Respiratory system
Upper respiratory tract infection
Infection and inflammation of the sinuses is known as sinusitis. Sinuses are air field cavities located in the face and skull.
Explain the Etiology/causes of sinusitis.
Viral infection
Bacterial infection
Due to dental sepsis
Allergies
Nasal polyps
Structural problem (deviated nasal septum)
Immune system disorders
Changes in the Temperature and Air.
Explain the Classification of sinusitis.
Sinusitis is classified based on its duration and severity as follows.
On the basis of duration:
1) Acute sinusitis
Acute sinusitis is characterized by symptoms of sinusitis lasting less than four weeks. Which is mainly seen due to bacterial or viral infection. In which facial pain, nasal congestion, nasal discharge and fatigue are seen.
2) Subacute sinusitis
In subacute sinusitis, symptoms of sinusitis occur for 4 to 12 weeks. It has symptoms similar to acute sinusitis but is less severe.
3) Chronic sinusitis
Chronic sinusitis is when symptoms of sinusitis persist for 12 weeks or more. Chronic sinusitis is caused by persistent inflammation, recurrent infection, allergies, or structural issues.
4) Recurrent sinusitis
Multiple episodes of acute sinusitis within a year are known as recurrent sinusitis.
On the basis of location:
1) Maxillary sinusitis
Maxillary sinusitis is an inflammation of the maxillary sinus located in the cheekbone. Maxillary sinusitis is the most common type of sinusitis.
2) Frontal sinusitis
Frontal sinusitis involves inflammation of the frontal sinuses. Which is located behind the forehead and it does the frontal head.
3) Ethmoid sinusitis
Ethmoid sinusitis involves inflammation of the ethmoid sinuses. Which is located between the ice. And it causes pain and pressure around the eye.
4) Sphenoid sinusitis
Sphenoid sinusitis involves inflammation of the sphenoid sinus. It is located behind the ethmoid sinus and deep in the skull. Which causes earache, headache and neck pain.
Explain the clinical manifestations/ Sign and symptoms of sinusitis.
Clinical signs depend on the type and severity of sinusitis.
Facial pain and pressure in eye, forehead, nose and cheek area.
Nasal congestion,
There is blockage and stuffiness in the nasal passages.
Nasal discharge
Thick discolored mucus discharge is seen.
Reduces sense of smell and taste
Cough
Sore throat
Fatigue
Fever
Head one
Toothache
Ear pressure or fullness
Halitosis
Vertigo
Blurred vision
Explain the diagnostic evaluation of sinusitis.
History Collection
Physical Examination
x ray
CT scan
Endoscopy
Rhinoscopy
Radiology
Explain the medical management of sinusitis.
Nasal decongestant
Administer nasal sprays or oral decongestants to reduce nasal congestion. So that drainage can be promoted. Do not use nasal decongestant sprays for long periods of time. Because it rebound congestion.
Saline nasal irrigation
Using a saline solution to flush out the nasal passages helps clear mucus and reduces inflammation and promotes drainage.
Nasal corticosteroid
Use of nasal corticosteroids to reduce inflammation of the nasal passages and sinuses and to relieve symptoms of congestion.
Antibiotic
If the sinusitis is due to a bacterial infection, provide antibiotic drugs to treat it.
Ex := Penicillin (Ampicillin).
Pain relievers (analgesic) Provide over the counter medicine to relieve facial pain, headache, earache, acetaminophen, ibuprofen,
Aspirin.
Mucolytics
Provide mucolytic drugs to thin and loosen mucus so that sinus drainage can be improved.
Provide proper steam inhalation to the child.
Provide antihistamine medication to the child.
Advise the child to rest in a properly well ventilated room.
To provide the child with nutritional diet, adequate fluid and nutritive diet with vitamins.
Explain the surgical management of sinusitis.
Surgical management is performed when medical management fails. The following are common surgical procedures performed for the management of sinusitis.
Functional Endoscopy Sinus Surgery (FESS)
FESS is the most common surgical procedure used for the treatment of chronic sinusitis. In which a thin flexible tube is attached to the endoscope and a camera is attached to it. With the help of which sinuses are visualized. The endoscope is introduced into the nostril through the nasal cavity and obstructions such as nasal polyps, scar tissue and bony growth are removed and the sinus opening is widened.
Image Guided Surgery
Image guided surgery is performed when the anatomy is distorted due to previous surgery or other diseases. In which location is decided and surgery is done with the help of CTscan or other image guided method.
Balloon sinuplasty
This is a minimally invasive procedure in which a small flexible balloon catheter is inserted into the inflamed sinus and the balloon is inflated to dilate and expand the opening of the sinus.
Cardwell Luck Operation
The Cardwell Luck operation is mainly performed for the treatment of chronic maxillary sinusitis. In which a large window is created in the maxillary sinus to improve drainage.
Sinus irrigation
In some cases, surgical management involves placing a sinus irrigation device such as a sinus stent or irrigation tube to promote drainage and reduce the risk of inflammation and infection.
Ethmoidectomy, maxillary antrostomy, sphenoidotomy
This is a specific procedure that targets the ethmoid, maxillary, and sphenoid sinuses by opening them and removing abnormal tissue and improving drainage.
Explain the Nursing management of sinusitis.
Proper assessment of the child.
To properly assess whether the child has symptoms like nasal congestion, facial pain, fever, nasal discharge or not.
To provide proper comfort measures to the child to relieve the child’s symptoms.
If the child is experiencing facial pain, provide analgesic medication to the child.
Maintain the child’s hydration status by providing adequate amount of fluid to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, symptoms and signs, and its treatment.
Continuously monitoring how effective the child’s treatment is.
Advise the child to take adequate rest.
Provide complete education to Jai Hind and his family members about preventive measures of Sinusitis including good hand hygiene, avoid exposure to tobacco and smoking, and give advice for adequate immunization.
To properly collaborate with other health care personnel for proper care of the child.
Advising parents of child to take proper follow up.
Advising the child’s parents to provide proper medication to the child.
Adenoids (which are small masses of tissue located behind the nasal cavity, near the throat). An infection or inflammation of the adenoids is called adenoiditis, the adenoids are part of the immune system and help trap bacteria and viruses that enter the body through the nose. Adenoiditis in children is usually caused by bacterial and viral infections.
In this there is abnormal growth of lymph nodes and it grows at the site of nasopharynx.
Tonsils and adenoids are lymphoid structures and are located mainly in the oropharynx and nasopharynx. They are flower-sized in childhood and become smaller as they move into adulthood.
Explain the Etiology/cause of Adenoiditis
The exact cause is unknown.
Streptococcus bacteria,
Staphylococcus bacteria,
Due to virus,
AD virus,
entero virus,
Due to frequent upper respiratory tract infections.
Explain the Clinical Manifestation / Sign and symptoms of the Adenoiditis.
Nasal obstruction.
Dull facial expression.
Nasopharyngeal blockage.
Difficulty swallowing.
Difficulty hearing.
difficulty speaking,
sore throat,
Breathing difficulties,
Ear problem,
swollen gland,
Getting a fever.
Explain the Diagnostic evaluation of the Adenoiditis.
History Collection,
Physical Examination,
Nasal endoscopy,
imaging studies,
x ray,
city scan,
laboratory test,
Throat swab.
Explain the surgical management of the Adenoiditis
Here, the tonsils and adenoids are surgically removed.
Preoperative nursing management
To admit the child to the hospital for surgery.
Complete examination of the child.
If there are children, prepare them carefully for surgery and keep their parents with them.
General physical examination of the child.
Carry out routine laboratory investigations of the child. Like urine, blood count, building time, clotting time etc.
If the child has any condition that creates complications in anesthesia and post-operative course such as fever, upper respiratory tract infection, postpone the operation.
Tonsillectomy is performed under general or local anesthesia.
Post operative management
After the operation, give the child side lying position or prone position and place a pillow under his chest.
Provide favlar position when the child is awake.
A child who has undergone tonsillectomy has dark brown blood coming out from the place.
Ask the child to get enough rest.
Observe the child for any type of haemorrhage.
Ask the child to sit quietly for 24 to 48 hours.
Ask the child to apply an ice pack.
Tell the child not to expectorate as it may lead to bleeding.
Giving the child too much fluid.
Maintain child’s hydration status.
Giving ice cream to a child.
Giving analgesic medicine to the child.
Giving antipyretic medicine to the child.
Do not take sour juice, hot food for a week as it can irritate the operative area.
Discharge teaching
Tell the child to report to the physician immediately if any kind of bleating is observed after discharge.
If you have children, ask them to take complete bed rest for two to three days.
Advising the child not to go into sunlight, exercise too much, cuffing, sneezing, trying to clear the throat, or blowing the nose too much can cause building.
Feed as much as the child can tolerate.
Ask the child to drink plenty of water.
Ask the child to take food in small and frequent amounts.
Informing the child’s parents that the stool will be dark or black because blood has been swallowed during the surgery.
If body temperature remains high and ear discomfort is present, report to physician immediately.
Tell the child to take regular follow up and come back after a week after the operation.
Infection and inflammation of the larynx (voice box) is known as laryngitis. Larynx is situated in the upper part of the respiratory track, its infection and inflammation is called laryngitis. It also causes hoarseness of voice and speech problem.
Explain the etiology/cause of laryngitis.
Laryngitis occurs due to bacterial infection bacteria like streptococcus, diphtheria.
Viral infections such as measles and mumps
Viruses responsible for the common cold and flu also cause laryngitis.
Exhaustive train
Exercising the vocal cords for too long (by speaking loudly for a long time) can lead to laryngitis.
irritants
Exposure to irritants like smoke, strong fumes and chemicals can cause laryngitis.
Acid reflex
Allergies
Respiratory infection
Inhalation of toxic substances
Explain the clinical manifestation/ sign & symptoms of laryngitis.
Horseness of voice,
dry cough,
sore throat,
throat pain,
Dysphagia (difficulty in swallowing),
Aphonia (loss of voice),
fever,
Fatig,
Malays,
irritation,
Respiratory distress,
Cold and flu like symptoms,
Swelling in the lymph nodes,
Pain immediately,
Breathing difficulties
Discomfort.
