The document discusses the common cold or nasopharyngitis in children. It is a frequent illness in childhood caused by viral infections of the upper respiratory tract. Clinical manifestations include fever, nasal congestion, sore throat, cough and runny nose. Diagnosis is made based on symptoms and physical examination. Treatment is generally supportive with antipyretics, nasal decongestants, and increased fluid intake. Complications may include ear infections, sinusitis or lower respiratory infections. Nursing care focuses on relieving symptoms, adequate rest and fluid intake, with a goal of promoting comfort and effective airway clearance. Prevention involves frequent hand washing and avoiding close contact with those exhibiting cold symptoms.

1. COMMON COLD OR
NASOPHARYNGITIS
IN CHILDREN
By NK

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

19. Thank you
for the
attention!