nasopharyngeal tonsils are commonly called Adenoids.
Nasopharyngeal Tonsil
Single pyramidal mass of sub-epithelial lymphoid tissue, present in nasopharynx at the junction of its roof and posterior wall.
The pharyngeal tonsil is composed of vertical ridges of lymphoid tissues separated by deep cleft and covered by Pseudostraitified ciliated columinar epithelium.
The free surface has 6 folds
It has no capsule
These lymphoid tissues consits of T and B lymphocytes.
It forms roof of waledeyer’s ring.
Can't normally see them because they are above and behind the uvula.
Arterial Supply
Ascending branch of facial artery
Ascending pharyngeal branch of external carotid
Pharyngeal branch of third part of maxillary artery.
Ascending cervical branch of inferior thyroid artery of thyrocervial trunk
Development
Adenoids begin forming in 3rd month of fetal development
Glandular primordia on posterior pharynx are infiltrated by lymphocytes.
Covered by pseudostratified ciliated epithelium
Fully formed by 7 month
Growth
They are not visible on X-ray in infants under age of one month.
50% of cases, it is visible at 6 month.
At the age of 2 years undergo hypertrophy and hyperplasia.
Can become nearly the size of a Table Tennis ball
Hypertrophy continues up to puberty (12 years)
Then, undergoes atrophy after puberty
Finally disappears in adults
Why does adenoid physiologically enlarge?
Poorly develop at birth.
Grows rapidly during childhood.
Generalized lymphoid hyperplasia occurs in children
Among the first aggregative lymphoid tissues in respiratory tract.
Physiology
Part of secondary immune system
No afferent lymphatics
Exposed to inspired antigens passed through the epithelial layer
Membrane cells and antigen presenting cells are involved in transport of antigen from the surface to the lymphoid follicle
Antigen is presented to T-helper cells
T-helper cells induce B cells in germinal center to produce antibody
Secretory IgA is primary antibody produced
Involved in local immunity
Etiology
Age : 3 -12 years
Season: winter
Food: Cold, sour, oily food
General lymphoid hyperplasia
Infection in tonsils alone or associated with
Rhinitis, Sinusitis, Tonsillitis
(esp. chronic maxillary sinusitis)
Recurrent attacks of rhinitis, sinusitis or tonsillitis may causes chronic adenoid infection
Allergy of respiratory tract.
Clinical features
Symptoms occur most commonly between ages of
3-7 years.
Depending on size of adenoid mass and space
3 types
Nasal symptoms
Aural symptoms
General symptoms
Nasal symptoms
Bilateral Nasal obstruction
Mouth breathing
interfere
Dry cough is one of the most common symptoms prompting patients to seek medical care. A systematic diagnostic approach is recommended to determine the underlying cause. Common causes of acute dry cough include upper respiratory infections, while chronic dry cough may be due to asthma, COPD, GERD, or postnasal drip. A careful history and physical exam can provide clues to the etiology, and initial tests may include a chest x-ray, spirometry, and trial treatments targeting suspected conditions. Management involves treating the identified cause through lifestyle changes, medications, or other therapies.
Approach to patient with uper and lower airway diseasesTigreentertainment
The document outlines the approach to patients presenting with upper and lower airway diseases. For cough, it discusses the definition, epidemiology, pathophysiology, differential diagnosis, approach, history questions, physical exam findings, and diagnostic tests. For dyspnea, it lists the differential diagnosis which includes congenital causes, infections, toxic/environmental exposures, tumors/cysts, allergy, pulmonary issues, cardiac causes, and renal failure. The document provides a thorough review of evaluating and diagnosing patients with cough or dyspnea.
This document discusses acute respiratory infections (ARIs) in India. It notes that ARIs affect over 700 million people annually in India and cause over 52 million cases of pneumonia. Mortality from ARIs ranges from 3,200 to 6,900 deaths annually. Risk factors for ARIs include low literacy, suboptimal breastfeeding, malnutrition, and unsatisfactory immunization coverage. Common types of ARIs discussed include the common cold, croup, bronchiolitis, and pneumonia. Diagnosis, treatment, and prevention strategies for ARIs are also outlined.
1. Bronchiolitis is most commonly caused by respiratory syncytial virus (RSV) in infants and young children, causing inflammation in the small airways.