Explain the Diagnostic evaluation of the laryngitis.
History Collection,
Physical Examination,
voice assessment,
laryngeal imaging,
vocal cord function test,
laboratory test,
Allergy test
Explain the medical management of laryngitis.
Antibiotic
Using antibiotic medicine to treat bacterial infections. Like Penicillin, Azithromycin
Antiviral
Using antiviral medicine to treat viral infections. such as acyclovir
Using corticosteroid drugs to control corticosteroid inflammation.
Pain relievers (analgesics)
Using over-the-counter drugs such as acetaminophen and ibuprofen to relieve pain. Which relieves pain and reduces body temperature.
Throat lozenges
Throat lozenges relieve throat irritation.
Hydration
Intake plenty of fluids to maintain hydration.
Warm salt water gargle
Gargle with warm salt water. So throat discomfort is removed.
Avoid irritants like smoking, pollutants etc.
Resting the Voice
Do not give advice or talk too much to the child, speak only when necessary.
Voice therapy
Voice therapy is provided in some cases to make the voice more effective.
Hydration
Ask the child to ingest fluids to keep the vocal cords hydrated.
Infection and inflammation of the pharynx is known as pharyngitis.
Also known as ‘sore throat’.
Pharyngitis Infection and inflammation of the pharyngs that are located in the lower part of the mouth is called sore throat.
These are mainly some types of viruses and bacteria that get into the pharyngs due to a cold, flu or sinus infection and cause the condition of pharyngitis.
Explain the Etiology/causes of pharyngitis (right cause of pharyngitis)
Bacterial infection
Pharyngitis is caused by group A streptococcus bacteria.
Viral infection
Viruses like common cold virus, influenza virus, Epstein Barr virus are responsible for causing pharyngitis.
Allergies
Exposure to allergens causes irritation and inflammation of the throat.
Environmental Factors
Exposure to smoke, dry air and pollutants can cause pharyngitis.
Irritant
Exposure to strong chemicals and fumes can cause pharyngitis.
Gastroesophageal reflex disease Backflow of stomach acid into the throat can cause irritation and pharyngitis.
Streptococcus bacteria,
Corynebacterium diphtheriae,
Nigeria gonorrhea,
Arcana bacterium hemolyticus (Corynebacterium),
Chlamydophila pneumoniae,
Mycoplasma pneumoniae,
Fusobacterium necrophorum,
Viral pharyngitis
rhino virus,
Corona Virus, ReceptorSyncytial Virus,
parainfluenza virus,
AD virus,
Orthomyxo viridae,
herpes simplex virus,
measles virus,
Coxsackie virus
A&B,
epstein barr virus,
cytomegalovirus,
H. IV infection.
infection
Mononucleosis.
AD virus.
candida albicans,
Immunocompromised
type of pharyngitis
1) Acute pharyngitis)
Acute pharyngitis is mainly caused by viral infections.
And the viral infection that causes the common cold is what causes a cute pharyngitis.
2) Chronic pharyngitis
Chronic pharyngitis is much longer and its duration is much longer than acute pharyngitis.
Explain sign & symptoms/ Clinical manifestation of pharyngitis.
sore throat,
Throat pain
Redness and swelling
Dysphagia
Hacking Cough
Fever
Head one
Discomfort
malays,
Dry throat.
Redness in the throat.
Soreness.
Very sore throat.
Difficulty swallowing.
Cough a lot.
High fever.
Irritation.
Discomfort.
Feeling like lump in throat.
headache.
Ear pain.
Swollen lymph nodes in the neck.
Difficulty breathing.
Difficulty speaking.
Pain when lying down.
Horseness of voice.
Explain the diagnostic evaluation of pharyngitis.
History Collection,
Physical Examination,
Complete blood count,
throat culture,
nasal swabbing,
Blood examination
Explain the management of pharyngitis
Antibiotic
Using antibiotic medicine to treat bacterial infections. Like Penicillin, Azithromycin
Antiviral
Using antiviral medicine to treat viral infections. such as acyclovir
Corticosteroid
Using corticosteroid drugs to control inflammation.
Pain relievers (analgesics)
Using over-the-counter drugs such as acetaminophen and ibuprofen to relieve pain. Which relieves pain and reduces body temperature.
Throat lozenges
Throat lozenges relieve throat irritation.
Hydration
Intake plenty of fluids to maintain hydration.
Warm salt water gargle
Gargle with warm salt water. So throat discomfort is removed.
Avoid Irritants Avoid irritants like smoking, pollutants etc.
Explain the prevention of the pharyngitis.
Advise on proper hand washing to avoid infection.
Use soapy water or alcohol based hand sanitizer.
If a person has an infection, keep all his belongings separate.
Wash hands frequently.
Do not touch the public phone.
To clean the telephone and TV remote computer keyboard etc. daily.
Avoid being in close contact with a person who is sick.
Do not smoke or be around people who smoke.
Humidify the house.
When sneezing or having a cold, cover the mouth and nose with a handkerchief or use a mask and maintain proper cleanliness.
Infection and inflammation of the tonsils is known as tonsillitis, which is mainly caused by bacterial and viral infections.
(Tonsils are small masses of tissue located at the side of the throat that filter and kill foreign bodies entering through the nose and mouth)
Explain the Etiology/causes of tonsillitis.
Tonsillitis is mainly caused by bacterial and viral infections. Tonsillitis is mainly caused by Group A Streptococcus bacteria. Common viruses include influenza virus, herpes simplex virus, cytomegalovirus, adenovirus, and Epstein-Barr virus.
Explain the clinical manifestation/sign & symptoms of tonsillitis.
Swelling is seen in the throat
Sore throat and throat pain
White and yellow patches are seen on the tonsils.
Dysphagia (difficulty in swallowing),
Swelling is seen in the lymph nodes in the neck
Referred pain is seen in the ear (epilateral earache),
Bad breath and foul smelling (halitosis),
fever,
one head,
Chiles,
malays,
discomfort,
Fatig,
sore throat,
pain
difficulty swallowing,
Fever,
feeling cold,
malays,
Redness.
irritation,
discomfort,
Sore throat.
Ear pain.
Get a fever.
headache.
Bad breath coming from the mouth.
Pain in the muscles.
Stiff throat.
Swelling in the lift node of the neck.
Swelling of the eyes, mouth and throat.
If there is a very dark case, then there will be nozia.
Trouble sleeping.
Loss of appetite.
Vomiting.
Abdominal pain.
Constipation.
Difficulty opening the mouth.
headache.
Explain the diagnostic evaluation of Tonsillitis.
History Collection
Physical Examination
Complete blood count
Throat Culture (Rapid Strip Test)
Write medical management of tonsillitis
Antibiotics
If tonsillitis is caused due to bacterial infection then giving antibiotic drug to treat it.
Pain relievers (analgesics)
Provide analgesic medicine to relieve pain.
Corticosteroids
Administration of corticosteroid drugs to reduce inflammation in selected cases.
Antipyretic
Use of antipyretic drug to reduce fever.
Fluid
Provide plenty of fluid to the child. So that dehydration can be prevented.
Rest
Provide adequate rest to the child.
Explain the surgical management of tonsillitis
Tonsillectomy
Patients with recurrent or chronic tonsillitis undergo tonsillectomy, which is surgical removal of the tonsils.
Complication of tonsillitis
Peritonsillar abscess occurs as a complication of tonsillitis.
Peritonsillar abscess is also known as ‘quincy’.
In which pus collection is seen in the peritonsillar space.
Explain the nursing management of the child with the Tonsillitis.
Preoperative care
All laboratory tests of the child should be done such as:
Hb,
Esr,
B.T,C.T.
Blood groping,
Urine for sugar and Albumin,
X-ray chest,
Throat culture.
To check vital signs every 4 hours.
General physical examination of the child.
Consult the child and his family members for the operation.
Preparing the patient in such a way that the operation is performed under general anesthesia in case of children and local anesthesia in case of adults.
Giving a mild sedative to the child at night so that he can get proper sleep and relieve anxiety.
If the operation is to be performed under general anesthesia
Preanaesthesia which is done the evening before the operation and medicine is provided half an hour before and if the operation is local
If performed under anesthesia, xylocaine gargles are administered 15 minutes before the operation.
Dress the child in a clean operative cloth and send it to the operation area.
Post operative care
After the operation
Take the child to the post-operative bed immediately and provide him semi-prone position.
Turn the child on one side and place a kidney tray under it and place a small puppy so that all the secretions can be drained properly.
Checking vital signs every 15-15 minutes.
If the pulse is weak and fast, and the blood pressure is low, then immediately inform the doctor.
When seeing the blood coming out of the throat, if it is very dark, then it is called normal and if it is fresh red, immediately inform the doctor.
Provide proper intravenous fluids to the child.
Maintaining intake output chart of child.
Routine care
If the child is fully conscious, put him in supine position.
Ask the child to spit out any saliva.
Asking the child to eat cold things like ice cream, jelly, pudding etc.
From the second day, provide less boiled egg, milk, bread, milk shake etc. and on the third to fourth day, if the child is on a diet, bring the child on a full diet.
Do not give the child to eat very hot food and do not give hard things like bread, raw, salad, spicy and fried and do not give fruits, vegetables, juice, soup all these things for a few days.
Maintaining child’s oral care.
Provide analgesic and antibiotic medicine to the child.
If there is a sore throat, provide aspirin spray to relieve it and gargle 15 minutes before meals.
If everything is normal, provide discharge to the child on the third to fifth day and advise for follow up.
advice on discharge.
remain indoors,
Do not get exposed to the sun.
Vigorous games, shouting, and Vigorous cleaning of throat, blowing nose.
Avoid respiratory tract infection.
report for follow up.
Allergic rhinitis means inflammation of the nasal mucosa due to any allergenic substance which is called allergic rhinitis.
Inflammation of the mucous membrane in the nasal cavity is called allergic rhinitis. Allergic rhinitis is called a type 1 hypersensitivity reaction.
