Downloaded 2,627 times
More Related Content
Similar to Lower respiratory tract infections ppt
Lower respiratory tract infections ppt
- 1. LOWER RESPIRATORY TRACTINFECTIONS MANALI H SOLANKI F.Y.M.SC.NURSING J G COLLEGE OF NURSING
- 2. TERMINOLOGY: • BRONCHITIS • PNEUMONIA •PULMONARY TUBERCULOSIS • HAEMOPTISIS • HAEMATEMESIS
- 3. INTRODUCTION • Lower respiratorytract infection comprises an array of diseases ranging from bronchitis to pneumonia. • Non-pneumonic LRTI is described as lower respiratory tract symptoms in a patient who has no history of these or any other chest signs related with infection, by all of the major respiratory viral groups.
- 4. ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM
- 10.
- 11. DEFINITION: • Bronchitis isan inflammation of the bronchial tubes, the airways that carry air to lungs
- 12. TYPES: • There aretwo types of bronchitis 1.Acute bronchitis 2.Chronic bronchitis
- 13. Acute bronchitis • Acute(i.e. recent onset) bronchitis is an inflammation of the lower respiratory passages (bronchi).
- 14. Chronic bronchitis • Chronicbronchitis is defined as a cough that occurs every day with sputum production that lasts for at least 3 months, two years in a row.
- 15. CAUSES: • Viral infectionthat causes the inner lining of the bronchial tubes to become inflamed and undergo the changes that occur with any inflammation in the body.
- 16. • Bacteria canalso cause bronchitis (a few examples include, Mycoplasma, Pneumococcus, Klebsiella, Haemophilus). • Chemical irritants (for example, tobacco smoke, gastric reflux solvents) can cause acute bronchitis
- 17. RISK FACTORS: • Smokers •People who are exposed to a lot of second-hand smoke • People with weakened immune systems • The elderly and infants • People with gastroesophageal reflux disease (GERD) • Those who are exposed to irritants at work
- 18.
- 19. • Coughing • Productionof clear, white, yellow, grey, or green mucus (sputum) • Shortness of breath • Wheezing • Fatigue • Fever and chills • Chest pain or discomfort • Blocked or runny nose
- 20. ASSESSMENT AND DIAGNOSTIC FINDINGS • Patient history
- 21.
- 22.
- 23.
- 25. Peak flow monitoring(PFM)
- 26.
- 27.
- 28. MEDICAL MANAGEMENT: • Ibuprofenor acetaminophen • Cough suppressant E.g. Delsym, Robitussin Cough, Dextromethorphan • Steroid medicine
- 29. • Nasal decongestants:like Naphazoline, Phenylephrine Oxymetazoline , Propylhexedrine, Phenylpropanolamine • Antiviral medicine Like amantadine, oseltamivir • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by bacteria
- 30. PREVENTION: • Avoid alcohol • Avoid irritants in the air • Drink more liquids • Get more rest • Eat healthy foods • Use a humidifier or vaporizer
- 31. • Avoiding peoplewho are sick with colds or the flu • Getting a yearly flu vaccine • Getting a pneumonia vaccine (especially for those over 60 years of age) • Washing hands regularly • Avoiding cold, damp locations or areas with a lot of air pollution • Wearing a mask around people who are coughing and sneezing
- 32. NURSING MANAGEMENT • Monitorfor adverse effects of bronchodilators- tremulousness, tachycardia, cardiac arrhythmias, central nervous system stimulation, hypertension. • Monitor oxygen saturation at rest and with activity. • Eliminate all pulmonary irritants, particularly cigarette smoke. Smoking cessation usually reduces pulmonary irritation, sputum production, and cough. Keep the patient’s room as dust-free as possible.
- 33. • Use posturaldrainage positions to help clear secretions responsible for airway obstruction. • Teach controlled coughing. • Encourage high level of fluid intake (8 to 10 glasses; 2 to 2.5 L daily) within level of cardiac reserve. • Give inhalations of nebulized saline to humidify bronchial tree and liquefy sputum. Add moisture (humidifier, vaporizer) to indoor air.