2. It typically presents with cough, wheezing, nasal congestion and difficulty breathing. Chest radiographs may show hyperinflation of the lungs.
3. Treatment is supportive with oxygen and monitoring since most cases resolve on their own. Hospitalization is needed for moderate to severe distress, hypoxemia or apnea. While recurrence is common, bronchiolitis often improves within a week.
1. Diabetic ketoacidosis is caused by a lack of insulin and results in hyperglycemia, dehydration, and acidosis. It can be prevented by never skipping insulin doses and monitoring blood glucose and ketone levels.
2. Hyperglycemic hyperosmolar non-ketotic syndrome is characterized by extreme hyperglycemia without ketosis or acidosis. Both conditions require treatment of hyperglycemia, fluid replacement, and insulin administration to reverse the process.
3. The document provides details on the pathophysiology, clinical presentation, diagnostic assessment, and management of diabetic ketoacidosis and hyperglycemic hyperosmolar non-ketotic syndrome.
This document discusses stroke, also known as cerebrovascular accident. It defines stroke as the onset of neurological dysfunction lasting over 24 hours due to disrupted blood flow to the brain. Strokes are classified as either ischemic, caused by occlusion of cerebral blood vessels, or hemorrhagic, caused by leakage of blood into brain tissue. Signs and symptoms vary depending on the affected brain region but may include weakness, sensory changes, speech problems, and altered consciousness. Treatment involves stabilizing vital functions, reperfusion therapies if given early, managing blood pressure, and long term prevention strategies like anticoagulants or surgery. Nursing care focuses on prevention of injuries, management of deficits, communication support, and education to promote recovery.
1. Burn injuries cause cell destruction of the skin layers and depletion of fluids and electrolytes from the body. Mortality rates are higher for children under 4 and adults over 65.
2. Preexisting medical conditions like heart, lung, and kidney disease negatively impact recovery from burn injuries and increase mortality.
3. Burn management involves assessing the size, depth, and cause of the burns and providing fluid resuscitation, wound care, pain management, and nutrition. The goal is to restore fluid and electrolyte balance, promote wound healing, and maximize patient function and independence.
Acute respiratory failure is a life-threatening condition where the lungs fail to provide adequate oxygenation or ventilation to the blood. It can be hypoxemic (low oxygen) or hypercapnic (high carbon dioxide). Causes include conditions affecting the respiratory center of the brain, spinal cord, nerves, muscles, airways, lungs, or blood vessels. Treatment focuses on identifying and treating the underlying cause, restoring adequate gas exchange through intubation and mechanical ventilation if needed, and monitoring the patient closely in a critical care setting. Nursing management includes airway care and ventilation support, repeated assessments, implementing comfort measures, education, and communication support.
This document summarizes acute renal failure, including its pathophysiology, categories, phases, clinical manifestations, assessment, medical and nursing management. Acute renal failure is a rapid loss of renal function due to kidney damage. It can be prerenal, intrarenal, or postrenal in origin and causes a decrease in glomerular filtration rate. Treatment focuses on restoring fluid and electrolyte balance, eliminating underlying causes, and potentially initiating dialysis to prevent complications like hyperkalemia and metabolic acidosis until renal function recovers. Nursing care involves close monitoring, preventing infections and skin breakdown, and providing psychosocial support.
Adrenal gland disorders include hypofunction which can lead to acute or chronic insufficiency, and hyperfunction which often leads to overproduction of androgens or cortisol. Acute adrenocortical insufficiency occurs suddenly due to infection or abrupt cessation of corticosteroid therapy, causing low blood pressure, fever, dehydration, hypoglycemia, and seizures. Congenital adrenal hyperplasia is inherited and causes overproduction of androgens due to inability to produce cortisol, resulting in masculinization of female genitalia and precocious puberty if untreated. The salt-losing form also causes loss of sodium and fluids leading to dehydration, weight loss, and
The document discusses cancer epidemiology, etiology, pathophysiology, and carcinogenesis. It notes that the most commonly diagnosed cancers are breast, lung, colorectal, liver, and cervical cancers. Cancer develops through multiple genetic mutations over time from factors like viruses, radiation, chemicals and lifestyle/diet. Carcinogenesis involves initiation of DNA damage, promotion of cell growth, progression to malignancy, and potential metastasis. Cancer development and growth involves deregulated cell proliferation, loss of differentiation, evasion of immune destruction, self-sufficiency in growth signals, insensitivity to anti-growth signals, sustained angiogenesis, and tissue invasion and metastasis.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
3. Review of the Respiratory System
1. Thoracic cavity encased by a bony
framework of the ribs, vertebrae and
sternum.