Explain the cause/Etiology of the Allergic Rhinitis.
air borne,
due to pollen,
due to dust,
Due to mold,
Because of the weeds,
Because of the grass.
Explain clinical manifestation /sign and symptoms of Allergic Rhinitis
sneezing,
nasal congestion,
Watery nasal discharge,
nasal itching,
Itching in the throat, soft palate and eyes,
whizzing sound,
dyspnea,
cuffing,
tightness in chest,
thick sputum,
headache,
feel tired,
Loss of consciousness level.
Loss of sleep.
Explain the diagnostic evaluation of the Allergic Rhinitis.
History Collection,
Physical Examination,
Total serum IgE test,
Peripheral blood count,
Nasal smear,
Nasal provocation test
Explain explain the management of Allergic Rhinitis (Write the management of Allergic Rhinitis).
1) Avoidance therapy,
2) Behavioral Pharmacological Therapy,
1) Avoidance therapy,
Allergy therapy involves providing therapy that involves telling the child to stay away from the thing that causes the allergy and telling the child to avoid the thing that causes the allergy.
2) Behavioral Pharmacological Therapy,
Provide antihistamine to the child,
Provide an adrenergic agent to the child,
Provide Mast Cell Stabilizer to the Child,
Provide corticosteroid to the child.
Explain the Nursing management of Allergic Rhinitis.
The nursing management of allergic rhinitis involves several key aspects.
assessment
The nurse assesses the child’s symptoms, triggers, and medical history to understand the severity of the allergic reaction and its effect on the child’s daily life.
Education
Providing education on allergen avoidance measures, such as keeping windows closed during high pollen seasons or using an air purifier, can help control symptoms.
Medication Administration
Nurse A Antihistamines, decongestants,
Proper administration of medications such as nasal corticosteroids and leukotriene inhibitors,
monitoring
Regularly monitor the child’s symptoms and effectiveness of medication.
Lifestyle modification
Nurses advise on lifestyle modifications such as using saline nasal sprays to relieve symptoms, staying hydrated, and avoiding non-allergens.
To provide proper psychological support to the child and his family members.
Advising the child’s parents for regular follow-up.
Peritonsillar abscess is known as a complication of tonsillitis in which pus collects around the tonsils.
That is, the collection of pus in the peritonsillar space. Thus, the collection of pus in the area around the peritonsillar space is called peritonsillar abscess.
Explain the Etiology/cause of the Peritonsillar Abscess.
Most Common Complications of Tonsillitis.
Streptococcus bacteria.
dental infection,
smoking,
Chronic Lymphatic Leukemia,
Stones or calcium deposits in the tonsils,
Aerobic and anaerobic bacteria,
streptococcus,
Caused by Staphylococcus bacteria.
Explain the clinical manifestation/ Sign and Symptoms of the Peritonsillar Abbess.
Inflammation occurs in the throat area.
Contralateral deviation of the uvula.
Hot Potato Voice
Swelling comes in a soft palette.
There is enlargement of the lymph nodes.
Severe sore throat.
Difficulty in swallowing.
pain
drooling,
salivation,
Fever,
muscle spasms,
Hot Potato/ Muffled Voice.
Ear becoming one,.
Pain in the neck.
Redness and edema in the tonsillectomy area.
Explain the Diagnostic of the Peritonsillar Abscess
history taking,
Physical Examination,
X-ray of neck,
Complete blood count test
Explain the medical management of the Peritonsillar Abscess.
Provide Adequate Antibiotic Medicine to Child.
Provide antipyretic medicine to the child.
Provide analgesic medicine to the child.
Explain the surgical management of the Peritonsillar abscess
1) Needle aspiration
In needle aspiration, a needle is inserted into the abscess and the pus is slowly drained.
2) Incision and drainage
Larger if there is a very large abscess
An incision is made and pus is drained from it.
3) Tonsillectomy
In a tonsillectomy, the entire tonsils are removed and treated.
Explain the Nursing management of the Peritonsillar Abbess
Pre operative care
Explain the pathophysiology of tonsillitis with the child and all the surgical procedures to the child and his family members.
Taking proper consent of the child’s parents.
Patent the proper airway if the child has airway obstruction.
Post operative management
If the pain increases, the child is discharged from the hospital immediately.
Providing IV fluid to the child.
Advise the child to intake only fluids for the next 24 hours.
Provide analgesic medicine to the child.
Do not give the child hot things to drink.
Provide continuous antibiotic medicine to the child.
Maintain proper hydration status of the child.
Do not give any type of spicy food to the child.
Giving oral antibiotic medicine when the child is ready to take oral fluids.
Provide analgesic medicine to the child.
Rinsing the mouth with warm water Warm water is 105 degrees Fahrenheit to 110 degrees Fahrenheit (40.6 °C to 43.3 °C).
Asking the child’s parents to make a cold application.
Ask the child to gargle 3 to 4 times in 24 to 48 hours.
Advising the child’s parents to provide proper medicine to the child’s parents.
Advising parents of child to take regular follow up.
The septum between the nostrils, which is normally thin and straight, deviates and protrudes from the midline, causing nasal obstruction and breathing difficulty. And if this septum is deviated from its place and it grows inwards in the nostril or if it is on one side, it is called deviated nasal septum.
Deviated nasal septum is a common physical disorder in which there is a displacement of the nasal septum of the nose. The septum mainly separates the right and left nasal cavities and is mainly located in the middle part and it divides the nose equally into two halves. Deviated nasal The septum mainly causes nasal obstruction and this can happen mainly in infections or even allergic reactions when the obstruction is found causing difficulty in breathing through the nose.
It is mainly seen in children and it is mainly congenital and also due to any injury.
Explain the Etiology/causes of deviated nasal septum
A deviated nasal septum is congenital and acquired.
Congenital factor occurs due to birth defect or genetic predisposition.
Deviated nasal septum is seen due to nasal trauma in accrual factor.
Explain Types of deviated nasal septum.
1) Columinal deviation or anterior dislocation.
In this the septum is dislocated from the front to the bottom and it goes to one side and it totally or partially blocks the nostril.
2) C shape deviation.
This septum is deviated to one side and its shape is like English letter “c”.
3)S sap deviation
In this the septum is deviated on either side or upwards and downwards like the English letter “S”.
4)Bonnie Spurs
In this the vomer bone of the nose is deviated spirally to one side of the nostril and the bony projection also causes nasal obstruction.
5) Thickened septum
In this if the nasal septum is normal then it is thin but due to any infection or trauma there is blood connection and due to hematoma the septum becomes thick (becomes thick) and due to this breathing difficulties occur.
Explain the clinical manifestation/ sign and symptoms of deviated nasal septum.
Difficulty in breathing,
Noisy breathing,
nasal congestion,
Recurrent sinus infections,
one head,
Post Nasal Drip,
nose bleed,
snoring,
Dry mucosa.
Explain the Diagnostic evaluation of deviated nasal septum.
History Collection,
Physical Examination,
Nasal endoscopy,
imaging studies,
x ray,
city scan,
Nasal airflow assessment,
Allergy testing.
Explain the medical management of deviated nasal septum
Nasal decongestant spray
Use nasal decongestant sprays and drops to reduce nasal congestion.
Nasal corticosteroid
Use of nasal corticosteroid sprays to reduce inflammation and swelling of the nasal passages.
Antihistamine
If there is nasal congestion and inflammation due to allergy, provide antihistamine drug.
Saline nasal irrigation
Use saline nasal irrigation in a regular manner. Which helps clear the nasal passages and relieves congestion.
Nasal Dilators Use external nasal dilators such as adhesive strips that widen the nasal passages to improve airflow.
Avoiding allergens
Minimize contact with allergens. So that nasal symptoms can be relieved.
Explain the surgical management of deviated nasal septum
Submucous resection
Submucous resection is a surgical procedure commonly used to treat a deviated nasal septum. In which the submucous tissue in the nasal septum is removed and repositioned.
Septoplasty
Septoplasty is a surgical procedure. In which the deviated septum, cartilage and bone are reshaped and repositioned. So that nasal air flow can be improved and breathing difficulty can be removed.
Rhinoplasty
Rhinoplasty is a cosmetic surgery. In which reshaping and resizing of the nose is done i.e. reconstruction of the nose is done. So that the appearance of the nose can be improved and the breathing issue can be solved.
If the deformity causes nasal obstruction, submucosal resection is performed under general local anesthesia.
Plastic surgery becomes necessary if a large part of the septum is resected.
If bleeding occurs, packing is placed.
Provide cold compression to the child.
Providing proper dressing to the child.
Do saline irrigation.
Tell the child not to blow his nose too much.
Teach the child relaxation and deep breathing techniques.
Asking the child to do small amounts of daily routine activities.
Epistaxis Mins nose bleed or nasal hemorrhage in nose
Rupture of vessels in any area of mucus membrane
Bleeding from the nostril or nasal cavity is seen due to this
This is known as epistaxis.
Epistaxis is also called nose bleed
A condition in which there is active bleeding from the nostrils
Occurs from the cavity or nasopharynx.
This happens when the blood vessels inside the nose a
Damaged or injured. From the front of the nose
Or the process of bleeding from the back
Bleed or called epistaxis.
Explain the Type of epistaxis
Epistaxis or nose bleed is divided into two types based on its location.
Anterior epistaxis
Anterior epistaxis involves bleeding from blood vessels in the front part of the nose. That area is known as the “Keiselbach Plexus” or “Little’s Area”. Anterior epistaxis is the most commonly seen type in which building occurs from the nostril. It can be managed by gently applying pressure or nasal packing.
Posterior epistaxis
Posterior epistaxis involves bleeding from the back part of the nose or the deeper nasal cavity. That is, bleeding is seen from the area with the sphenopalatine artery. That area is known as the “Woodruff Plexis”. Posterior epistaxis is most common but controlling it is a challenge. In which bleeding is seen from the nostrils and blood drains into the throat, hence blood is seen in the sputum. Management of posterior epistaxis requires surgical procedures.
Explain the Etiology/causes of epistaxis.