- 34. • Avoid dairyproducts if these increase sputum production. • Encourage the patient to assume comfortable position to decrease dyspnoea. • Use pursed lip breathing at intervals and during periods of dyspnoea to control rate and depth of respiration and improve respiratory muscle coordination. • Discuss and demonstrates relaxation exercises to reduce stress, tension, and anxiety.
- 35. • Encourage frequentsmall meals if the patient is dyspnoeic; en a small increase in abdominal contents may press on diaphragm and impede breathing. • Offer liquid nutritional supplements to improve caloric intake and counteract weight loss. • Avoid foods producing abdominal discomfort. • Encourage use of portable oxygen system for ambulation for patients with hypoxemia and marked disability.
- 36.
- 37. DEFINITION • Pneumonia isan inflammation of the lungs caused by bacteria, viruses, or chemical irritants. It is a serious infection or inflammation in which the air sacs fill with pus and other liquid.
- 38.
- 39.
- 40.
- 41.
- 42.
- 43.
- 44.
- 45. CAUSES: • Bacterial • Viral •Fungal • Nosocomial and others
- 46. RISK FACTORS • Smoke. •Abuse alcohol. • Have other medical conditions, such as chronic obstructive pulmonary disease (COPD), emphysema, asthma, or HIV/AIDS. • Are younger than 1 year of age or older than 65
- 47. • Have aweakened or impaired immune system. • Take medicines for gastroesophageal reflux disease (GERD). • Have recently recovered from a cold or influenza infection. • Are malnourished. • Have been recently hospitalized in an intensive care unit.
- 48. • Have beenexposed to certain chemicals or pollutants. • Are Native Alaskan or certain Native American ethnicity. • Have any increased risk of breathing mucus or saliva from the nose or mouth, liquids, or food from the stomach into the lungs.
- 49. SIGN AND SYMPTOMS • Cough • Rusty or green mucus (sputum) coughed up from lungs • Fever • Fast breathing and shortness of breath • Shaking chills
- 50. • Chest painthat usually worsens when taking a deep breath (pleuritic pain) • Fast heartbeat • Fatigue and feeling very weak • Nausea and vomiting • Diarrhoea • Sweating • Headache • Muscle pain
- 51. ASSESSMENT AND DIAGNOSTIC FINDINGS • Chest x ray
- 52.
- 53.
- 54.
- 55.
- 56.
- 57.
- 58.
- 59. MEDICAL MANAGEMENT • MACROLIDES •TETRACYCLINES • FLUOROQUINOLONES
- 60.
- 61.
- 62. COMPLICATIONS OF PNEUMONIA: • Abscesses • Respiratory Failure • Bacteraemia • Empyema and Pleural Effusions • Collapsed Lung
- 63. NURSING MANAGEMENT • Maintaina patent airway and adequate oxygenation. • Obtain sputum specimens as needed. • Use suction if the patient can’t produce a specimen • Provide a high calorie, high protein diet of soft foods
- 64. • To preventaspiration during nasogastric tube feedings, check the position of tube, and administer feedings slowly. • To control the spread of infection, dispose secretions properly. • Provide a quiet, calm environment, with frequent rest periods.
- 65. • Monitor thepatient’s ABG levels, especially if he’s hypoxic. • Assess the patient’s respiratory status. Auscultate breath sounds at least every 4 hours. • Monitor fluid and intake output. • Evaluate the effectiveness of administered medications. • Explain all procedures to the patient and family
- 66. PREVENTION • Good Hygieneand Preventing Transmission • Changing Hospital Practices • Vaccines • Viral Influenza Vaccines (Flu Shot) • Pneumococcal Vaccines • Vitamins
- 67.
- 68. DEFINITION • Pulmonary tuberculosisis a chronic infectious inflammation of the lung, as well as a special pneumonia.
- 69. CAUSES AND RISKFACTORS • Alcoholism • IV drug abuse • Crowded living conditions • Homelessness • Poverty
- 70. • Immigration fromcertain countries • Low body weight • Certain medical treatments (such as corticosteroid treatment or organ transplants)
- 71. SIGN AND SYMPTOMS • Cough (usually cough up mucus) • Coughing up blood • Excessive sweating, especially at night • Fatigue • Fever • Unintentional weight loss
- 72. Other symptoms thatmay occur with this disease: • Breathing difficulty • Chest pain • Wheezing
- 73. ASSESSMENT AND DIAGNOSTIC FINDINGS • Biopsy of the affected tissue (rare) • Bronchoscopy • Chest CT scan • Chest x-ray • Interferon-gamma blood test such as the QFT-Gold test to test for TB infection • Sputum examination and cultures • Thoracentesis
- 74.
