This document provides information on lower respiratory tract infections (LRTIs). It discusses various types of LRTIs including pneumonia, bronchitis, tuberculosis, and others. It covers causative organisms, risk factors, signs and symptoms, diagnostic evaluations, treatment including medications, nursing diagnoses, and patient education.
Pneumonia is a serious infection that inflames the air sacs in the lungs. It can cause symptoms such as coughing, chest pain, fever, and difficulty breathing. It's important to seek medical attention if you suspect you have pneumonia. Here are some notes for dear medical students, i hope it helps you..
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
Pneumonia is a serious infection that inflames the air sacs in the lungs. It can cause symptoms such as coughing, chest pain, fever, and difficulty breathing. It's important to seek medical attention if you suspect you have pneumonia. Here are some notes for dear medical students, i hope it helps you..
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
TUBERCULOSIS HAS BEEN EXCLUDED BECAUSE IN INDIA TUBERCULOSIS IS THE MOST COMMON CAUSE OF CHRONIC COUGH AND REST OTHER CAUSES OF CHRONIC COUGHS ARE IGNORED
discuss about basic concept of lower respiratory disease condition of pnuemonia -describe as definition,classification,etiology,riskfactor, clinical manifestation,diagnostic evaluation,medical management,surgical management,and nursing management and taking care of patient with pnuemonia disease condition
TUBERCULOSIS HAS BEEN EXCLUDED BECAUSE IN INDIA TUBERCULOSIS IS THE MOST COMMON CAUSE OF CHRONIC COUGH AND REST OTHER CAUSES OF CHRONIC COUGHS ARE IGNORED
discuss about basic concept of lower respiratory disease condition of pnuemonia -describe as definition,classification,etiology,riskfactor, clinical manifestation,diagnostic evaluation,medical management,surgical management,and nursing management and taking care of patient with pnuemonia disease condition
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
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June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
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Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
6. 1. According to the causative organisms
(a)Bacterial :-
• Pneumococcal pneumonia caused by Streptococcus pneumoniae*
• Staphylococcal pneumonia caused by Staphylococcus aureus
• Influenzal pneumonia caused by Haemophiles influenza
• Gram-negative bacterial pneumonia caused by Klebsiella
pneumonia
CLASSIFICATION
7. b) Viral:- Rhinovirus, coronaviruses, influenza virus, respiratory syncytial
virus (RSV), adenovirus and parainfluenza. People following organ
transplantation or immunocompromised present high rates of
cytomegalovirus pneumonia.
c) Fungal:- Fungal pneumonia caused by histoplasmosis, aspergillosis,
candidiasis, blastomycosis
d) Parasitic:- Parasitic pneumonia (caused by protozoa, nematodes,
Platyhelminthes)
CONT..
8. 2. According to the environment
a) Community-acquired pneumonia.
b) Hospital acquired pneumonia.
c) Ventilator acquired Pneumonia. (VAP)
d) Pneumonia in the immuno-compromised host (opportunistic
pneumonia).
e) Aspiration pneumonia
CONT..
9. 3. According to the areas of the lung involved/affected
a) Lobar pneumonia
b) Multilobed pneumonia
c) Bronchial pneumonia
d) Interstitial pneumonia
e) Alveolar (acinar) pneumonia
f) Segmental pneumonia
CONT..
10. • There are many causes of pneumonia including bacteria, viruses,
mycoplasmas, fungal agents and protozoa.
• It may also result from inhalation of toxic or caustic chemicals, smoke,
dusts or gases or aspiration of food, fluids, or vomitus.
• Pneumonia may complicate to chronic illnesses.
ETIOLOY
11. • Age 60 or older
• Smoking
• Air pollution, Inhalation of noxious substances.
• Altered consciousness : Alcoholism, head injury, anesthetic drug overdose
• Tracheal intubation
• Upper Respiratory Tract Infection
• Chronic Disease : Chronic lung disease, Diabetes mellitus, heart disease,
cancer
RISK FACTORS
12. • Immunosuppression
• Malnutrition
• Prolonged bed rest and immobility
• Aspiration of fluid, liquid, foreign or gastric content.
• Prolonged hospital stay.
• Residence in institutional areas where transmission is prone.