2. Lobes of the lungs: Right= 3; Left=2
3. Mediastinum contains the esophagus,
trachea, large blood vessels and the
heart.
4. Two pleural membranes are separated by
enough fluid for lubrication.
6. Airways:
* Infants are nose breathers
I. Upper: (shared by both the respiratory
and alimentary tracts)
a. Sequence of airway muscle activation
is different in breathing and swallowing.
b. Inspiration is short during crying,
coughing, sneezing
7. Airways:
II. Lower Airways
a. Newborn airways have little smooth
muscles
b. Growth of the respiratory system
follows a general growth curve during the
early weeks of life.
c. Airways grow faster than the thoracic
and cervical portions of the vertebral
column
8. Respiratory Units: *Gas exchange
a. Infants and young children have less
alveolar surface area for gas exchange
b. Respiratory rate steadily decreases until
it levels off maturity
c. Infant Breathing: diaphragmatic,
abdominal
d. Respiration facilitated by 2 processes:
1. a. Compliance 2. Resistance
b. Recoil
9. Respiratory Units:
• Compliance is normally high in the mature
newborn and infant
• As the child grows, chest wall compliance
decreases and elastic recoil increases
11. ACUTE
NASOPHARYNGITIS (Viral)
Common Colds
* Usually self-limiting and resolves
within 4-10 days without
complications
Causative Agents:
a. Rhinovirus
b. Respiratory Syncitial Virus
c. Adenovirus
d. Influenza virus
e. Parainfluenza virus
12. Clinical Manifestations:
1. Fever- may complicate to otitis
media
2. Nasal inflammation
3. Vomiting and diarrhea may be
present
4. Dryness and irritation of nasal
passages and pharynx
5. Sneezing
6. Chills
7. Muscular aches
8. Irritating nasal discharge
16. 4. Abdominal pain
5. Anterior cervical lymphadenopathy
6. Pain
Complications:
a. Acute glomerulonephritis
b. Rheumatic fever
DIAGNOSIS:
*Throat culture
17. THERAPEUTIC MANAGEMENT
1. If due to GAHBS
-Oral Penicillin for 10 days
-IM Pen G benzathine
- if allergic to penicillin=
Erythromycin
Other drugs to treat GAHBS
pharyngitis:
a. clarithromycin e. amoxicillins
b. azithromycin
c. clindamycin
d. cephalophorins
18. 2. Bed rest
3. Cold and warm compress to the
neck
4. Saline gargles
5. Cool liquid/ ice chips
6. Antibiotic therapy compliance
19. TONSILLITIS
Predisposing factors:
1. Pharyngitis
2. Young children
3. Viral/ Bacterial infections
CLINICAL MANIFESTATIONS:
1. Inflammation of the palatine tonsils
2. Difficulty of swallowing and breathing
3. Dry and irritated oropharynx
20. THERAPEUTIC MANAGEMENT:
1. If with viral pharyngitis- symptomatic
treatment
2. If caused by GABHS- Antibiotic treatment
3. Surgery: Tonsillectomy
Conditions that will allow for surgery:
a. With frequent streptococcal infection
b. History of development of peritonsillar
abscess
c. Massive hypertrophy that results in
21. difficulty of breathing or eating
d. Malignancy or obstruction of the
airways that results in cor pulmonale
Adenoidectomy (removal of the adenoids)
Condition that will allow for Surgery:
a. With hypertrophy of the adenoids that
obstruct nasal breathing
22. Contraindications for Tonsillar or Adenoidal
Surgery:
1. Cleft palate
2. Acute infections at the time of surgery
3. Uncontrolled systemic diseases
4. Blood dyscracias
24. Post Surgery Management:
1. Supine / Side lying
2. Suctioning
3. Discourage to cough frequently, clear
the throat and blow the nose
4. Inspect secretions and vomitus for fresh
bleeding
5. Ice collar
6. IV analgesics
25.