Nasal trauma (most common cause),
nasal infection,
nasal irritant,
dry air,
allergies,
Underlying medication (heparin, warfarin),
Bleeding due to too much blowing of the nose is also caused by picking the nose with fingernails.
Due to trauma to the nose or face,
A condition such as epistaxis occurs due to a blow to the nose due to a fall or road traffic accident.
can,
Due to the facture in the nasal bone,
Epistaxis can occur due to upper respiratory infection in children.
Viral rhinitis, acute rhinitis.
Due to any foreign body in the nose.
Due to deviation of nasal septum.
Due to climate change.
Due to any growth in the nasal cavity such as polyps or benign and malignant tumors.
hypertension,
Due to heart disease,
bleeding disorder,
Due to certain types of medication,
oral anticoagulant,
Acute infections like typhoid, pneumonia, malaria,
Dengue, fever, measles.
Excessive sneezing.
Nose blowing.
Due to trauma to the nose.
Leukemia.
Due to vitamin k deficiency.
Explain / Clinical manifestation & symptoms of epistaxis
Bleeding from the nose (nose bleed),
Blood draping from the nostrils,
Presence of blood clot,
mouth bleed,
Tachycardia,
one head,
Disneys,
Fanting,
difficulty breathing,
difficulty swallowing,
nasal congestion,
headache,
confusion,
fainting,
disneys,
weekness.,
Vomiting.
Explain the diagnostic evaluation of epistaxis.
History Collection
Physical Examination
Nasal endoscopy
x ray
CT scan
Angiography
Biopsy
Explain the medical management of epistaxis.
Pressure
Pressure is applied on the soft part of the nose i.e. the nose is pinched with thumb and index finger for 10 to 15 minutes and mouth breathing is asked. This method is called Trotter method. During this method the child is given a sitting or semi-fowler position.
Ice pack
Applying ice packs or cold compresses to nosebleeds can constrict blood vessels and reduce bleeding.
Nasal spray
Using an over-the-counter saline nasal spray or decongestant. Which helps the blood vessels to shrink.
Topical medicine
Using petroleum jelly as a topical agent. Which moisturizes the nasal mucosa and protects the nasal mucosa.
1) Anterior nose bleed
If there is a small amount of bleeding, it stops on its own and does not require any kind of treatment.
Bleeding clots over the place where the nose is bleeding and this stops the bleeding.
If the bleeding is from the blood vessels, then it can be easily seen, then the doctor cauterizes, i.e. seals it, so the bleeding stops.
In case of very complicated cases, nasal packing should be done to stop the bleeding.
Placing a nasal packing creates pressure in the nose and causes the blood to clot thus stopping the bleeding.
There are many different types of nasal packing available such as
Petrolatum gauze,
Balloon nasal packs,
Synthetic sponge packs etc.
Medical personnel directly apply the medicine to the nose to relieve congestion, relieve pain, and stop bleeding.
Local application of vasoconstriction also stops bleeding.
A child who gets nasal packing has chances of blocked sinuses leading to sinus infection, so start antibiotic medicine and keep packing mainly for 48 to 72 hours.
2) Posterior nose bleed
If there is a posterior nose bleed, it does not stop on its own, to stop it, you have to go to the hospital and seek medical treatment.
Posterior nose bleeds are said to be very serious.
To control the posterior nosebleed, the doctor places a packing in the posterior nose.
Different packings are available but the main common nasal packing is a balloon nasal pack.
Posterior nasal packing feels more uncomfortable than anterior nasal packing and often requires sedative medicine and pain killer medicine.
Other complications include infection and blockage of the breathing passage.
So the child has to be kept under close monitoring in the hospital.
Posterior nasal packing is to be left in place for 48 to 72 hours.
If bleeding does not stop even after packing then surgical procedure is required.
Explain the surgical management of epistaxis
Surgical management is performed to control the bleeding when medical management fails to control the nose bleed. It uses the following surgical methods.
Cauterization
In cauterization, bleeding blood vessels are sealed using heat, electricity, or chemicals. In which silver nitrate is mostly used as a chemical.
Nasal packing
In nasal packing, gauze or a special balloon is inserted into the nasal cavity and pressure is applied to the building point to stop the building. Nasal packing includes anterior and posterior nasal packing.
ligation
In ligation, the blood vessels are ligated or tied to stop the build-up.
Explain the Nursing management of the Epistaxis.
Some children who experience nosebleeds can handle it without the need for a physician.
Leaning forward when nosebleed as there are chances of blood going to the throat and breathing in it.
Press the lower part of the nose with thumb and first finger for 5 to 20 minutes.
Sit quietly and keep the head slightly above the heart, do not lie down.
Providing ice compression in the nose. By providing compression of ice, the blood vessels will become constricted and blood will stop coming from the nose.
After pinching the nose release it and slowly see if it bleeds or not then pinch the nose again and apply eye packing over it.
Stay at home and rest with head elevated at 30 to 45 degrees.
Do not move the nose too much.
In case of sneezing, open the mouth so that the air inside the body can escape through the mouth and not harm the nose too much.
Do not lift any heavy objects.
Try to keep your head higher than your heart level.
Eat plain and cold food and avoid drinking hot liquids for 24 hours.
Avoid taking medicines that thin the blood. (such as Aspirin, Ibrufen, Clopidogrel, Visulfate and Warfarin).
If there is back bleeding from the nose, try to remove the blood clot.
Use a nasal decongestant for some time as it constricts the blood vessels of the nose and bleeding stops.
Apply packing in the nose.
See where the bleeding is.
Check for any signs and symptoms of bereavement.
If there is profuse nosebleeding it is a condition of shock so check vital signs carefully.
Do not swallow blood as it may cause conditions like vomiting and nosia.
Provide adequate oxygen.
Giving analgesic medicine to the child.
Provide antibiotic medicine to the child.
Nasal packing makes it difficult to swallow and eat, so provide liquid to the child.
Surgical ligation is required if frequent bleeding or epistaxis occurs.
It involves ligation of the external carotid artery, ethmoid artery, and internal maxillary.
Prevention
Mainly because nose bleeds occur in the winter season, children who have frequent nose bleeds should use a humidifier at home.
Use petroleum jelly (Vaseline), antibiotic ointment, or saline nasal spray to moisten the nasal passages.
Do not shake the nose too much.
If nose bleeding is caused by any other medical condition like liver disease, long standing sinus condition then consult a doctor and get the problem under control.
Do not lift heavy objects.
Avoiding smoking.
Common cold is an acute viral contagious infection that creates inflammation in the mucosal membrane of the nose, which occurs in the upper respiratory tract and is caused by rhinovirus, pycovirus or coronavirus etc.
A common cold lasts up to a week on average.
Mild cold lasts for two to three (2 to 3) days. Severe cold lasts up to two weeks (2 weeks).
Transmission of infection
The common cold is spread by direct hand-to-hand contact with infected secretions or from a contaminated area.
For example, if a person has a common cold and he touches his nose and touches something else, the virus of the common cold is present on that place, now if another person touches that place, there are chances of getting a common cold.
In addition, the common cold virus lives on this place for a few hours, such as pens, books, telephones, computer keyboards, and coffee cups.
Explain the clinical manifestation / Sign and symptoms of common cold.
Nasal stuffiness and drainage from it.
Nasal congestion occurs.
Sore or scratchy throat.
sneezing.
Hoarseness of voice.
Muscle weakness.
Mild fever.
Uncontrollable sweating.
Loss of appetite.
feeling tired
expectoration
Heavy filling in the ear.
Irritation.
Restlessness.
Drain nasal discharge.
Vomiting.
to become one
Explain the management of the common cold.
There is no cure for the common cold because the common cold is primarily caused by a virus infection and no antibiotic therapy is used.
Home treatment is mainly used to reduce the symptoms of common cold i.e. there is no specific treatment for common cold.
Adequate rest and adequate water intake are supportive measures in common cold.
Over the counter medicines like throat lozenges, throat sprays, cough syrups help to relieve the symptoms.
Decongestants such as pseudoepinephrine or antihistamines are used to relieve nasal symptoms.
Saline sprays or humidifiers are also beneficial.
Acetaminophen
or ibuprofen
It is used if there is a sore throat, mild fever or body ache.
The use of aspirin or drugs of the aspirin group in children and
Do not do in teenagers as it can cause conditions like Reye’s syndrome.
(Reyes syndrome)
A rare but serious condition in this can cause confusion, brain swelling, and liver damage.
There are some other measures by which nasal congestion can be relieved such as:
Nasal congestion can be relieved by instilling salt water drops into the nostrils.
A total mist humidifier increases air moisture.
Applying petroleum jelly on the skin of the nose smooths out the roughness.
Hard candy or cough drops help relieve a sore throat (in children above three years of age).
A warm bath or heating pad is used to relieve the pain.
Nasal congestion is also relieved by steaming hot water.
Prevention
Prevention is more important than curing the common cold.
The common cold virus can be transmitted from one person to another up to 12 feet, so it is very important to be careful not to infect children.
To prevent the common cold, keep children away from people who have the common cold for two to three days.
Wash children’s hands frequently and properly.
Anti-bacterial or alcohol based hand sanitizers are used to avoid transmitting any respiratory illness.
Cover the nose and mouth of a child who has a respiratory tract infection.
If any member of the family has an infection i.e. common cold, keep their towels, and all their utensils separate and use disposable items so that the infection cannot be transmitted from one person to another.
Lifestyle modifications like avoiding smoking, managing stress can reduce the chances of getting the common cold.
Lower Respiratory tract infection
Inflammation of the brocae and bronchial tubes is known as bronchitis. Bronchitis is also known as ‘blue blotter’.
Bronchitis means infection and inflammation of the bronchi of the lower respiratory tract is called bronchitis. In bronchitis, the condition of breathing difficulties arises due to the production of mucus in the bronchi due to infection.
Explain The Etiology/causes of bronchitis
virus
Rhino virus, influenza virus, parainfluenza virus
Bacteria Mycoplasma pneumoniae, Bordetella pertussis
Air pollution
Exposure to Chemical Fumes
Contact to allergens
Weak immune system
common cold,
Sinusitis.