CONT..
16. • Hemoptysis
• Headache
• Crackling sounds over affected area
• Dullness on percussion
• Decrease in breath sounds
• Unequal chest expansion
CONT..
17. • Physical examination.
• Chest X-ray.
• Gram stain and culture and sensitivity tests of sputum.
• Blood culture.
• Immunologic test to detect microbial antigens.
• CT Scan thorax.
• Fiberoptic bronchoscopy or transcutaneous needle aspiration [biopsy].
• ABG.
DIAGNOSTIC EVALUATION
18. • Appropriate antibiotic therapy
– Macrolide antibiotics: inhibitors of bacterial protein synthesis such as
azithromycin, clarithromycin
– Fluroquinolones: inhibitors of DNA synthesis such as moxifloxacin,
levofloxacin
– lactams: inhibitors of bacterial cell wall synthesis (Penicillin,
amoxicillin, clavulanate (Augmentin), ceftriaxone, cefuroxime,
tazobactam, meropenem)
• Antipyretic
• Analgesic
• Bronchodilators medications: albuterol sulphate, metaproterenol or
methylxanthines.
MANAGEMENT
19. • Oxygen therapy
• Nutritional support
• Fluid and electrolyte management
• Deep breathing exercises and spirometry
• Chest physiotherapy
• Nasotracheal suctioning
CONT..
20. NURSING DIAGNOSIS
1. Impaired gas exchange related to presence of retained secretions at the
capillary alveolar membrane evidenced by cyanosis, dyspnea, confusion,
hypoxia
INTERVENTION
• Assess the respiratory status, skin colour, mental status, heart rhythm and
body temperature.
• Auscultate lung fields.
• Elevate head of bed.
• Suctioning is to be done as indicated.
• Encourage fluids to at least 2500 mL per day, unless contraindicated.
NURSING MANAGEMENT
21. • Assist with and monitor effects of nebulizer treatments and other.
• Perform chest physiotherapy, incentive spirometer.
• Administer medications, as indicated, for example, mucolytics,
expectorants, bronchodilators, and analgesics.
• Provide supplemental fluids such as IV infusion, humidified oxygen, and
room humidification.
• Monitor serial chest x-rays, ABGs, and pulse oximetry readings.
CONT..
22. NURSING DIAGNOSIS
2. Ineffective breathing pattern related to inflammation and pain evidenced
by Changes in respiratory rate, diminished/adventitious breath sounds,
Ineffective cough.
INTERVENTION
• Assess rate, depth of respirations and chest movement.
• Elevate head and encourage frequent position changes, deep breathing,
and effective coughing.
• Maintain bedrest
• Monitor ABGs and pulse oximetry.
• Administer oxygen therapy by appropriate
CONT..
23. NURSING DIAGNOSIS
3. Activity Intolerance relate to imbalance between oxygen supply and demand,
General weakness evidenced by report of weakness, fatigue, exertional
dyspnea or tachypnea, Abnormal heart rate response to activity.
INTERVENTION
• Evaluate client's response to activity.
• Note reports of dyspnea, increased weakness and fatigue, and changes in vital
signs during and after activities
• Provide a quiet environment and limit visitors during acute phase
• Encourage use of stress management and diversional activities.
• Explain importance of balancing activities with rest.
• Assist with self-care activities as necessary.
CONT..
24. NURSING DIAGNOSIS
4. Knowledge deficit regarding condition, treatment, self care, discharge
needs, related to lack of exposure , information misinterpretation as
evidenced by reports the problem, inaccurate follow-through of
instructions.
INTERVENTION
• Assess the level of understanding of the patient and knowledge.
• Explain about the disease condition, its signs and symptoms and
treatment modalities.
• Explain and demonstrate about the importance of effective coughing and
deep breathing exercises.
CONT..
25. • Emphasis necessity of continuing antimicrobial therapy.
• Explain about balanced rest and activity, avoiding smoking, well-rounded
diet, and avoidance of crowds during cold and flu season and of persons
with upper respiratory infections.
• Stress importance of continuing medical follow-up and obtaining
vaccinations and immunizations as appropriate for both children and
adults.
CONT..
28. • Advise patient to complete entire course of antibiotics.