26. Post Surgery Management:
7. Local anesthetics
8. Antiemetics
9. Food and fluid restriction until the child
is fully alert and without signs of
hemorrhage.
10. Soft foods
11. Observe for signs and symptoms of
hemorrhage
27. Home Care
Discharge instructions include:
1. Avoid foods that are irritating highly
seasoned
2. Avoid gargles
3. Avoid vigorous tooth brushing
4. Discourage coughing or clearing of the
throat
5. Prevent from putting objects into the
mouth
28. 7. Use of analgesics and ice collar for pain
8. Limit activity- to decrease the risk of
bleeding
30. CLINICAL MANIFESTATIONS:
1. Dry nasal mucosa and throat
2. Dry cough
3. Tendency towards hoarseness
4. Sudden onset of fever accompanying:
a. Flushed face
b. Photophobia
c. Myalgia
d. Hyperesthesia
e. Prostration
5. Subglottal croup/
laryngotracheobronchitis
31. THERAPEUTIC MANAGEMENT:
1. Uncomplicated type= symptomatic
treatment
a. Acetaminophen/ paracetamol/
ibuprofen
b. Hydration
2. Zanamavir and rimantidine- given in
children under 18 years old
3. Tamiflu (oseltamavir)- given to children
over 1 year and adults
35. * Occurs most often in boys than girls
CROUP SYNDROMES classic signs:
1. Hoarseness
2. Inspiratory stridor
3. Varying degrees of respiratory distress
from swelling and obstruction in the
region of the larynx
4. Steeple sign
36.
37. ACUTE
LARYNGOTRACHEOBRONCHITIS
- Affects children younger than 5
years old
- Causative microorganisms:
1. Parainfuenza virus type 1,2 and 3
2. Respiratory syncitial virus
3. Influenza types A and B
4. M. pneumoniae
- Usually preceded by URI
38. Clinical Manifestations:
1. Gradual onset of low grade fever
2. Barky, brassy cough
3. Inflammation of the mucosal lining
4. Inspiratory stridor with suprasternal
retractions
5. Cough
6. Hoarseness
7. Respiratory distress in infants
39.
40. 8. Hypoxia
9. Respiratory acidosis
THERAPEUTIC MANAGEMENT
Goal: Maintaining airway and providing
adequate respiratory exchange
1. High humidity with cool mist; with
supplemental Oxygen
2. Increase fluid intake; IV therapy
41. 3. Nebulized (racemic) epinephrine if not
alleviated by cool mist
4. Corticosteroids
5. Severe cases: Mix helium to Oxygen
6. Cardiac, respiratory and non-invasive
blood gas monitoring
7. Intubation equipment and bag and valve
mask equipment should be readily
accessible.
8. Rest to conserve energy.
42. PNEUMONIA
• Inflammation of the pulmonary
parenchyma
Morphologic Classification:
1. Lobar pneumonia
2. Bronchopneumonia
3. Interstitial pneumonia
43. CLINICAL MANIFESTATIONS:
• May vary depending on the etiologic agent,
child’s age, systemic reaction to infection,
extent of lesions and degree of bronchial
and bronchiolar obstruction
General signs of Pneumonia:
1. Fever
2. Cough- unproductive to productive with
whitish sputum
3. Tachypnea
44. 4. Ronchi or fine crackles
5. Dullness to percussion
6. Chest pain
7. Retractions
8. Nasal flaring
9. Pallor to cyanosis
10.X-ray: Diffuse or patchy infiltration; with
peribronchial distribution
11. GIT signs: anorexia, vomiting, diarrhea,
abdominal pain
45. TYPES of Pneumonia:
1. Viral pneumonia- associated with URIs
S/S:a. mild to high fever
b. slight cough to severe cough
c. malaise
d. fatigue
e. cough with small amounts of whitish
sputum
46. f. Breath sounds: wheezes, fine crackles
g. X-ray: Diffuse patchy infiltration with
peribronchial distribution
THERAPEUTIC MANAGEMENT *Symptomatic
1. Oxygen administration
2. Chest physiotherapy
3. Postural drainage
4. Antipyretics
5. Increase fluids
47. 2. Primary atypical pneumonia
Most common cause: M. pneumoniae
- most common in ages between 5-12
years old
S/S:
a. General systemic symptoms:
1. fever
2. chills (in older children)