Explain the clinical manifestations/ Sign and symptoms of bronchitis.
Shortness of breath,
Runny and Stuffy Nose,
Chest congestion,
whizzing sound,
Yellow or green mucus production is observed,
chest tightness,
diaphoresis,
low grade fever,
fatigue,
clubbing,
dry cuffing,
whizzing sound,
Difficulties in swallowing,
sore throat,
fever,
chiles,
tachypnea
Explain the diagnostic evaluation of bronchitis.
History Collection
Physical Examination
x ray
CT scan
Sputum culture
Blood test
Explain the management of bronchitis
Bronchodilators Administer bronchodilators drugs to relax the respiratory muscles and dilate the bronchi.
Antipyretic
To maintain the child’s body temperature and provide proper antipyretic medication if the child has fever condition.
Antibiotics Provide antibiotic drugs to treat bacterial infections.
Cough expectorant
Provide cough expectorant drug to expel phlegm.
Nasal decongestants Provide nasal decongestants to relieve congestion.
Rest and Hydration Adequate rest and plenty of fluid intake.
Avoid irritants Avoid contact with irritants.
Explain the Nursing management of bronchitis
To assess the child properly and completely.
Properly assess the child’s respiratory status.
To assess the child’s vital signs completely.
Assess child’s oxygen saturation properly.
Continuous monitoring of child’s respiratory status and oxygen saturation to properly assess the child’s condition.
Monitoring child’s body temperature continuously.
Advise the child for continuous fluid intake to maintain the child’s hydration status and keep the mucus thin.
Provide a properly comfortable position to the child.
Provide adequate oxygen to the child to maintain oxygen saturation of the child’s body and provide respiratory support.
Providing properly prescribed medication to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs and its treatment.
To provide proper work and comfortable environment to the child.
Bronchiectasis is a chronic respiratory condition characterized by abnormal and irreversible dilation, inflammation and thickening of the bronchi and bronchioles.
This results in accumulation of mucus and the mucus is not cleared properly from the airways, leading to recurrent respiratory infections.
Explain the Etiology/causes of bronchiectasis.
Infection (previous respiratory infection such as pneumonia, tuberculosis
Genetic disorder (cystic fibrosis)
Immune system disorders (rheumatoid arthritis, inflammatory bowel disease)
Auto immune conditions
Allergic bronchopulmonary aspergillosis
Environmental Factors
Explain the clinical manifestations/ Sign and symptoms of bronchiectasis.
chronic cough,
Excessive sputum production,
blood in cough,
Shortness of breath,
whizzing sound,
chest pain,
Recurrent respiratory infection,
clubbing of fingers,
weight loss,
Fatig,
weakness,
Explain the diagnostic evaluation of bronchiectasis
History Collection
Physical Examination
x ray
CT scan
Pulmonary function test
Sputum culture
Bronchoscopy
Explain the medical management of bronchiectasis
Bronchodilators
Administer bronchodilator drugs to relax the airway muscles and dilate the bronchi.
Antibiotics to provide antibiotic drugs to treat bacterial infections.
Expectorant and mucolytic
Provide expectorant and mucolytic drugs to thin and expel mucus.
Airway clearance techniques
Airway clearance techniques like chest physiotherapy, postural drainage
Explain the surgical management of bronchiectasis.
In severe cases, the severely damaged lung tissue is surgically removed.
Explain the Nursing management of bronchiectasis.
Nursing management of bronchiectasis in a child involves caregiver involvement with the goal of controlling symptoms, preventing severity, and improving quality of life.
Airway Clearance Techniques (ACTs):
The nurse should provide education to the patient (child) and his caregiver about various ACTs, such as chest physiotherapy, postural drainage, percussion and vibration, to help clear saliva from the airway and reduce the risk of infections.
Exercise and Physical Activity:
Regular physical activity as per the child’s ability can help improve the child’s lung function and overall well-being.
Nutritional support
Providing Adequate Nutritional Food to Child with Bronchiectasis.
Medical management
Properly providing prescribed medications to the child, including bronchodilators, mucolytics, and antibiotics.
Oxygen therapy:
After measuring the oxygen saturation of the child, provide oxygen to the child in an adequate amount.
Immuneization
Advise the child’s parents to provide influenza vaccine and pneumococcal vaccine to the child to reduce the risk of respiratory infection.
Education and Support
To provide proper psychological support to the child and his family members.
To provide complete education to the child and his family members about the child condition, its causes, symptoms and signs, and its treatment and prevention.
Advising the child’s parents to follow up regularly and take medication.
Pulmonary tuberculosis is a serious infection caused by the bacterium Mycobacterium tuberculosis that primarily affects the lungs but can also spread to other areas of the body.
Pulmonary tuberculosis is spread through air i.e. by coming into contact with the coughing or sneezing of an infected person.
Explain the Etiology/cause of pulmonary tuberculosis
Close contact with active tuberculosis patients
Weak immune system (HIV, organ transplantation, cancer, corticosteroid therapy)
Edge
Subtons abuse
Living in over crowded area
Malnutrition
Chronic health conditions
Explain the clinical manifestations / Sign and symptoms of pulmonary tuberculosis.
Persistent Cough (Cough present for more than three weeks)
blood in sputum,
chest pain,
fever,
feeling cold,
swollen gland,
fatigue,
night sweats,
loss of appetite,
weight loss,
Shortness of breath,
poor growth,
cuffing,
Explain the diagnostic evaluation of pulmonary tuberculosis.
History Collection
Physical Examination
Tuberculin skin test
x ray
Sputum test
Blood test
Explain the management of pulmonary tuberculosis.
Antibiotic therapy
A combination of antibiotics is given as a treatment for pulmonary tuberculosis. In which isoniazid, rifampin, ethambutol and pyrazinamide medications are given. A course of this medicine is done for six to nine months.
Directly Observed Treatment Short Courses (DOTs)
In DOTs therapy, the TB patient is supervised by a health care provider. The patient takes exactly the regular medicine and its effectiveness is observed. So it can be known whether the patient has completed the full course of treatment or not.
Isolation
TB positive child is isolated. Because TB is a contagious disease and it is spread through air to each other. Hence the child is isolated to prevent it from spreading.
Nutritional support
To provide adequate nutrition support to the child with TB to improve his immune system and gain weight.
Education and counselling
Providing education and counseling to the child about tuberculosis. Educate the child and his family members about infection control measures.
Explain the nursing management of pulmonary tuberculosis (pulmonary
To maintain the child’s body temperature and provide proper antipyretic medication if the child has fever condition.
Providing antibiotic drugs to treat bacterial infections.
Provide cough expectorant drug to expel phlegm.
Provide nasal decongestants to relieve congestion.
Adequate rest and plenty of fluid intake.
Avoid contact with irritants.
To assess the child properly and completely.
Properly assess the child’s respiratory status.
To assess the child’s vital signs completely.
Assess child’s oxygen saturation properly.
Continuous monitoring of child’s respiratory status and oxygen saturation to properly assess the child’s condition.
Monitoring child’s body temperature continuously.
Advise the child for continuous fluid intake to maintain the child’s hydration status and keep the mucus thin.
Provide a properly comfortable position to the child.
Provide adequate oxygen to the child to maintain oxygen saturation of the child’s body and provide respiratory support.
Providing properly prescribed medication to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs and its treatment.
To provide proper work and comfortable environment to the child.
Explain / Define lung abscess in children.
In lung abscesses, pus filled cavities are seen in the lung parenchyma with inflammation and necrosis in the surrounding tissue.
Explain the Etiology / causes of lung abscess
Bacterial infection
Lung abscesses are mostly caused by bacterial infections. Bacterial causes include Streptococcus pneumoniae, Klebsiella pneumoniae, Staphylococcus aureus.
Foreign body inhalation
Foreign body aspiration
trauma
Tuberculosis
Chronic lung disease
Explain the clinical manifestations/ Sign and symptoms of lung abscess.
Persistent cough
Blood in sputum
Foul smelling in sputum
Chest pain
Dyspnea
Shortness of breath
Fever
Chills
Wickness
diaphoresis
Cyanosis
Explain the diagnostic evaluation of lung abscess
History Collection
Physical Examination
x ray
CT scan
like this. R. I
Sputum culture
Complete blood count
C reactive protein
Erythrocytes sedimentation rate
Biopsy
Explain the medical management of lung abscess.
Antibiotic therapy
Using broad-spectrum antibiotics (amoxicillin, clindamycin) to treat bacterial infections.
Oxygen therapy
Provide supplemental oxygen if required.
Percutaneous drainage
If the abscess is large and antibiotics fail to treat it, drainage is necessary. Perform percutaneous drainage under CT scan.
Supportive care
Supportive care includes pain management, oxygen therapy, hydration levels, etc.
Treat underline condition
Treating underlying conditions associated with lung abscess.
Surgery
Perform pulmonary resection (lobectomy) in severe cases.
Explain the nursing management of lung abscess
A combination of antibiotics is given as treatment for the child. In which isoniazid, rifampin, ethambutol and pyrazinamide medications are given. A course of this medicine is done for six to nine months.
To provide adequate nutrition support to the child so that his immune system can be improved and weight gain can be achieved.
Providing education and counseling to the child about tuberculosis. Educating the child and his family members about infection control measures.
To maintain the child’s body temperature and provide proper antipyretic medication if the child has fever condition.
Providing antibiotic drugs to treat bacterial infections.
Provide cough expectorant drug to expel phlegm.
Provide nasal decongestants to relieve congestion.
Adequate rest and plenty of fluid intake.
Avoid contact with irritants.
To assess the child properly and completely.
Properly assess the child’s respiratory status.
To assess the child’s vital signs completely.
Assess child’s oxygen saturation properly.
Continuous monitoring of child’s respiratory status and oxygen saturation to properly assess the child’s condition.
Monitoring child’s body temperature continuously.
Advise the child for continuous fluid intake to maintain the child’s hydration status and keep the mucus thin.
Provide a properly comfortable position to the child.