• Once clinically stable, encourage gradual increase in activities to bring
energy level back to pre-illness stage.
• Encourage breathing exercises.
• Explain that a chest X-ray is usually taken 4 to 6 weeks after recovery.
• Advise smoking cessation and avoid excessive alcohol intake.
• Advise patient to keep up natural resistance with good nutrition and
adequate rest.
• Advice patient to practice frequent handwashing, especially after contact
with others.
PATIENT EDUCATION
29.
30. Bronchitis is inflammation or swelling of the bronchial tubes (bronchi).
More specifically, bronchitis is when the lining of the bronchial tubes
becomes inflamed or infected.
DEFINITION
31. Acute bronchitis
Acute bronchitis is a shorter illness that commonly follows a cold or viral
infection, such as the flu. Acute bronchitis usually lasts a few days or weeks
Chronic bronchitis
Chronic bronchitis is characterized by a persistent, mucus-producing cough
on most days of the month, three months of a year for two successive years
in absence of a secondary cause of the cough.
TYPES
32. • Viruses, bacteria, and other particles that irritate the bronchial tubes.
• Smokers: People who are exposed to a lot of secondhand smoke
• People with weakened immune systems
• The elderly and infants
• People with gastroesophageal reflux disease (GERD)
• People who are exposed to air pollution
ETIOLOGY
33. • Coughing
• Production of clear, white, yellow, grey, or green mucus (sputum)
• Shortness of breath
• Wheezing
• Fatigue
• Fever and chills
• Chest pain or discomfort
• Blocked or runny nose
CLINICAL MANIFESTATIONS
35. • Antibiotics - these are effective for bacterial infections, but not for viral
infections. They may also prevent secondary infections.
• Cough medicine - one must be careful not to completely suppress the
cough, for it is an important way to bring up mucus and remove irritants
from the lungs.
• Bronchodilators - these open the bronchial tubes and clear out mucus
MEDICAL MANAGEMENT
36. • Mucolytics - these thin or loosen mucus in the airways, making it easier
to cough up sputum.
• Anti-inflammatory medicines and glucocorticoid steroids - these are
for more persistent symptoms.
• Pulmonary rehabilitation program - this includes work (DBE,
Spirometer exercises) with a respiratory therapist to help breathing.
CONT..
37. • Ineffective breathing pattern related to imbalance between supply and
demand of oxygen evidence by shortness of breath.
• Ineffective airway clearance related to broncho constriction.
• Self care deficit related to fatigue secondary to increased effort for
breathing evidence by poor personal hygiene.
• Activity intolerance due to fatigue and ineffective breathing patterns
evidenced by weakness, fatigue.
NURSING DIAGNOSES
38. • Assess the condition of patient.
• Assess the vital signs
• Provide comfortable position.
• Change the position periodically.
• Maintain personal hygiene.
• Use pulse oximetry & suction.
• Deep breathing exercise learn to patient.
NURSING INTERVENTIONS
39. • Refer to physiotherapist (if need).
• Provide oxygen according to physician order.
• Provide psychological support to patient.
• Provide knowledge about chronic bronchitis.
• Administer medication according to physician order bronchodilators,
antibiotics, mucolytics.
CONT..
41. • Avoiding tobacco smoke and exposure to second hand smoke
• Quitting smoking
• Avoiding people who are sick with colds or the flu
• Getting a yearly flu vaccine
• Getting a pneumonia vaccine
• 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
HEALTH EDUCATION
42.
43. Bronchiectasis is a condition anatomically defined by chronic, irreversible
dilation and distortion of the bronchi caused by inflammatory destruction
of the muscular and elastic components of the bronchial walls.
OR
Bronchiectasis is defined as permanent, abnormal dilatation of one or
more large bronchi.
DEFINITION
46. 1. Cylindrical/tubular bronchiectasis
The luminal dilatation is uniform and
the wall thickening is smooth and there
is failure of normal tapering of the
bronchi.
CONT..
47. 2. Saccular or cystic bronchiectasis
Most severe form of bronchiectasis. The bronchi are severely dilated and
the bronchi end blindly in a dilated thick walled cyst.
CONT..