3. headache
48. 4. anorexia
5. myalgia
b. Symptoms followed by:
1. rhinitis
2. sore throat
3. dry, hacking cough
c. Initial non-productive cough, progresses
to mucopurulent to blood-streaked
d. X-ray: 1. Round cell infiltrate
49. 2. edema of the alveolar septa
3. with varying distribution of areas of
inflammation, necrosis and ulceration of the
mucosal lining of bronchi and bronchioles
4. with areas of consolidation
5. emphysema
Nursing Management:
1. Symptomatic treatment
2. Convalescence
50. 3. Bacterial Pneumonia- acquired through
aspiration; hematogenous
- Staphylococcus pneumoniae: most
common bacterial pathogen (community
acquired)
S/S:
1. Acute onset fever- usually high
2. Toxic appearance
3. Headache
4. Chills
56. TUBERCULOSIS
*Causative agent: M. Tuberculosis
*Transmission: Inhalation of
microdroplets into the respiratory
tract after someone has coughed
or sneezed
Pathophysiology:
Droplet/airborne
↓
Invasion of the bronchial tree
↓
Implantation into the bronchioles/
alveolus
57. ↓
Multiplication
↓
Inflammatory process
↓
Bacilli leave the focal area and carried to the
regional lymph nodes
↓
Extension of primary lesion
↓
Extensive tissue destruction
↓
Erosion of blood vessels to near distant sites
↓
Bleeding
58. Clinical Manifestations:
1. Fever
2. Malaise
3. Anorexia
4. Weight loss
5. Aching pain
6. Tightness of the chest
7. Hemoptysis
8. Lung on the affected side does not
expand well
9. Diminished breath sounds
10.Crackles
11. Dullness to percussion
59. Diagnosis:
1. History of contact with infected person
2. TB test/ PPD test= 5 tuberculin units to
.0.1 ml of solution
Results:
I. Induration more than or equal to 5mm
a. children in close contact with known
or suspected cases
b. with suspected tuberculosis disease
60.
61. c. with clinical evidence of TB
d. Receiving immunosuppresssive
therapy, immunosuppressive conditions
e. CXR- with active or previously
active TB
II. Induration more than or equal to 10 mm
a. With increased risk of
disseminated disease
b. increase risk of exposure to TB
62. a. Born and with parents in high
prevalence TB regions of the world
b. Frequently exposed to adults who are
HIV infected, homeless, users of illicit
drugs, residents of nursing homes,
incarcerated or institutionalized persons,
or migrant farm workers
63. III. Induration of more than or equal to
15mm
a. without any risk factors
66. Management: for Latent tuberculosis
infection with (+) positive Skin testing
1. Isoniazid (INH)- given for 9 months or
direct observation therapy alternately 2-
3 times a week
2. Rifampin- daily for 6 months
- if resistant to INH
3. Combi = INH, Rifampin and PZA
(Pyrazinamide)
69. ASTHMA is a chronic inflammatory
disorder of the airway that causes
airway hyperresponsiveness, mucosal
edema and mucus production.
It is the most common chronic disease
of childhood
70. Risk Factors:
1. Age
2. Heredity
3. Gender
4. Mother under 20 years old
5. Smoking
6. Ethnicity
7. Previous life threatening attacks
8. Lack of access to medical care
9. Psychologic and psychosocial problems
73. PATHOPHYSIOLOGY
Contact with triggering factors
↓
Initial release of inflammatory mediators from
the bronchial mast cells, macrophages and
epithelial cells
↓
Migration and activation of other inflammatory
cells
↓
74. ↓
Alteration in epithelial integrity and autonomic
neural control of airway
↓
Increase in airway smooth muscle responsiveness
Alteration in epithelial integrity and autonomic
neural control of airway tone
↓
Wheezing, dyspnea, smooth muscle
responsiveness
75. Conditions relating to ASTHMA occurrence:
1. Patients with asthma may experience
symptom-free periods alternating with
acute exacerbations.
