兒童呼吸系統(tǒng)疾病英文版

1、Respiratory Dysfunction,,Anatomy and Physiology of the Childhood Respiratory System,Upper respiratory tract NosePharynxLarynxEpiglottisLower respiratory tractTracheaBronchiBronchioles and alveoli,The Upper Airwa

2、y differences: shorter 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

3、 less alveolar surface area,Anatomy and Physiology of the Childhood Respiratory System,,Pneumonia,Definition,An inflammation or infection of the bronchioles and alveolar spaces of the lungs,,Pneumonia,Introduction,occ

4、ur: 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 p

5、neumonia) Interstitial pneumonia,Pneumonia,classification,Morphological classification,Etiologic Agent,Infectiousvirus bacterial Mycoplasma(支原體肺炎) chlamydial （衣原體肺炎）fungi pneumocystis(肺囊蟲(chóng)),Noninfectious fo

6、reign body aspiration,,Pneumonia,classification,Course Agent,Acute 3 months,,Pneumonia,classification,State of Illness,Mild Severe,,Pneumonia,classification,the clinical manifestations of bronchopne

7、umonia,Mild bronchopneumonia fever: irregular fever cough:dry,hacking,non-productive to productive cough tachypnea:RR40~80ts/m nasal flaring, sighing respiration, three depre

8、ssion signs and cyanosis fixed fine moist rales,Pneumonia,,the clinical manifestations of bronchopneumonia,Severe bronchopneumoniacirculation systemmanifestations of myocarditissigns of heart failurene

9、rvous system gastrointestinal Chest:X-ray film,Pneumonia,,Severe bronchopneumonia,Circulation system myocarditis, congestive heart failure,pathogens,invading the myocardium and produce toxin,toxic myocarditis

10、,hypoxia,pulmonary artery hypertension,CHF,,,,,,,Pneumonia,manifestation,Severe bronchopneumonia,manifestations of myocarditis pale tachycardia diminished cardiac sound and arrhythmia

11、 ST slowing down T wave updown,,Pneumonia,manifestation,Severe bronchopneumonia,Signs of heart failure Restless obvious cyanosis grey facesTachypnea:RR> 60ts/mTachycardia:HR> 160-180b

12、pmSweating dyspnea cervical vein distentionoliguria or anuria face/lower limbs edemaHepatomegaly progressively,,Pneumonia,manifestation,Severe bronchopneumonia,Nervous system: dysphoria(煩躁) irritabl

13、e alert/stuporous convulsion somnolence(嗜睡) intracranial hypertension,,Pneumonia,manifestation,Severe bronchopneumonia,Gastrointestinal,anorexia vomiting abdominal distention

14、 toxic enteritis hemorrhage of GI absent intestinal sound bloody stool,,Pneumonia,manifestation,Severe bronchopneumonia,Chest:X-ray film di

15、ffuse or patchy infiltration,small spotted shadow of the right middle,,Pneumonia,manifestation,Therapeutic Management,principle antimicrobial therapy supportive measures,,Pneumonia,therapy,principle,control infecti

16、on 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

17、 clindamycin PG-resistent: cephalosporin PG and cephalosporin-resistent: vancomycin,,Pneumonia,therapy,Supportive Measures,control cough and dyspnea keep airway clear give ox

18、ygen position: semi-reclining,,Pneumonia,therapy,Nursing Diagnosis,Impaired gas exchange collection mucous in airway Ineffective airway clearance mechanical obstruction, inflammation

19、 and increased secretions,,Pneumonia,Anticipated goals,The child will show normal respiratory function will receive optimum oxygen supplyThe child will maintain patent airway will expectorate secretions adeq

20、uately,Pneumonia,,Nursing Intervention,,,,Restore Optimal Respiratory Function Maintain Airway Cleaning Provide Adequate Rest and Nutrition Observation Prevent Infection,,Nursing Intervention,Restore Optimal

21、Respiratory Function,Keep comfortable environment Position child for maximum ventilation — semi-reclining position Provide Oxygen: mask nasal cannula intubation mechanical ventilation,,Maintain Airway

22、Cleaning,Institute suctioning of airway, cough effectively and postural drainage Provide nebulization Chest Physiotherapy Administer medications,,Provide Adequate Rest and Nutrition,Provide quiet e

23、nvironment darken room , schedule visiting time Bed rest Appropriate diet high-protein and carbohydrate digestive, nutritional liquid and semi-liquid diet small frequent

24、feeding enteral or parenteral nutrition,,,,observation,Temperature:prevent hyperthermia seizureSigns of heart failureSigns of intracranial hypertentionSigns of toxic enteroplegia and GI blood,,Signs of h

25、eart 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,,observa

26、tion,Signs of intracranial hypertension,Alert or stuporousSeizurecoma irregular respiration,,observation,Signs of toxic enteroplegia and GI blood,abdominal distention treatment: supply potassium, dietary rest

27、riction, placing nasogastric tube, inject neostigmine.Bowl soundVomitingBlood stool,,observation,Prevent Infection,Assess signs of infection vital signs, temperature fluctuation sputum culture

28、, sensitivity reports and WBC Maintain aseptic environment Limit visitors and isolate the patients Administer antibiotics,,Before treatment,After treatment,,several special types of pneumonia

29、,Viral pneumonia most common cause: RSV peak attack rate: < 2 age onset: acute or insidious symptom: fever, cough, tachypnea, nasal flaring cyano

30、sis, respiratory fatigue,,IntercostalSubcostalSuprasternal,,,Pneumonia,several special types of pneumonia,Staphylococcal pneumonia（葡萄球菌肺炎） season: October and May following: viral upper respiratory tract

31、 age: girls symptom: tachypnea，cyanosis and anxiety signs in infants: lethargic, irritable, toxic gastrointestinal disturbances,,Pneumonia,several special types of pneumonia,Mycoplasmal pneumonia(支原體肺炎)

32、 age: 5-12 years season: fall and winter symptom: dry, hacking cough, fever extrapulmonary complications: blood, heart, CNS,,Pneumonia,several special types of pneumonia,Chlamydial pneumonia（衣原體肺炎） age: < 6 mont