lower respiratory tract disorder

LOWER RESPIRATORY TRACT DISORDERS

Presented By:Pandya Tejas.J.

2nd Year M.Sc Nursing StudentChild Health Nursing

Sumandeep Nursing College

1/6/2015 2

Anatomy of the Lower Respiratory Tract

1/6/2015 Free template from www.brainybetty.com 3

1/6/2015 Free template from www.brainybetty.com 4

1/6/2015 Free template from www.brainybetty.com 5

1/6/2015 Free template from www.brainybetty.com 6

1/6/2015 Free template from www.brainybetty.com 7

1/6/2015 Free template from www.brainybetty.com 8

1/6/2015 Free template from www.brainybetty.com 9

1/6/2015 Free template from www.brainybetty.com 10

Role of Nurse

1/6/2015 Free template from www.brainybetty.com 11

1/6/2015 Free template from www.brainybetty.com 12

Bronchopneumonia

1/6/2015 Free template from www.brainybetty.com 13

Introduction:Pneumonia is an inflammation of thePneumonia is an

inflammation of the parenchyma of the lungs.parenchyma

of the lungs.

Pneumonia can be classified anatomically

asPneumonia can be classified anatomically as lobar or

lobularlobar or lobular,,

bronchopnemoniabronchopnemonia andand interstitial

pneumoniainterstitial pneumonia.

Pathologically there is consolidation of

alveoliPathologically there is consolidation of alveoli or

infiltration of the interstitial tissue withor infiltration of the

interstitial tissue with inflammatory cell or bothinflammatory

cell or both

1/6/2015 Free template from www.brainybetty.com 14

Definition:

Acute inflammation of the walls of the smaller bronchial

tubes, with irregular areas of consolidation due to spread of

the inflammation into the peribronchiolar alveoli and the

alveolar ducts of the lungs.

INCUBATION PERIOD IS 1 TO 3 DAYS

1/6/2015 Free template from www.brainybetty.com 15

Etiology:-• Viral Pneumonia by RSV Influenza

• Bacterial:-

• Klebsiella

• E. coli

• H. influenza

• Gram (+)& (-) Bacteria

• Staphylococcus

• Chlamydia & Mycoplasma organism

• Pneumocystis carinii

• Fungi

• Histoplasmosis

• Coccidiomycosis

• Metazoa

• Aspiration of food, oily nose drops and liquid paraffin

• Kerosene poisoning

• Hypersensitivity pneumonia 16

Some terms

Recurrent pneumonia is defined is defined as 2 or as 2

or more episodes in a single yr episodes in a single yr or

3 or more or 3 or more episodes ever, with radiographic

clearing episodes ever, with radiographic clearing

between occurrences. between occurrences.

Slowly resolving pneumonia refers to the refers to the

persistence of symptoms or radiographic persistence of

symptoms or radiographic abnormalities beyond the

expected time abnormalities beyond the expected time

course.

1/6/2015 Free template from www.brainybetty.com 17

PATHOPHYSIOLOGY:

1/6/2015 Free template from www.brainybetty.com 18

Clinical Manifestation• Onset of pneumonia may be insidious starting Onset of

pneumonia may be insidious starting with URTI or may be

acute with high fever,

• Dypsnea

• grunting respiration.

• Respiratory rate always is increased.

• In drawing of chest

1/6/2015 Free template from www.brainybetty.com 19

Conti…• Nasal Flare Nasal flaring: with inspiration, the side of the

nostrils flares outwards

• Wheezing

• Coughing

• High fever

• Crackles

• techypnea

• Chest pain

• Respiratory distress

1/6/2015 Free template from www.brainybetty.com 20

Diagnosis

1/6/2015 Free template from www.brainybetty.com 21

Conti…

• The peripheral white blood cell (WBC) count can be The

peripheral white blood cell (WBC) count can be useful in

differentiating viral from bacterial useful in differentiating

viral from bacterial pneumonia.

• In viral pneumonia, the WBC count can be normal or

elevated but is usually not higher than

20,000/mm3,elevated, with a lymphocyte predominance.

Bacterial with a lymphocyte predominance. Bacterial

pneumonia (occasionally, adenovirus pneumonia)

ispneumonia (occasionally, adenovirus pneumonia) is

often associated with an elevated WBC count in the often

associated with an elevated WBC count in the range of

15,000-40,000/mm3 and granulocytes.

1/6/2015 Free template from www.brainybetty.com 22

Conti….Chest X-ray

CT-Scan

ASO-titer

Tuberculin Skin Test

1/6/2015 Free template from www.brainybetty.com 23

Treatment

1/6/2015 Free template from www.brainybetty.com 24

1/6/2015 Free template from www.brainybetty.com 25

Prevention

1/6/2015 Free template from www.brainybetty.com 26

1/6/2015 Free template from www.brainybetty.com 27

• Treatment of suspected bacterial pneumonia is based on

the presumptive cause and the clinical appearance on

the presumptive cause and of the child.

• For mildly ill children who do not require hospitalization,

amoxicillin is recommended. In communities with a high

percentage of penicillin-resistant pneumococci, high (80–

90 mg/kg/24 hr) should be prescribed.90 mg/kg/24 hr)

should be prescribed.

• Therapeutic alternatives include cefuroxime axetil or

amoxicillin/clavulanate amoxicillin/clavulanate

1/6/2015 Free template from www.brainybetty.com 28

• For school-aged children and in those in whom infection with M.

pneumonia or C. pneumoniae (atypical pneumonias) is

suggested, a macrolide antibiotic such as azithromycin is an

appropriate choice.

• In adolescents, a respiratory fluoroquinolone , a respiratory

fluoroquinolone (levofloxacin, gatifloxacin, moxifloxacin, may

be considered for atypicalgemifloxacin).

• The empirical treatment of suspected bacterial pneumonia in a

hospitalized child requires an pneumonia in a clinical

manifestations at the time of presentation.

• Parenteral cefuroxime (150 mg/kg/24 hr), cefotaxime, or

ceftriaxone is the mainstay of therapy cefotaxime, when bacterial

pneumonia is suggested.

• If clinical features suggest staphylococcal pneumonia

(pneumatoceles, empyema), initial antimicrobial therapy should

also include vancomycin or therapy should also include

vancomycin or clindamycin.clindamycin. 29

Complication

1/6/2015 Free template from www.brainybetty.com 30

If present of the plural effusion perform the

Inter costal Drainage

1/6/2015 Free template from www.brainybetty.com 31