儿童呼吸系统疾病英课件

1、 Respiratory Dysfunction儿童呼吸系统疾病英1 Respiratory Dysfunction儿童Anatomy and Physiology of the Childhood Respiratory SystemUpper respiratory tract NosePharynxLarynxEpiglottisLower respiratory tractTracheaBronchiBronchioles and alveoli儿童呼吸系统疾病英2Anatomy and Physiology of the The Upper Airway differences: s

2、horter and narrow 4 mm 20 mm nose breather airway resistance loosely mucous membranes and soft tissue The Lower Airway differences: right bronchus is more wider, shorter, vertical less alveolar surface areaAnatomy and Physiology of the Childhood Respiratory System儿童呼吸系统疾病英3 The Upper Airway differen

3、ces:Pneumonia儿童呼吸系统疾病英4Pneumonia儿童呼吸系统疾病英4Definition An inflammation or infection of the bronchioles and alveolar spaces of the lungsPneumonia 儿童呼吸系统疾病英5Definition An inflammation or Introduction occur: in infants and young children recovery: children sooner than adults exist type: disease or compli

4、cation season: late winter and early spring Pneumonia 儿童呼吸系统疾病英6Introduction occur: in infan Lobar pneumonia Bronchopneumonia (lobular pneumonia) Interstitial pneumoniaPneumonia classificationMorphological classification儿童呼吸系统疾病英7 Pneumonia classificationMEtiologic Agent Infectiousvirus bacterial My

5、coplasma(支原体肺炎) chlamydial （衣原体肺炎）fungi pneumocystis(肺囊虫) Noninfectious foreign body aspirationPneumonia classification儿童呼吸系统疾病英8Etiologic Agent Noninfectious Course Agent Acute 3 months Pneumonia classification儿童呼吸系统疾病英9Course Agent Pneumonia classState of Illness Mild Severe Pneumonia classificati

6、on儿童呼吸系统疾病英10State of IllnessPneumonia clasthe clinical manifestations of bronchopneumoniaMild 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 ra

7、lesPneumonia 儿童呼吸系统疾病英11the clinical manifestations ofthe clinical manifestations of bronchopneumoniaSevere bronchopneumoniacirculation systemmanifestations of myocarditissigns of heart failurenervous system gastrointestinal Chest:X-ray filmPneumonia 儿童呼吸系统疾病英12the clinical manifestations ofSevere b

8、ronchopneumonia Circulation system myocarditis, congestive heart failure pathogens invading the myocardium and produce toxintoxic myocarditishypoxia pulmonary artery hypertensionCHFPneumonia manifestation儿童呼吸系统疾病英13Severe bronchopneumonia Severe bronchopneumonia manifestations of myocarditis pale ta

9、chycardia diminished cardiac sound and arrhythmia ST slowing down T wave updown Pneumonia manifestation儿童呼吸系统疾病英14Severe bronchopneumonia Severe bronchopneumoniaSigns of heart failure Restless obvious cyanosis grey facesTachypnea:RR 60ts/mTachycardia:HR 160-180bpmSweating dyspnea cervical vein diste

10、ntionoliguria or anuria face/lower limbs edemaHepatomegaly progressively Pneumonia manifestation儿童呼吸系统疾病英15 Severe bronchopneumoniSevere bronchopneumonia Nervous system: dysphoria(烦躁) irritable alert/stuporous convulsion somnolence(嗜睡) intracranial hypertension Pneumonia manifestation儿童呼吸系统疾病英16Seve

11、re bronchopneumonia PneSevere bronchopneumonia Gastrointestinal anorexia vomiting abdominal distention toxic enteritis hemorrhage of GI absent intestinal sound bloody stoolPneumonia manifestation儿童呼吸系统疾病英17Severe bronchopneumonia Severe bronchopneumonia Chest:X-ray film diffuse or patchy infiltratio

12、n small spotted shadow of the right middlePneumonia manifestation儿童呼吸系统疾病英18Severe bronchopneumonia smTherapeutic Management principle antimicrobial therapy supportive measuresPneumonia therapy儿童呼吸系统疾病英19Therapeutic ManagementPneumoniprinciple control infection promote oxygenation and comfort preven

13、t complication fever management fluid intake family support Pneumonia therapy儿童呼吸系统疾病英20principlePneumonia therapy儿童呼吸Antimicrobial therapy PG given by IM or IV PG-allergic: erythromycin clindamycin PG-resistent: cephalosporin PG and cephalosporin-resistent: vancomycin Pneumonia therapy儿童呼吸系统疾病英21An

14、timicrobial therapy Supportive Measures control cough and dyspnea keep airway clear give oxygen position: semi-reclining Pneumonia therapy儿童呼吸系统疾病英22Supportive Measures contrNursing Diagnosis Impaired gas exchange collection mucous in airway Ineffective airway clearance mechanical obstruction, infla

15、mmation and increased secretions Pneumonia 儿童呼吸系统疾病英23Nursing Diagnosis ImpairedAnticipated goalsThe child will show normal respiratory function will receive optimum oxygen supplyThe child will maintain patent airway will expectorate secretions adequatelyPneumonia 儿童呼吸系统疾病英24Anticipated goalsThe chi

16、ld wilNursing Intervention儿童呼吸系统疾病英25Nursing Intervention儿童呼吸系统疾病英2 Restore Optimal Respiratory Function Maintain Airway Cleaning Provide Adequate Rest and Nutrition Observation Prevent InfectionNursing Intervention儿童呼吸系统疾病英26 Restore Optimal Respirator Restore Optimal Respiratory Function Keep comf

17、ortable environment Position child for maximum ventilation semi-reclining position Provide Oxygen: mask nasal cannula intubation mechanical ventilation儿童呼吸系统疾病英27 Restore Optimal Respiratory Maintain Airway Cleaning Institute suctioning of airway, cough effectively and postural drainage Provide nebu

18、lization Chest Physiotherapy Administer medications儿童呼吸系统疾病英28Maintain Airway Cleaning IProvide 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

19、frequent feeding enteral or parenteral nutrition 儿童呼吸系统疾病英29Provide Adequate Rest and NutrobservationTemperature:prevent hyperthermia seizureSigns of heart failureSigns of intracranial hypertentionSigns of toxic enteroplegia and GI blood儿童呼吸系统疾病英30observationTemperature:preventSigns of heart failure

20、 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儿童呼吸系统疾病英31Signs of heart failure usSigns of intracranial hypertensionAlert or stuporousSeizurecoma irregular respiration ob

21、servation儿童呼吸系统疾病英32Signs of intracranial hypertenSigns of toxic enteroplegia and GI bloodabdominal distention treatment: supply potassium, dietary restriction, placing nasogastric tube, inject neostigmine.Bowl soundVomitingBlood stoolobservation儿童呼吸系统疾病英33Signs of toxic enteroplegia anPrevent Infec

22、tion 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儿童呼吸系统疾病英34Prevent Infection Assess sBefore treatmentAfter treatment儿童呼吸系统疾病英35Before treatmentAf

23、ter treatmen several special types of pneumonia Viral pneumonia most common cause: RSV peak attack rate: 2 age onset: acute or insidious symptom: fever, cough, tachypnea, nasal flaring cyanosis, respiratory fatigue IntercostalSubcostalSuprasternal Pneumonia 儿童呼吸系统疾病英36 several special types several