Nursing Management of Respiratory Infections

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Questions and Answers

What is the percentage of pneumonia instances that were severe enough to necessitate hospitalization?

15-20%

20-25%

7-13% (correct)

1-5%

Which factor is NOT mentioned as influencing the course of respiratory infections in children?

Nutritional status (correct)

Age of the child

Season

Preexisting medical problems

What anatomical feature makes infants more prone to respiratory difficulties?

Longer bronchi

Shorter and wider Eustachian tubes

Wider tracheal lumen

Less alveolar surface area (correct)

Which type of tonsils is located at the base of the tongue?

Lingual Signup and view all the answers

Which of the following is NOT a common symptom of tonsillitis?

Headaches Signup and view all the answers

What type of infections are the upper respiratory tract infections commonly associated with in children?

Otitis media Signup and view all the answers

What is the primary function of the tonsils?

To filter and protect respiratory and alimentary tracts Signup and view all the answers

Why are infants more likely to experience respiratory difficulties compared to older children?

They have less IgA production in pulmonary mucosa. Signup and view all the answers

What is the recommended duration for antibiotic treatment in cases of bacterial tonsillitis?

7 to 10 days Signup and view all the answers

Which of the following is NOT a contraindication for tonsillectomy?

Chronic headaches Signup and view all the answers

Which symptom is typically associated with tonsillitis?

Difficulty swallowing Signup and view all the answers

What is a common analgesic used for promoting comfort in patients with tonsillitis?

Acetaminophen Signup and view all the answers

After a tonsillectomy, which position is recommended for children to facilitate secretion drainage?

On the abdomen or side lying Signup and view all the answers

Which of the following fluids should be avoided post-tonsillectomy?

Citrus juices Signup and view all the answers

What is a primary nursing diagnosis related to tonsillitis?

Ineffective airway clearance related to discomfort Signup and view all the answers

Which statement accurately describes post-operative care after a tonsillectomy?

Activities that may aggravate the operative site should be minimized. Signup and view all the answers

What is the highest incidence age group for otitis media?

Children aged 6 months to 2 years Signup and view all the answers

Which gender is more frequently affected by otitis media in children under school age?

Boys Signup and view all the answers

What is a common predisposing factor for otitis media?

Household smokers Signup and view all the answers

What bacterial agent is commonly associated with otitis media?

Streptococcus pneumoniae Signup and view all the answers

Which symptom is NOT typically associated with acute otitis media in children?

Cough Signup and view all the answers

What occurs when the eustachian tube is blocked?

Fluid retention in the middle ear Signup and view all the answers

What may indicate an abnormal observation of the tympanic membrane during otoscopy?

A dull-gray membrane with visible fluid level Signup and view all the answers

How might an infant express discomfort due to otitis media?

Crying and pulling at the ear Signup and view all the answers

Which symptom is NOT commonly associated with Chronic Otitis Media?

Barking cough Signup and view all the answers

What is the primary purpose of tympanostomy tubes in the treatment of Chronic Otitis Media?

To facilitate drainage and ventilation of the middle ear Signup and view all the answers

What nursing diagnosis is related to the pressure caused by the inflammatory process in Chronic Otitis Media?

Discomfort related to pressure Signup and view all the answers

Which intervention is NOT recommended for a child experiencing discomfort due to Chronic Otitis Media?

Frequent cleansing with soap and water Signup and view all the answers

What is a common characteristic of croup syndrome in children?

Barking cough that worsens at night Signup and view all the answers

When observing a child with croup, which symptom might indicate worsening condition?

Noisy inspirations and restlessness Signup and view all the answers

Which treatment option is NOT typically used for managing croup symptoms?

Antihistamines Signup and view all the answers

What nursing intervention is most appropriate for a child with Chronic Otitis Media to promote drainage?

Encourage the child to lie on the affected side Signup and view all the answers

Study Notes

Nursing Management of Upper and Lower Respiratory Infections and Disorders

Respiratory infections are a leading cause of infant mortality in developing countries.
150 million episodes of community-acquired pneumonia, and 2 million pneumonia-related deaths occur in children under 5 years old in developing countries.
7-13% of pneumonia cases are severe enough to be life-threatening.
Respiratory tract infections are the most common acute illnesses in children.
The cause and severity of infections are influenced by factors such as age, season, living conditions, and pre-existing medical problems.

