Child Health Nursing/Theory Lecture Notes PDF

Child Health Nursing/Theory (1402340) Lecture Week 4- Part 1 ‘‘The Child with Respiratory Dysfunction” Dr. Haytham Al-Oran Mutah University Faculty of Nursing 27th Oct. 2024 Learning Objectives On completion of this lecture, the...

Child Health Nursing/Theory (1402340) Lecture Week 4- Part 1 ‘‘The Child with Respiratory Dysfunction” Dr. Haytham Al-Oran Mutah University Faculty of Nursing 27th Oct. 2024 Learning Objectives On completion of this lecture, the student will be able to: - Define each key term listed - Discuss various factors associated with respiratory illness in children - Explain etiologic agents, clinical manifestations of upper respiratory tract infections (acute streptococcal pharyngitis, tonsillitis &otitis media) - Describe therapeutic management used for upper respiratory tract infections (acute streptococcal pharyngitis, tonsillitis &otitis media)  General Classifications Upper Respiratory Tract Lower Respiratory Infections Tract Infections Acute viral Bronchitis nasopharyngitis Bronchiolitis Acute streptococcal Pneumonia pharyngitis Tonsillitis Influenza CROUP Otitis media syndromes Long-term respiratory dysfunctions Acute Epiglottitis Acute Laryngotracheobronchitis Asthma Acute Spasmodic Cystic fibrosis Laryngitis Acute Tracheitis Respiratory Infections Described according to the area involvement: Upper respiratory tract: oronasopharynx, pharynx, larynx & upper part of trachea Lower respiratory tract: lower trachea, bronchi, bronchioles & alveoli Respiratory tract infections spread from one structure to another Acute Streptococcal Pharyngitis ❑ Group A beta-hemolytic Streptococcus(GABHS) is the most common causative organism ❑ Children with GABHS infection are at risk for: i. Acute glomerulonephritis (may appear in an average of 10 days) ii. Rheumatic fever (may appear in an average of 18 days)  Acute Streptococcal Pharyngitis (Cont….) ❑ Clinical manifestations Subside in 3-5 days Headache, fever & abdominal pain Inflamed of tonsils & pharynx Uvula is edematous and red  Acute Streptococcal Pharyngitis (Cont….) ❑ Clinical manifestations (Cont….) Strawberry tongue Anterior cervical lymphadenopathy Dysphagia Red- sandpaper-like rash ❑ Diagnostic evaluation Throat swab  Acute Streptococcal Pharyngitis (Cont….) ❑ Therapeutic management Oral penicillin or amoxicillin is prescribed for 10 days Intramuscular (IM) benzathine penicillin G Macrolides Oral cephalosporins ❑ Analgesics (such as acetaminophen or ibuprofen) Children with streptococcal infection are noninfectious to others  Tonsillitis ❑ Tonsils are masses of lymphoid tissue located in the pharyngeal cavity (four types) ❑ Play a role in filter and protect respiratory tracts & antibody formation ❑ Children normally have larger tonsils than adults ❑ Causative agent (Bacterial or viral)  Clinical Manifestations of ❑ Tonsillitis Tonsils enlarged, they may meet in the midline (kissing tonsils) ❑ Difficulty breathing & swallowing ❑ Night snoring = enlarged tonsils or adenoids ❑ Bad breath (halitosis)  Therapeutic Management of ❑ Tonsillitis Antibiotics x 10 days if positive for (GABHS( ❑ Tonsillectomy Indications i. Sleep -disordered breathing ii. Recurrent throat infections: ✔ Seven or more episodes in preceding year ✔ Five or more episodes in each of preceding 2 years ✔ Three or more episodes in each of preceding 3 years Post Operative Care/ Tonsillectom ❑ Prone or side lying position until awake ❑ A soft to liquid diet ,cool water & ice collar ❑ Administer analgesics/ antipyretic / antiemetic ❑ Fluids with a red or brown color are avoided ❑ Milk, ice cream, or pudding is not usually offered  Post Operative Care/ Tonsillectomy ❑ Avoiding coughing or(Cont….) clearing of throat or putting objects in mouth ❑ Routine suctioning is avoided ❑ Inspect for frequent swallowing (bleeding &vomiting of bright red blood) ❑ Resume normal activity within 1-2 weeks after operation  Otitis Media Otitis media with effusion Acute otitis media (AOM) (OME) -Fluid in middle ear without -Inflammation of middle symptoms of acute infection ear with a rapid onset of the signs and symptoms Incidenc e highest in the winter months ❑ Occur in first 24 months of life, but incidence decreases with age  Otitis Media (Cont... ❑ Causative pathogens.) i. Streptococcus pneumoniae ii. Haemophilus influenzae ii. Moraxella catarrhalis ❑ Predisposing factors Viral respiratory tract infection (Respiratory syncytial virus[RSV] or Influenza) Allergic rhinitis, Down syndrome, cleft palate, daycare attendance, passive smoking and bottle propping during feeding Infants fed breast milk have a lower incidence of OM than formula-fed infants nical ❑ Fever Manifestations of Otitis Med ❑ Irritable and indicate their discomfort by holding or pulling at their ears and rolling their head from side to side ❑ Earache (otalgia) ❑ Purulent discharge (otorrhea) ❑ Loss of appetite & refusal to feed  Diagnostic Evaluation of Otitis Media ❑ Assessment of tympanic membrane Tympanic membrane: (a)Normal, (b) Acute otitis media, (c) Otitis media  Therapeutic Management of Otitis Media ❑ First-line antibiotics (oral amoxicillin; recommended for 5 to 7 days with older than 2 years old , and 10 days with younger children) ❑ Second-line antibiotics (include amoxicillin/clavulanate OR Macrolides OR cephalosporins) herapeutic Management of Otitis Media (Cont ❑ Supportive care (Acetaminophen or ibuprofen) ❑ Myringotomy (to alleviate severe pain) ❑ Tympanostomy tube (treat recurrent chronic OM) Prognosis of OM