Provide adequate oxygen to the child to maintain oxygen saturation of the child’s body and provide respiratory support.
Providing properly prescribed medication to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs and its treatment.
To provide proper work and comfortable environment to the child.
Abnormal fluid collection seen in the pleural cavity is known as pleural effusion.
Explain the Etiology/causes of pleural effusion
Congestive heart failure
Pneumonia
Pulmonary embolism
Cancer
Liver disease
Kidney disease
Tuberculosis
Auto Immune Diseases
Explain the clinical manifestations / Sign and symptoms of pleural effusion.
Shortness of breath
Chest pain
Dry cough
Reduce chest expansion
Dullness to percussion
Decreases breath sound pleuritic pain
Fever
Fatigue
Explain the diagnostic evaluation of pleural effusion
History Collection
Physical Examination
x ray
CT scan
Ultra sound
Thoracocentesis
Pleurodesis
Pleural fluid analysis
Pleural biopsy
Explain the medical management of pleural effusion.
Diuretic
If the pleural effusion is due to congestive heart failure or fluid overload, give a diuretic drug to treat it.
Antibiotics Providing antibiotic drugs to treat bacterial infections.
Anti-inflammatory medication
Provide anti-inflammatory medication or corticosteroid drug to treat pleural effusion due to autoimmune disease or inflammatory condition.
Chemotherapy & Radiation Therapy
If the pleural effusion is due to cancer, chemotherapy and radiation therapy should be provided to treat the cancer.
Pain relievers
Providing pain relievers to relieve pain. such as ibuprofen
Antipyretic
Provide antipyretic drug to remove fever.
Oxygen Therapy Providing supplemental oxygen to improve oxygen levels.
Explain the surgical management of pleural effusion
Video Assisted Thoracic Surgery (VATS)
This is a minimally invasive procedure. In which a small incision is made on the chest wall and a thoracoscope is inserted and the fluid is drained and a biopsy is collected from the abnormal tissue.
Pleurodesis
Pleurodesis is a procedure in which adhesions are created between the two layers of the pleura to prevent fluid accumulation due to swelling. In which a sclerosing agent is instilled into the pleural space during thoracoscopy which induces adhesion formation.
Pleurectomy
In a pleurectomy procedure, the parietal pleura and visceral pleura are surgically removed. So that fluid accumulation between them can be prevented.
Pleural Catheter Placement Pleural catheter placement involves inserting a small tube through the chest wall into the pleural space through which fluid is continuously drained.
Explain the complications of pleural effusion
Pneumothorax
empyema
Plural thickening
Atelectasis
Respiratory failure
Pulmonary hypertension.
Explain the Nursing management of pleural effusion
To assess the child properly and completely.
Properly assess the child’s respiratory status.
To assess the child’s vital signs completely.
Assess child’s oxygen saturation properly.
Continuous monitoring of child’s respiratory status and oxygen saturation to properly assess the child’s condition.
Monitoring child’s body temperature continuously.
Provide fluids to the child in small amounts.
Provide a properly comfortable position to the child.
Provide adequate oxygen to the child to maintain oxygen saturation of the child’s body and provide respiratory support.
Providing properly prescribed medication to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs and its treatment.
To provide proper work and comfortable environment to the child.
Pulmonary edema is a condition in which fluid accumulates or builds up around the lungs and collects in the air sacs, causing breathing difficulties, coughing, wheezing, and feeding difficulties.
Explain the Etiology/causes of pulmonary edema.
heart condition,
Due to infection,
Due to allergic reaction,
Due to toxic inhalation,
high altitude,
Due to aspiration,
Congestive heart failure,
renal failure,
Acute kidney injury,
liver disease,
Due to blood disorder,
Exposure to certain toxins and drugs,
heart disease,
Acute respiratory distress syndrome,
near drowning,
Explain the clinical manifestation/sign & symptoms of pulmonary edema.
Shortness of breath,
rapid breeding,
Breathing difficulties,
expectoration,
whizzing,
cyanosis,
tachycardia,
Restlessness and agitation,
feel tired,
not hungry,
feeding difficulties,
Nasal flaring and apnea,
Excessive sweating,
Persistent cough and frothy mucus,
blood in cough,
whizzing,
Feeling like suffocation,
Chest tightness and pain,
fatigue,
restlessness,
Increase heart rate,
Swelling in leg.
Explain the diagnostic evaluation of pulmonary edema
History Collection
Physical Examination
Chest x-ray
Echocardiogram
Electrocardiogram
Complete blood count
Arterial blood gas analysis
Brain natriuretic peptide
Basic metabolic panel
Explain the medical management of pulmonary edema
Oxygen therapy
Provide supplemental oxygen to improve oxygen levels.
Diuretic
Provide diuretic medicine like frusemide. which prevents fluid overload and reduces pulmonary congestion. Diuretics increase urine output and remove excess fluid from the body.
Vaso dilators
Administer a vasodilator drug such as nitroglycerin or nitroprusside to reduce heart load and decrease cardiac output load. which dilates blood vessels and improves cardiac output.
inotropic agent
Administration of inotropic agents to improve myocardial contractility. such as dobutamine
Positioning
Elevating the child’s head from the bed and providing the child with an upright sitting position. So that lung expansion and venous return can be improved.
Fluid retraction
Perform fluid retraction in fluid overloaded conditions to prevent pulmonary congestion.
Treat underlying causes
Identifying and Treating the Causes of Pulmonary Edema
Explain the Nursing management of pulmonary edema
To assess the child properly and completely.
Properly assess the child’s respiratory status.
To assess the child’s vital signs completely.
Assess child’s oxygen saturation properly.
Continuous monitoring of child’s respiratory status and oxygen saturation to properly assess the child’s condition.
Monitoring child’s body temperature continuously.
Provide fluids to the child in small amounts.
Provide a properly comfortable position to the child.
Provide adequate oxygen to the child to maintain oxygen saturation of the child’s body and provide respiratory support.
Providing properly prescribed medication to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs and its treatment.
To provide proper work and comfortable environment to the child.
Empyema is a condition in which pus accumulates in the space (plural space) between the lungs and the inner surface of the chest wall.
Abnormal pus collection seen in the pleural cavity is known as empyema. Empyema is also known as ‘pyothorax’ and ‘purulent pleuritis’.
Empyema is mainly seen as a complication of pneumonia and lung abscess.
Explain the Stage of Empyema
Exudative stage Exudative stage is the early stage of empyema. In which sterile serous fluid accumulates in the pleural space.
Fibropurulent Stage In this stage the pleural fluid becomes purulent (pus like) and fibrous septa form pockets with localized pus.
Organizing stage
This is the last stage of empyema. In which fibrin and pus are organized in the pleural space and form a thick pleural peel.
Explain the Etiology/causes of empyema
Bacterial infection (Streptococcus pneumoniae)
Viral infection
Fungal infection
Pneumonia
Tuberculosis
Lung abscess
trauma
Chest Wound
Chest surgery
Immunosuppression
Explain the clinical manifestations of Empyema (right clinical manifestation
dyspnea,
Cough,
fever,
chest pain,
anemia,
Movement on the affected side is diminished
Shortness of breath
Chest tightness
Chest pain
Persistent cough
weakness
Fatig
Night sweats
Anorexia
Weight loss
Explain the diagnostic evaluation of Empyema
History Collection
Physical Examination
x ray
CT scan
Ultra sound
Sputum analysis
Thoracocentesis
Blood test
Explain the management of Empyema
Antibiotics Provide antibiotics to treat bacterial infections.
Pain relievers (analgesics)
Provide analgesic drugs to relieve pain.
Antipyretic
Provide antipyretic drug to reduce fever.
Mucolytic
Providing mucolytic drugs to break up and clear mucus.
Thoracocentesis In thoracocentesis, pus or fluid is aspirated by direct needle insertion into the pleural cavity.
Chest tube drainage
In chest tube drainage, a chest tube (thoracostomy tube) is placed in the pleural space and the pus is drained.
Fibrinolytic therapy
In cases with fibropurulent empyema, a fibrinolytic agent such as plasminogen activator is instilled into the pleural space. which breaks down the fibrin and helps in drainage.
Explain the Nursing management of pulmonary edema
To assess the child properly and completely.
Properly assess the child’s respiratory status.
To assess the child’s vital signs completely.
Assess child’s oxygen saturation properly.
Continuous monitoring of child’s respiratory status and oxygen saturation to properly assess the child’s condition.
Monitoring child’s body temperature continuously.
Provide fluids to the child in small amounts.
Provide a properly comfortable position to the child.
Provide adequate oxygen to the child to maintain oxygen saturation of the child’s body and provide respiratory support.
Providing properly prescribed medication to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs and its treatment.
To provide proper work and comfortable environment to the child.
Emphysema is a Greek word meaning ‘inflation’.
Emphysema is a chronic lung disease. In which over distension and over inflation of the air sac (alveoli) of the terminal bronchioles in the lungs are seen and the air sac is gradually damaged. Due to which shortness of breathing is seen. Emphysema is also known as ‘pink puffer’.
Hyperinflation is observed in the alveoli due to some reason.
Due to which destruction is seen in the wall of alveoli capillary.
Hence the elasticity of the alveoli is lost and the gas exchange capacity of the alveoli is also lost.
Air is trapped in the alveoli. The condition of emphysema is seen.
Explain the Etiology/causes of emphysema.
A second hand smoker
Air pollution
Exposure to dust, chemicals, fumes
Alpha one antitrypsin deficiency
Genetic factor
Explain the clinical manifestation/ sign & symptoms of the emphysema.
Shortness of breathing,
dyspnea,
tachypnea,
chest retraction,
chronic cough,
whizzing sound,
Chest tightness,
barrel chest,
Increase vibration and thrill felt,
Decreased breath sounds,
Roncus (a wheezing sound produced in the bronchial tubes),
Prolong expiration,
anorexia,
weight loss,
wickness,
cyanosis,
Decreases exercise tolerance,
hypoxia,
hypercapnia,
cyanosis,
Frequent respiratory infections,
Fatig,
Dia Faresis,
Weight loss
Explain the diagnostic evaluation of emphysema
History Collection,
Physical Examination,
Pulmonary function test,
x ray,
CT scan,
MRI,
alpha antitrypsin test,
electrocardiogram,
Complete blood count,
Exercise tolerance test,
Pulmonary function test,
ABG Analysis,
Explain medical management of emphysema
Bronchodilators
Administer bronchodilators to relieve bronchial spasm and relax the muscles surrounding the airways. Bronchodilators relax the muscles around the airways and relieve spasm.