2. Many children with asthma exhibit an
allergic component
3. Vagal and sympathetic nerve influences
are responsible for the tone of bronchial
smooth muscles
76. Conditions relating to ASTHMA occurrence:
4. Narrowing and shortening of the airway
increases airway resistance to airflow.
5. The number of ventilated alveoli affects
the oxygen levels of the blood.
77. Manifestations:
1. Dyspnea
2. Wheezing
3. Coughing
4. Prodromal itching at the front of
the upper neck or the upper part
of the back
5. Discomfort, irritability,
restlessness, apprehension
6. Headache, tired feeling
7. Tightness of the chest
78. 8. Respiratory symptoms
9. Wheezing
10. Shortness of breath, deep
breathing
11. Expiratory phase becomes
prolonged with audible wheezes
DIAGNOSIS:
1. Pulmonary function test
1. Incentive spirometry
2. Peak expiratory flow meter
79. 2. Bronchoprovocation testing
3. Skin testing
4. Laboratory tests
- CBC
5. X-ray- frontal and lateral
MANAGEMENT
1. Allergen control
2. Drug therapy
Long term control meds
1. Inhaled corticosteroids
82. Review of the Cardiovascular
System
Cardiac Development and Function
1. The heart is a 4-chambered organ
2. The heart’s location is slightly to
the left of the sternum in the
space between 2 pleural cavities
3. Layers:
Myocardium
Endocardium
Pericardium
Pericardial space
87. Post Natal Development
1. Heart is larger in relation to body size
2. Heart occupies a large space within the
mediastinum
3. LV walls become thicker; LV pressures on
the L side is increased
88. Cardiac Physiology:
The primary function of the heart is to provide
effective oxygen transport to meet the
body’s metabolic need
3 factors that influence stroke volume:
1. Preload- volume of blood returning to the
heart
2. Afterload- resistance against which the
ventricles must pump when ejecting blood
89. 3. Contractility- efficiency of the
myocardial fiber shortening
Frank Sterling’s Law of the Heart:
“The greater the myocardial fiber length or
stretch, the greater is the force of
contraction”
Contractile state (Inotropic State)- vigor
of contraction
91. Congestive Heart Failure
It is the inability of the heart to
pump adequate blood to the
systemic circulation at normal
filling pressures to meet the body’s
metabolic demands
Causes:
1. Volume overload
2. Pressure overload
3. Decreased contractility of the
myocardium
4. High cardiac output demands
103. Therapeutic Management
1. Improve cardiac function
Drugs that enhance the cardiac
function:
a. Digitalis glycosides
b. Ace inhibitors
c. Beta Blockers
2. Remove accumulated fluid and
sodium
a. Diuretic administration
b. Fluid restriction
104. c. Low salt formulas
3. Decrease cardiac demands
a. Provide neutral thermal
environment
b. Treat existing infections
c. Reduce effort of breathing
d. Provide rest and decrease
environmental stimuli
4. Improve tissue oxygenation
a. Oxygen – humidified
5. Reduce respiratory distress
6. Maintain nutritional status
105. KAWASAKI DISEASE
It is a form of vasculitis identified by an
acute febrile illness with multiple
system involvement
With widespread inflammation of the
small and medium-sized blood vessels,
usually the coronary arteries
Cause: Unknown but may be due to:
1. Autoimmunity/ Passive immunity
2. Young age
3. Infection
4. Genetic predisposition
107. Clinical Manifestations:
A. Acute Phase
a. Abrupt onset of fever
b. Bulbar conjunctiva of the eyes
become reddened
c. Inflammation of the pharynx
d. Oral mucosal inflammation with
cracked lips; strawberry tongue
e. Rash with desquamation
108. f. edema of the hands and feet
g. Erythema of the palms and soles
h. cervical lymphadenopathy
i. Myocarditis with decreased LV
function
Coronary arteries begin to enlarge
109. B. Subacute Phase
a. Resolution of fever
b. Enlargement and dilatation of the
arteries
c. Thrombocytosis
d. Periungal desquamation of the hands
and feet
e. Arthritis affecting the large