48. 3. Varicose bronchiectasis
The bronchi resemble like varicose veins.
The luminal dilation is characterized by
alternating areas of luminal dilation and
constriction, creating a beaded appearance,
and the wall thickening is irregular.
CONT..
49. • Bronchiectasis has both congenital and acquired causes.
1. CONGENITAL CAUSES
• Kartagener syndrome/ Immotile Ciliary Syndrome: autosomal
recessive disorder, defect in the action of cilia.
• Primary immunodeficiencies.
• Williams-Campbell syndrome: Also known as Broncho-malacia is a
disease of the airways where cartilage in the bronchi is defective.
ETIOLOGY
50. • Marfan 's syndrome: Disorder of connective tissue, resulting in
abnormally long and thin digits.
• Patients with alpha I-antitrypsin deficiency
CONT..
51. 2. ACQUIRED CAUSES
• Infections caused by the staphylococcus, klebsiella, or the causative
agent of whooping cough, Tuberculosis, allergic bronchopulmonary
aspergillosis
• Chronic bronchitis
• Bronchial tumor
• Inhaled foreign bodies
• Alcoholism, heroin (drug use),
• Inflammatory bowel disease, especially ulcerative colitis.
• A Hiatal hernia can cause Bronchiectasis when the stomach acid
aspirated into the lungs.
CONT..
52.
53. • 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.
• Mild < 10 mL
• Moderate 10-150 ml.
• Severe > 150 mL
CLINICAL MANIFESTATIONS
54. • Chronic cough
• Hemoptysis:
– Frequent.
– More commonly in dry variety.
– Usually mild
• Recurrent pneumonia: same segment
• Systemic manifestations: fever, weight loss
CONT..
55. • History and physical examination
• Chest x- rays
• Sputum cultures
• Blood test
• Pulmonary function test
• CT scan thorax
• ABG analysis
• Bronchoscopy
• Immunoglobulin
• Cilia function and structure — Kartagener syndrome.
INVESTIGATIONS
56. Goals:
l. Eliminate cause
2. Improve tracheobronchial clearance
3. Control infection
4. Reverse airflow obstruction
TREATMENT
58. • Mucolytics.
• Bronchodilators.
• Antibiotics: The choice of antibiotics should be accurately by the
results of sputum culture and drug sensitivity test.
CONT..
60. Bronchial artery embolization:
A catheter is used to deliver small particles that block the blood supply
to the particular part of body. (Hemoptysis)
CONT..
61. Pneumonectomy: A surgical procedure in
which an entire lung is removed. A
pneumonectomy is an open chest technique
(thoracotomy).
Lobectomy: removes one lobe of the lung.
Removal of two lobes is called bilobectomy.
CONT..
62. Sleeve resection: Removing a lobe of
the lung along with part of the
bronchus.
Segment Resection (Segmentectomy):
Removal of the larger portion of the
lung but not the whole lobe .
CONT..
63. • Natural therapy
• Yoga
• Healthy lifestyle
• Emotional support
• Drug free salt therapy
PREVENTIVE MODALITIES
64. • The inhalation of natural pure sodium chloride (NaCl) in a
controlled environment (air temperature 18° to 24°C and relative
humidity 40% to 60%) is called halotherapy.
• Salt therapy is a gentle, non-invasive and drug free treatment
assisting the body to cleanse itself of toxins and naturally improve
general health and wellbeing.
• Salt has natural healing properties that help sufferers of respiratory
issues, skin problems and is also great for overall health.
Drug free salt therapy (halotherapy)
65. • A device called a halogenerator grinds salt into microscopic
particles and releases them into the air of the room. Once inhaled,
these salt particles are claimed to absorb irritants, including
allergens and toxins, from the respiratory system.
• The therapy involves sitting and relaxing in a specially designed
salt room and breathing in the microscopic salt particles.
• Sessions usually last for about 30 to 45 minutes.
Cont..
66. • Impaired gas exchange related to ventilation—perfusion inequality as
evidenced by decreased level of Sp02
Goal: Improvement in gas exchange
• Ineffective clearance related to increased production, ineffective
bronchopulmonary infection, and complications
Goal: Achievement of airway clearance airway mucus cough, other
NURSING DIAGNOSES