Inhaled corticosteroid
Inhaled corticosteroid drugs to reduce airway inflammation.
Mucolytics
Providing mucolytics drugs to thin the mucus and expel it from the lungs.
Antibiotics Provide antibiotic drugs to prevent bacterial infections.
Oxygen therapy Providing supplemental oxygen to improve blood oxygen levels.
Explain the surgical management of emphysema
Bullectomy
In a bullectomy, the affected bulla (air field space) is removed. So that compression on healthy lung tissue can be removed.
Lung Volume Reduction Surgery (LVRS)
In LVRS, the damaged lung portion is removed. So that the child can perform lung function well.
Lung Transplantation Lung transplantation is the treatment for severe cases in which the lung function is significantly compromised. In which the lungs provided by the donor are replaced with the affected lung.
Explain the nursing management of emphysema
To monitor the child’s vital signs.
Assess respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deep breathing and cuffing exercises.
To provide knowledge to the child about pursed lip breathing and diaphragmatic breathing.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer prescribed medicine (bronchodilator) to the child.
To maintain proper records and reports.
To assess the child properly and completely.
Properly assess the child’s respiratory status.
To assess the child’s vital signs completely.
Assess child’s oxygen saturation properly.
Continuous monitoring of child’s respiratory status and oxygen saturation to properly assess the child’s condition.
Monitoring child’s body temperature continuously.
Provide fluids to the child in small amounts.
Provide a properly comfortable position to the child.
Provide adequate oxygen to the child to maintain oxygen saturation of the child’s body and provide respiratory support.
Providing properly prescribed medication to the child.
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs and its treatment.
To provide proper work and comfortable environment to the child.
Explain the complications of emphysema
Chronic obstructive pulmonary disease
Pneumonia
Pneumothorax
Atelectasis
Recurrent respiratory tract infection
Respiratory failure
Respiratory acidosis
Pulmonary embolism involves obstruction and blockage of one or more pulmonary arteries due to thrombus formation (blood clot).
This thrombus originates in the vascular system or right heart and travels to the pulmonary artery.
Explain the Etiology/cause of pulmonary embolism.
deep vein thrombosis,
Hypercoagulation,
venus statis,
Due to trauma,
Due to inherited or acquired clotting disorders,
Due to infection.
Prolonged immobilization
Heart failure
Heart disease
Hormonal factor
Advanced Edge
Obesity
Explain the clinical manifestation/sign & symptoms of pulmonary embolism.
Rapid onset of dyspnoea,
Shortness of Brith,
Pleuritic chest pain,
Tachycardia,
diaphoresis,
Blood in cough (haemoptysis),
cyanosis,
fever,
fainting,
Calf & thigh pain.
Explain the diagnostic evaluation of pulmonary embolism (pulmonary
History Collection
Physical Examination
Chest x-ray
Ultra sound
Magnetic resonance imaging
Pulmonary angiography
Ventilation perfusion scan
D dimer test
Electrocardiogram
Explain the management of pulmonary embolisms
Anticoagulant therapy
Provide anticoagulant drug for treatment of pulmonary embolism. Which prevents the formation of blood clot and helps dissolve the clot. Giving heparin, low molecular weight heparin medicine as anticoagulant drug.
Thrombolytic therapy
Providing thrombolytic therapy to rapidly dissolve the clot in life threatening and emergency conditions. which breaks down clots. For example tissue plasminogen activator (tPA)
Inferior vena cava filter
Inferior vena cava filters are used when anticoagulant therapy is contraindicated or ineffective. In which an inferior vena cava filter is placed which prevents the clot in the lower area of the body from traveling to the lungs and depositing in the filter there.
Supplemental Oxygen Provide supplemental oxygen to maintain adequate oxygen levels.
Embalectomy An embolectomy involves the surgical removal of a clot (embolism).
Explain the Nursing management of pulmonary embolisms.
The nurse plays an important role in assessing the child for signs and symptoms of pulmonary embolism, including
Sudden chest pain, shortness of breath, rapid heartbeat,
May include coughing and fainting.
Continuously monitor the child’s oxygen level.
The nurse should prioritize stabilizing the child’s condition by ensuring adequate oxygenation, providing oxygen as needed, and initiating cardiac monitoring. Depending on the severity of symptoms, administer intravenous fluids to maintain hemodynamic stabilization.
Proper collaboration with other health care personnel for proper care of child
Giving the child proper medication, usually including anticoagulants (such as heparin or low molecular weight heparin) to prevent further clotting, and providing thrombolytic medication.
To provide complete education to the child, his parents and his caregivers about the child’s condition, its causes, its symptoms and signs, and its treatment.
Properly monitoring how effective the treatment provided to the child is.
To provide adequate emotional and psychological support to the child and his family members.
To provide proper work and comfortable environment to the child.
To provide education to the child’s parents to provide regular medication to the child.
Pneumothorax is a medical condition. In which there is leakage of air or gas into the pleural cavity causing the lung to collapse. Pneumothorax in a child is a condition in which air leaks into the space between the lungs and the chest wall, causing
There are chances of lung collapse. It can be caused by injury, lung disease or congenital abnormalities. Symptoms include chest pain, shortness of breath and sometimes a bluish tint to the skin due to oxygen deficiency.
Explain the Etiology/ causes of pneumothorax.
Chest trauma (ribus fracture)
Lung disease (asthma, pneumonia, cystic fibrosis),
Congenital Anaemolis,
Invasive medical procedures (biopsy, mechanical ventilation)
Medical Procedures
Spontaneous
Explain the clinical manifestations/ Sign and symptoms of Pneumothorax.
Sudden sharp chest pain,
Shortness of breath,
rapid breathing,
chest tightness,
cyanosis,
rapid heart rate,
Decrease Bridge Sound,
Restlessness and anxiety,
feeling tired
Explain the diagnostic evaluation of Pneumothorax.
History Collection,
Physical examination, chest x-ray,
CT scan,
ultrasound,
ABG Analysis,
blood test,
Explain the medical management of Pneumothorax
Needle insertion
In needle insertion, a hollow needle that is connected to a flexible tube (catheter) is inserted into the air filled space. Then the needle is removed and the syringe is attached to the catheter and the air is removed.
Chest tube insertion
In chest tube insertion, a flexible chest tube is inserted into the air filled space and has a one way valve attached to it which continuously removes air from the chest cavity.
Surgery
Some cases require surgery. In which a small incision is made and all the air is removed.
Observation
Monitoring the child properly and continuously.
Oxygen therapy
Provide oxygen therapy to the child to relieve the child’s symptoms, due to which the child’s breathing difficulties can be relieved.
Treatment of underlying causes
Identify the cause of pneumothorax in a child and treat it properly.
Explain the Nursing management of Pneumothorax
assessment
Properly assess the child’s condition, including the child’s vital signs, respiratory status, oxygen saturation level, etc.
Oxygen therapy
Provide oxygen therapy to the child to relieve the child’s breathing difficulties and improve his oxygen level.
monitoring
Monitoring the child properly and continuously, including the colour, amount and consistency of drainage.
Pain management
If the child is in pain, provide analgesic medication to the child to relieve the pain. And providing him a properly comfortable position.
Education and Support
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs, and its treatment.
Positioning
Providing the child with a proper position to expand the child’s lungs and improve drainage.
Collaboration
To properly collaborate with other healthcare personnel for proper care of the child.
Documentation
Properly documenting the treatment provided to the child and its assessment and interventions.
Advise the child’s parents to provide regular medication to the child.
Advising the child’s parents to follow up regularly.
Cystic fibrosis is a hereditary and genetic disorder that commonly affects the lungs in which mutations in the cystic fibrosis conductance regulator (CFTR) cause abnormal secretion of excessively thick, tenacious mucus and sweat, saliva in the lungs.
Explain the Etiology/causes of Cystic fibrosis
genetic factors,
hereditary,
family history,
Respiratory infection
Environmental Factors: Exposure to Allergens, Air Pollutants (Dust, Chemicals)
occupational factor,
Hyperreactive airways
Due to inhalation of certain types of irritating materials, such as smoking, shops, and strong orders of perfumes.
Due to respiratory tract infection.
Explain the Clinical manifestation/Sign and symptoms of the Cystic fibrosis
dyspnea,
whizzing,
Weight is slowly gained,
Generalized hyperresonance lung sound auscultation,
malabsorption,
Coughing with or without expectoration of sputum,
Chronic cuffing,
Shortness of breath,
Tightness filling in chest,
Increases respiratory rate,
Child a pale, irritable, hard to see,
chest pain,
A diminished breath sound,
headache,
muscle twitching,
confusion,
Coma.
Explain the diagnostic evaluation of Cystic fibrosis
History Collection,
Physical Examination,
Pulmonary function test, spirometer,
Peak expiratory flow measurement,
Fractional exhale, nitric oxide test, pulse oximetry,
chest x-ray,
CT scan,
sputum analysis,
blood test,
complete blood count,
ABGs Analysis,
allergy testing,
Explain the medical management of Cystic fibrosis.
Inhaled corticosteroid
This medication is most effective for long-term control of asthma. It reduces airway inflammation and decreases mucus production. For example budesonide, beclomethasone. In addition, a long-acting beta agonist is also inhaled.
Long acting beta agonist
These bronchodilators drugs are used to dilate the bronchi. For example salmeterol
Leukotriene modifiers
Mast cell stabilizers
Mast cell stabilizers inhibit inflammatory chemicals released from mast cells in the airways to relieve asthma symptoms. For example Nedocromil
Quick Relief Medication
Quick relief medication is used to relieve symptoms quickly. In which short acting beta agonist and oral corticosteroid drugs are used.