weight-bearing joints
110. C. Convalescent Phase
All clinical signs are resolved but have not
yet returned to normal
Diagnosis:
1. Elevated ESR
2. Elevated CRP
3. Sterile pyuria with mononuclear cells on
microsopic analysis
115. Review of the anatomy and physiology:
Primary function:
Digestion and absorption of nutrients
The mechanical functions of digestion are
immature:
1. Swallowing
-Automatic reflex action for the 1st 3
months
116. - No voluntary control unless the
striated muscles of the throat establish
cerebral connections
- Voluntary control begins
approximately 6 week of age
- At the start of the 6th month,
capable of swallowing, holding food in the
mouth and spitting it out
117. 2. Sucking
- Reflexive activity of the newborn
with the muscular action of the tongue to
do a forward thrust
3. Chewing
- Facilitated by the eruption of the
primary teeth
118. The GIT Anatomy and Physiology:
1. Stomach
-round until 2 years old; elongates until
7 years old
- stomach capacity increases with age
2.Intestinal tract
- functional at birth
- salivary amylase to moisten the
mouth and throat
119. - at 2 years old, more enzymes are
excreted to aid in digestion
Functions:
1. Digestion
a. Mechanical/ muscular activity
producing GI motility (movement)
b. Chemical or enzymatic activity
resulting from GI secretions
120. 5 types of GI secretions:
1. Enzymes
2. Hormones
3. Hydrochloric acid
4. Mucus
5. H2o and electrolytes
121. Process of Digestion:
Biting and chewing; mixing of food with
saliva
↓
Salivary amylase begins process of digestion
of complex starches and CHO
↓
Upper esophageal sphincter relaxes
↓
123. ↓
Gastric glands secretes enzymes, HCl acid
and mucus and mix with food
↓
Partially digested food and watery gastric
secretions are delivered to the small
intestines
↓
Absorption of nutrients in the small
intestines
124. B. Absorption- occurs in the small intestines
The large intestines completes the process
of absorption
C. Elimination of waste products
*Bacteria affects the color and odor of stool
and gas formation:
a. Brown color
b. Bleeding
1. Tarry black/ melena
2. Bright/ dark red
125. 3. Scybala
*Defecation occurs when the internal and
exernal anal sphincters relaxes following
distension of the rectum by feces
*Frequency of defecation is increased in
newborns
128. Pathophysiology:
Absence of ganglion cells in the affected
areas of the intestine nervous system
stimulation
↓
Lack of independent enteric nervous system
stimulation
↓
Loss of rectosphincteric reflex
↓
129. ↓ ↓
Decreased ability Absence of
of the internal peristalsis
sphincters to relax
(Contraction of abnormal
bowel)
↓ ↓
Inability to pass out stools
130.
131.
132. Clinical Manifestations:
1. Newborn period
1. Abdominal distension
2. Vomiting
3. Constipation
4. Failure to pass meconium
5. Signs of acute intestinal obstruction
6. Bilious vomiting
133. 2. Infants
a. abdominal distention relieved by rectal
stimulation/ enema
3. Older infants and children
a. constipation
b. abdominal distention
c. vomiting
d. history of delayed meconium passage
e. chronic constipation
134. Older children
a. evidence of previous GI dysfunction
b. Failure to thrive
c. chronic constipation
DIAGNOSIS:
1. Barium enema
2. Rectal biopsy
3. Anorectal manometry
135. THERAPEUTIC MANAGEMENT
A. Surgery- majority of cases
- Removal of aganglionic portion for the
purposes of:
1. relieving obstruction
2. restoring normal motility
3. preserving the function of the
external anal sphincter
136. Procedure:
1. Initial prep- Fluid and electrolyte
replacement
2. Creation of an ostomy proximal to the
aganglionic site
3. Complete, corrective surgery
137. Surgeries performed:
1. Soave endorectal pull-through
2. Anorectal myomectomy
- if with short segment disease
Nursing Care:
A. Pre-op care
1. Enema
2. Low fiber, high calorie, high
protein/ TPN
3. GOLYTELY- with pull-through
procedure
138.
139.
