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1、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 mm 20 mm nose breather airway resistance loosel
2、y mucous membranes and soft tissue The Lower Airway differences: right bronchus is more wider, shorter, vertical less alveolar surface area,Anatomy and Physiology of the Childhood Respiratory System,Definition,An inflammation or infection of the bronchioles and alveolar spaces of the lungs,Pneumonia
3、,Introduction,occur: in infants and young children recovery: children sooner than adults exist type: disease or complication season: late winter and early spring,Pneumonia,Lobar pneumonia Bronchopneumonia (lobular pneumonia) Interstitial pneumonia,Pneumonia,classification,Morphological classificatio
4、n,Etiologic Agent,Infectious virus bacterial Mycoplasma(支原体肺炎) chlamydial （衣原体肺炎） fungi pneumocystis(肺囊虫),Noninfectious foreign body aspiration,Pneumonia,classification,Course Agent,Acute 3 months,Pneumonia,classification,State of Illness,Mild Severe,Pneumonia,classification,the clinical manifestati
5、ons of bronchopneumonia,Mild 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,Seve
6、re bronchopneumonia circulation system manifestations of myocarditis signs of heart failure nervous system gastrointestinal Chest:X-ray film,Pneumonia,Severe bronchopneumonia,Circulation system myocarditis, congestive heart failure,pathogens,invading the myocardium and produce toxin,toxic myocarditi
7、s,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 cya
8、nosis 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(
9、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,
10、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,therap
11、y,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 D
12、iagnosis,Impaired gas exchange collection mucous in airway Ineffective airway clearance mechanical obstruction, inflammation and increased secretions,Pneumonia,Anticipated goals,The child will show normal respiratory function will receive optimum oxygen supply The child will maintain patent airway w
13、ill 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 f
14、or 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 a
15、nd 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,Temperature:prevent hyperthermia seizure Signs of
16、heart failure Signs of intracranial hypertention Signs 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,Alert or stuporous Seizur