- 75. MEDICAL MANAGEMENT • 1stline drugs DRUG DOSE Isoniazide (INH) 300 mg/day Rifampicin 600 mg/day Pyrazinamide 1500 mg/day 25 mg/kg/day Ethambutol 1200 mg/day 15-25 mg/kg/day Streptomycin 0.75—1gm/day 25 mg/kg/day
- 76. 2nd line drugs Amikacin(AG) 15 mg/kg/day Aminosalicylic acid 8-12 gm/day Capreomycin 15 mg/kg/day Ciprofloxacin 1500 mg/day (divided) Clofazimine 200 mg/day Cycloserine 500-1000 mg/day (divided) Ethionamide 500-750 mg/day Levofloxacin 500 mg/day Rifabutin 300 mg/day
- 77. Current recommended treatmentfor pulmonary TB has three regimens— • 6 Month Regimen—virtually 100% effective, more expensive. (usually only used in pulmonary TB)
- 78. First 2 months DRUG DOSE Isoniazide—300mg 1 tablet daily (300mg) Rifampicin—300mg 2 tablets daily (600mg) Pyrazinamide—500mg 3 tablets daily (1500mg) Ethambutol—400mg 3 tablets daily (1200mg)
- 79. Next 4 months DRUG DOSE Isoniazide—300mg 1 tablet daily (300mg) Rifampicin—300mg 2 tablets daily (600mg) Pyridoxine—10mg 1 tablet daily (10mg) for 6 months
- 80. 9 Months Regimen •First 2 months DRUG DOSE Isoniazide—300mg 1 tablet daily (300mg) Rifampicin—300mg 2 tablets daily (600mg) Ethambutol—400mg 3 tablets daily (1200mg)
- 81. Next 7 months DRUG DOSE Isoniazide—300mg 1 tablet daily (300mg) Rifampicin—300mg 2 tablets daily (600mg) Pyridoxine—10mg 1 tablet daily (10mg)
- 82. 12 Months Regimen—inexpensive andreasonably effective. • Regimen 1—effectiveness is nearly 100% Injection 1gm (IM)—Twice Streptomycin Weekly Tablet Isoniazide 15 mg/kg/day Tablet Pyridoxine 1 tablet of 10mg daily
- 83. Regimen 2—very cheap, effectivenessis 80-90% Isoniazide 1 tablet daily (300mg) Tablet Thiocetazone 1 tablet daily (150mg) Pyridoxine 1 tablet daily (10mg)
- 84. Prophylactic Dose • Isoniazideis indicated for the prophylactic use of TB, the dose is 300mg/day (5mg/kg/day) or 900mg twice weekly for 6 months in most cases and 12 months in case of immuno-compromised patients
- 85. ADVERSE EFFECT OFDRUGS Isoniazide Peripheral Neuropathy Rifampicin Cholestatic jaundice + renal toxicity + Flu like syndrome Pyrazinamide Hepatotoxicity + Hyper- Uricaemia Ethambutol Retinobulbar optic neuritis
- 86.
- 87.
- 88. NURSING MANAGEMENT • IneffectiveAirway Clearance may be related to excessive, thickened mucous secretions, possibly evidenced by presence of rhonchi, tachypnea, and ineffective cough. • Acute pain related to localized inflammation and persistent cough.
- 89. • Imbalance nutritionless than body requirement related to frequent cough, anorexia and fatigue. • Risk for infection related to inadequate primary defences and decreased cilliary action • Anxiety related to outcome of diseases as evidenced by poor concentration on work, isolation from others, rude behaviour
- 90. • Activity Intolerancerelated to imbalance between O2 supply and demand, possibly evidenced by reports of fatigue, dyspnoea, and abnormal vital sign response to activity. • Knowledge deficit regarding the treatment modalities and prognosis
- 91. ABSTRACT • Lower respiratorytract infection and rapid expansion of an abdominal aortic aneurysm: a case report
- 92.
- 94.