儿童呼吸系统疾病英文版 ppt课件

Respiratory Dysfunction Anatomy and Physiology of the Childhood Respiratory System Upper respiratory tract Nose Pharynx Larynx Epiglottis Lower respiratory tract Trachea Bronchi Bronchioles and alveoli The Upper Airway differences: shorter and narrow 4 mm3 months Pneumonia classification State of Illness Mild Severe Pneumonia classification the clinical manifestations of bronchopneumonia uMild bronchopneumonia fever: irregular fever cough:dry,hacking,non-productive to productive cough tachypnea:RR4080ts/m nasal flaring, sighing respiration, three depression signs and cyanosis fixed fine moist rales Pneumonia the clinical manifestations of bronchopneumonia uSevere bronchopneumonia lcirculation system manifestations of myocarditis signs of heart failure lnervous system l gastrointestinal l Chest:X-ray film Pneumonia Severe bronchopneumonia Circulation system myocarditis, congestive heart failure pathogens invading the myocardium and produce toxin toxic myocarditis hypoxia pulmonary artery hypertension CHF Pneumonia manifestation Severe bronchopneumonia manifestations of myocarditis pale tachycardia diminished cardiac sound and arrhythmia ST slowing down T wave updown Pneumonia manifestation Severe bronchopneumonia Signs of heart failure Restless obvious cyanosis grey faces Tachypnea:RR 60ts/m Tachycardia:HR 160-180bpm Sweating dyspnea cervical vein distention oliguria or anuria face/lower limbs edema Hepatomegaly progressively Pneumonia manifestation Severe bronchopneumonia Nervous system: dysphoria(烦躁) irritable alert/stuporous convulsion somnolence(嗜睡) intracranial hypertension Pneumonia manifestation Severe bronchopneumonia Gastrointestinal anorexia vomiting abdominal distention toxic enteritis hemorrhage of GI absent intestinal sound bloody stool Pneumonia manifestation Severe bronchopneumonia Chest:X-ray film diffuse or patchy infiltration small spotted shadow of the right middle Pneumonia manifestation Therapeutic Management principle antimicrobial therapy supportive measures Pneumonia therapy principle control infection promote oxygenation and comfort prevent complication fever management fluid intake family support Pneumonia therapy Antimicrobial therapy PG given by IM or IV PG-allergic: erythromycin clindamycin PG-resistent: cephalosporin PG and cephalosporin-resistent: vancomycin Pneumonia therapy Supportive Measures control cough and dyspnea keep airway clear give oxygen position: semi-reclining Pneumonia therapy Nursing Diagnosis Impaired gas exchange collection mucous in airway Ineffective airway clearance mechanical obstruction, inflammation and increased secretions Pneumonia Anticipated goals uThe child will show normal respiratory function will receive optimum oxygen supply uThe child will maintain patent airway will expectorate secretions adequately Pneumonia Nursing Intervention Restore Optimal Respiratory Function Maintain Airway Cleaning Provide Adequate Rest and Nutrition Observation Prevent Infection Nursing Intervention Restore Optimal Respiratory Function Keep comfortable environment Position child for maximum ventilation semi-reclining position Provide Oxygen: mask nasal cannula intubation mechanical ventilation Maintain Airway Cleaning Institute suctioning of airway, cough effectively and postural drainage Provide nebulization Chest Physiotherapy Administer medications Provide Adequate Rest and Nutrition Provide quiet environment darken room , schedule visiting time Bed rest Appropriate diet high-protein and carbohydrate digestive, nutritional liquid and semi-liquid diet small frequent feeding enteral or parenteral nutrition observation uTemperature:prevent hyperthermia seizure uSigns of heart failure uSigns of intracranial hypertention uSigns of toxic enteroplegia and GI blood Signs of heart failure use cardiac monitor vital signs oxygen saturation breath sounds, color of skin, intake and output, electrolyte levels side effect of medication heart failure signs observation Signs of intracranial hypertension uAlert or stuporous uSeizure ucoma uirregular respiration observation Signs of toxic enteroplegia and GI blood uabdominal distention treatment: supply potassium, dietary restriction, placing nasogastric tube, inject neostigmine. uBowl sound uVomiting uBlood stool observation Prevent Infection Assess signs of infection vital signs, temperature fluctuation sputum culture, sensitivity reports and WBC Maintain aseptic environment Limit visitors and isolate the patients Administer antibiotics Before treatmentAfter treatment several special types of pneumonia Viral pneumonia most common cause: RSV peak attack rate: girls symptom: tachypnea，cyanosis and anxiety signs in infants: lethargic, irritable, toxic gastrointestinal disturbances Pneumonia several special types of pneumonia Mycoplasmal pneumonia(支原体肺炎) age: 5-12 years season: fall and winter