140. 4. Measure abdominal circumference
5. Educate parents for ostomy care
B. Post operative care
- same with any abdominal surgery
1. NPO
2. NGT to suction
3. MIO
4. Monitor return of bowel sounds
and passage of stool
5. Colostomy care
141. GASTROESOPHAGEAL REFLUX
- Transfer of gastric contents to the
esophagus
Pathophysiology:
Feeding
↓
Food propelled towards the esophagus
↓ ↓
Stomach Episodes of
↓ transient relaxation
↓ of LES
143. Factors that contribute to the presentation
and severity of GERD:
1. Frequency of reflux
2. Gastric acidity
3. Gastric emptying
4. Esophageal clearing mechanisms
5. Integrity of the esophageal mucosal barrier
6. Sensitivity of the viscera
7. Responsiveness of the airway
144. Factors that affect LES pressure:
1. Gastric distention
2. Increased abdominal pressure
High Risk:
1. Premature infants with bronchopulmonary
dysplacia
2. Tracheoesophageal or esophageal atresia
repairs
3. Neurologic disorders
146. 4. Irritability
5. Hematemesis
6. Anemia
7. Failure to thrive
8. Older children: adult-like pattern
a. heartburn
b. regurgitation
c. reswallowing
9. Barrett mucosa
10. hoarseness
147.
148.
149. DIAGNOSIS:
1. History of vomiting
2. Stool Guaiac test
3. Assessment of growth and nutritional
status
4. Barium swallow
5. Esophageal pH monitoring
6. Endoscopy with biopsy
7. Scintigraphy and manometry
150. 8. Empiric medical therapy
THERAPEUTIC MANAGEMENT
1. Small, frequent feedings of thickened
formula
2. Frequent burping
3. Positioning- prone if awake
4. Decrease fat intake, spicy foods
151. 5. Pharmacologic therapy
a. Acid suppressant meds
Eg. Omeprazole. Lansoprazole
b. Antacids
Eg. Aluminum hydroxide (Maalox)
6. Surgery
Nissen fundoplication- creation of an
antireflux valve around the portion of the
intra-abdominal esophagus by decreasing the
diameter of the distal esophagus
152.
153. APPENDICITIS
Inflammation of the veniform appendix
Causes:
1. Obstruction of the lumen of the
appendix by hardened fecal material,
foreign bodies, microorganisms, parasites
2. Fold of peritoneum causes the appendix
to adhere to the cecum
3. Lymphoid hyperplasia
154. 4. Fibrous stenosis from inflammation or
stenosis
5. Diet high in sugar and low in fiber
CLINICAL MANIFESTATIONS
1. Colicky, abdominal pain located around the
umbilicus
2. Vague periumbilical localization (referred
pain)
3. Focal abdominal tenderness (Mc Burney’s
Point)
155. 4. Rebound tenderness
5. Nausea and vomiting, anorexia
6. Pain at the right hip
7. Low-grade fever
8. Psoa’s sign
9. Obturator sign
156. Diagnosis:
1. History and PE
2. CBC, Urinalysis, Pregnancy test
3. UTZ
MANAGEMENT
1. Assessment: location and extent of pain
2. Auscultate for the presence of bowel
sounds
157. 3. Appendectomy before perforation
4. If ruptured:
a. IV fluids/ electrolytes
b. Systemic antibiotics
c. NG tube suction
5. Post op management
a. Semi-fowler’s, knees up
b. Restrict activity
c. Ice bag over abdomen for comfort
159. INTUSSUSCEPTION
The proximal segment of the bowel
telescopes into a more distal
segment, pulling the mesentery
with it.
Cause: Unknown
1. Males
2. Cystic fibrosis
162. ↓ ↓
Arterial blood flow Leaking of blood
stops and mucus to
intestinal lumen
↓ ↓
Ischemia Currant jelly-like
stools
↓
Pouring of mucus into
the intestine
164. 5. Vomiting
6. Rectal bleeding/ hematest positive stools
7. If distal bowel remains distended,
necrosis and perforation may occur
Diagnosis:
1. Barium enema
2. Abdominal radiograph
3. Rectal exam
165. MANAGEMENT
1. Initial treatment of choice: Non-surgical
hydrostatic reduction
2. Administration of air pressure
- With IVF administration, NG
decompression, antibiotic therapy
(before hydrostatic reduction)
3. Surgery: Manual reduction of the
invagination with resecting any non-
viable intestine
166. NCM 102
Care of Mother, Child, Family and Population
Group At-risk or With Problems
CYGNETTE SIRON- LUMBO
Lecturer