Developmental Variations of the Respiratory System in Children

The respiratory tract is shorter and the structures are closer together in children, making transmission of infectious pathogens more efficient.
Infants primarily use abdominal muscles for breathing.
Infants have a lower IgA (immunoglobulin A) production in the pulmonary mucosa, making them more prone to respiratory difficulties from mucus, edema, or foreign objects.
Children have less alveolar surface area for gas exchange.

Eustachian Tube

The Eustachian tube in young children is shorter and wider, and more horizontal than in older children.
This position reduces the benefit of gravity for drainage, increasing the risk for issues like otitis media.

Upper Respiratory Infections (URIs) in Children

Tonsillitis:
- Tonsils are masses of lymphoid tissue in the throat.
- Their main functions are to filter and protect the respiratory and alimentary tracts from pathogens.
- They also aid in antibody formation.
- Types of tonsils include Palatine, Pharyngeal (adenoids), Lingual, and Tubal.
- Tonsillitis is characterized by tonsil swelling, caused by bacterial or viral infection.
Otitis Media:
- Inflammation and fluid accumulation in the middle ear.
- The Eustachian tube is often narrower than in older children, which obstructs secretions and leads to middle ear infections.
- More common in young children due to horizontal Eustachian tubes and frequent respiratory infections.
Laryngotracheobronchitis (Croup):
- A viral infection of the upper airway, causing inflammation.
- Typically occurs in children 3 months to 5 years old, with a peak during the second year of life.

Bronchiolitis

Acute respiratory distress and wheezing in infants.
Caused by viral infections affecting the small airways (bronchioles), narrowing them and hindering breathing.
More common during winter months.

Asthma

Causes swelling and inflammation in airways leading to the lungs.
Airway tightening and narrowing occurs during asthma attacks, hindering air passage and causing breathing difficulties.
Causes include heredity, allergies, pollution (indoor/outdoor), foods, cold air, strong emotions and exercise.

Pneumonia

A lung infection caused by bacteria, viruses, parasites, or other agents (like aspiration or ingestion of chemical agents).
Infection causes fluid or mucus buildup in air sacs (alveoli) in the lungs, making breathing difficult and causing coughing.
Common in winter months, with children under 2 years old at higher risk.

Nursing Considerations for Infections

General care: rest and comfort, adequate hydration (warm liquids), soft liquid diet, cool mist, salt gargles, or throat lozenges.
Medical interventions: antibiotics (when bacterial), pain/fever reducers.
Surgical interventions: tonsillectomy (for severe cases) or adenoidectomy.
Post-operative care: positioning to facilitate drainage, suctioning, observing for complications (bleeding), soft foods.
Home care: Avoiding activities that could worsen bleeding. Monitoring for post-operative bleeding. teaching about home care.

Nursing Diagnoses

Ineffective airway clearance
Impaired swallowing
Pain related to surgery
Altered oral mucous membranes
High risk for injury
Anxiety/fear
Altered family processes
Discomfort (Pressure due to inflammation)
High risk for impaired skin integrity (related to drainage)

Nursing Interventions and Management

Specific to tonsillectomy: Position the child for drainage. Minimize activities that may cause bleeding.
Specific to Otitis Media: Administer antibiotics. Position for drainage or use a heating pad. Administer antibiotics promptly.
Specific to Bronchiolitis: Provide supplemental oxygen, encourage breast milk or fluids, monitor vital signs.
Specific to Asthma: Administer inhaled corticosteroids and bronchodilators.
Specific to pneumonia: Administer antibiotics, monitor for signs of dehydration.

Important Considerations for Respiratory Disorders in Infants/Children

The severity and course of respiratory infections depend on various factors and may require medical or surgical interventions.
It's vital to prioritize the child's airway, breathing, and circulation (ABCs).
Early recognition and appropriate management are crucial for preventing complications and improving patient outcomes.

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Description

Explore the critical aspects of nursing management for upper and lower respiratory infections and disorders in children. This quiz covers the prevalence, causes, and developmental variations of respiratory systems in pediatric patients. Understand the implications of respiratory infections on child mortality and the importance of timely intervention.