Oral corticosteroids
In severe conditions, oral corticosteroids such as prednisolone, methylprednisolone are given to quickly reduce airway inflammation.
Explain the nursing management of bronchial asthma
1) Impaired gas exchange related to altered oxygen supply, obstruction of airway
To monitor the child’s vital signs.
Assess the child’s respiratory rate, rhythm and breathing pattern.
Assessing child’s breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deepbreathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
2) Ineffective airway clearance related to obstruction from narrowed lumen
To monitor the child’s vital signs.
Assess the child’s respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deep breathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
3) Ineffective breathing pattern related to bronchospasm
To monitor the child’s vital signs.
Assess the child’s respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deepbreathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
4) Anxiety related to disease condition, hospitalization
Assessing the child’s condition.
Pay attention to the child’s psychological needs and listen carefully to the child’s parents.
Encouraging the child to express his feelings, discomfort and anxiety.
To solve all the doubts and queries of the child.
Providing knowledge to the child about his condition and treatment so that his anxiety is removed and the child becomes confident.
Providing psychological support to the child.
Providing mind diversional therapy and recreational therapy to the child.
5) Activity intolerance related to fatigue, dyspnea
Assessing the child’s condition.
Checking the child’s activity level.
Provide bed rest to the child initially.
Then gradually anchor the child for range of motion exercises.
Assisting the child with his activities.
Provide rest to the child between activities.
To check if the child has any type of breathing difficulty during the activity.
If breathing difficulty is found, stop the child’s activity and provide rest.
Infection and inflammation of the lung parenchyma (alveoli) known as pneumonia occurs due to bacterial, viral or fungal infections. In which the air sac fills with fluid or pus and becomes solid.
The alveoli work normally to exchange gas but in the condition of pneumonia there is interference in gas exchange due to infection and inflammation and accumulation of pus.
Explain the classification of pneumonia
Pneumonia is classified based on its cause, anatomical structure and severity.
On the Basis of Etiological Factors
Bacterial pneumonia
Pneumonia caused by bacterial infection is known as bacterial pneumonia. Pneumonia is caused by Streptococcus pneumoniae, Mycoplasma pneumoniae and Haemophilus influenzae bacteria.
Viral pneumonia
Pneumonia caused by a viral infection is known as viral pneumonia. Viruses such as influenza, corona virus, adeno virus and respiratory syncytial virus are responsible for causing pneumonia.
Fungal pneumonia
Pneumonia caused by fungal infection is known as fungal pneumonia.
On the Basis of Anatomical Structure
Pneumonia is classified as follows based on the anatomical structure
Lobar pneumonia
Lobar pneumonia is an infection in one or more lobes of the lungs.
Broncho pneumonia
In bronchopneumonia, infection occurs in the bronchi in addition to multiple lobes.
Interstitial pneumonia
In interstitial pneumonia, the interstitial tissue and alveolar septa are infected.
On the Basis of Broad Classification
Community acquired pneumonia
Pneumonia occurring in the community is called Community Acquired Pneumonia.
Hospital acquired pneumonia
Pneumonia occurring after 48 hours of hospitalization is called hospital acquired pneumonia.
Ventilator Associated Pneumonia
Pneumonia caused by endotracheal intubation or mechanical ventilation is called ventilator-associated pneumonia.
Aspiration pneumonia
Pneumonia due to endogenous or exogenous subtense aspirate is called aspiration pneumonia.
Explain the Etiology/causes of Pneumonia.
Due to bacterial infection,
Due to viral infection,
Due to fungal infection,
Aspiration of gastric contents,
Inhalation of Chemical Substances and Fumes
Explain the clinical manifestations/ Sign and symptoms of pneumonia.
Productive Cough (Green and Yellow Color),
blood in sputum,
Shortness of breath,
chest pain,
cyanosis,
orthopnea,
tachypnea,
dyspnea,
fever,
dehydration,
Malay,
confusion,
swatting,
nozia,
vomiting,
diarrhea,
anorexia,
crackle breath sound,
Chest retraction.
Explain the diagnostic evaluation of pneumonia
History Collection
Physical Examination
Pulmonary function test
x ray
CT scan
Sputum culture
Complete blood count
C reactive protein
Blood culture
Pulse oximetry
Arterial blood gas analysis.
Explain the complication of pneumonia
Respiratory failure
Sepsis
Lung abscess
Pleural effusion
Atelectasis
Explain the medical management of pneumonia.
Antibiotic therapy
Providing antibiotic drugs to treat bacterial pneumonia.
Antiviral drug
Giving antiviral drugs to treat viral pneumonia.
Fever Management
Provide the over-the-counter medicine acetaminophen to relieve fever.
Pain relievers (analgesics)
Provide analgesic drugs to reduce chest pain.
Oxygen Therapy Providing supplemental oxygen to maintain oxygen levels.
Cough expectorant
Provide expectorant to thin and expel phlegm.
Rest and Fluids Provide adequate rest to the child. Also maintaining hydration levels.
Explain the nursing management of pneumonia.
1) Ineffective airway clearance related to broncho constriction and increased mucus production
To monitor the child’s vital signs.
Assess the child’s respiratory rate, rhythm and breathing pattern.
Assessing child’s breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deep breathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing immobilization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain proper records and reports of the child.
2) Impaired gas exchange related to decrease ventilation
To monitor the child’s vital signs.
Assess respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deepbreathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain proper records and reports of the child.
3) Infective breathing pattern related to chest pain
To monitor the child’s sign.
Assess respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deepbreathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
If the spo2 level is low, provide oxygen therapy to the child.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To properly maintain records and reports of the child.
Bronchial asthma is a chronic inflammatory respiratory disorder. In which the respiratory tract becomes hyperresponsive to certain stimuli, the airway becomes inflamed and narrowing, and the airway constricts and becomes obstructed due to mucus production.
Asthma is reversible. Certain etiological factors cause airway hyperresponsiveness.
This leads to inflammation in the airways, resulting in hypersecretion of mucus, contraction of the airway muscles and swelling of the bronchial membrane.
This causes narrowing of the airways. So cough, chest tightness, shortness of breath and wheezing sound are seen.
Explain the Etiology/causes of Bronchial asthma
genetic factors,
family history,
Respiratory infection
Environmental Factors: Exposure to Allergens, Air Pollutants (Dust, Chemicals)
occupational factor,
Hyperreactive airways
Due to inhalation of certain types of irritating materials, such as cigarette smoking, shops, and strong orders of perfumes.
Due to respiratory tract infection.
Explain the Clinical manifestation/Sign and symptoms of the Bronchial asthma
dyspnea,
whizzing,
Coughing with or without expectoration of sputum,
Chronic cuffing,
Shortness of breath,
Tightness filling in chest,
Increases respiratory rate,
Child a pale, irritable, hard to see,
chest pain,
A diminished breath sound,
headache,
muscle twitching,
confusion,
Coma.
Explain the diagnostic evaluation of asthma
History Collection,
Physical Examination,
Pulmonary function test, spirometer,
Peak expiratory flow measurement,
Fractional Exhaled, Nitric Oxide Test,
pulse oximetry,
chest x-ray,
CT scan,
sputum analysis,
blood test,
complete blood count,
ABGs Analysis,
allergy testing,
Explain the medical management of bronchial asthma.
Controller medication
Controller medications are used to control symptoms.
Inhaled corticosteroid
This medication is most effective for long-term control of asthma. It reduces airway inflammation and decreases mucus production. For example budesonide, beclomethasone. In addition, a long-acting beta agonist is also inhaled.
Long acting beta agonist
These bronchodilators drugs are used to dilate the bronchi. For example salmeterol
Leukotriene modifiers
Leukotriene modifiers block the action of leukotriene as an inflammatory molecule in asthma. which reduces airway inflammation and prevents symptoms. For example montelukast,
Mast cell stabilizers
Mast cell stabilizers inhibit inflammatory chemicals released from mast cells in the airways to relieve asthma symptoms. For example Nedocromil
Biological therapy
Biologic medications are used in cases with severe asthma. For example monoclonal antibodies targeting IgE
Quick Relief Medication
Quick relief medication is used to relieve symptoms quickly. In which short acting beta agonist and oral corticosteroid drugs are used.
A short acting beta agonist
Short acting beta agonists are used to quickly relieve the condition of bronchospasm and improve airflow during an asthma attack. For example
Salbutamol and Levalbuterol
Oral corticosteroids
In severe conditions, oral corticosteroids such as prednisolone, methylprednisolone are given to quickly reduce airway inflammation.
Spacer device
These devices are used with a metered dose inhaler. So that the medicine delivered to the lung can be improved.
Explain the nursing management of bronchial asthma
1) Impaired gas exchange related to altered oxygen supply, obstruction of airway
To monitor the child’s vital signs.
Assess the child’s respiratory rate, rhythm and breathing pattern.
Assessing child’s breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deepbreathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
2) Ineffective airway clearance related to obstruction from narrowed lumen
To monitor the child’s vital signs.
Assess the child’s respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deep breathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
3) Ineffective breathing pattern related to bronchospasm
To monitor the child’s vital signs.
Assess the child’s respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Providing the child with a fowler position and restricting his activities.
Explain and anchor the child about deepbreathing and cuffing exercises.
To provide knowledge about pursed leap breathing and diaphragmatic breathing to the child.
Anchor the child to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the child.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
4) Anxiety related to disease condition, hospitalization
Assessing the child’s condition.
Paying attention to the child’s psychological needs and listening carefully to the child’s parents.
Encouraging the child to express his feelings, discomfort and anxiety.
To solve all the doubts and queries of the child.
Providing knowledge to the child about his condition and treatment so that his anxiety is removed and the child becomes confident.
Providing psychological support to the child.
Providing mind diversional therapy and recreational therapy to the child.
5) Activity intolerance related to fatigue, dyspnea
Assessing the child’s condition.
Checking the child’s activity level.
Provide bed rest to the child initially.
Then gradually anchor the child for range of motion exercises.
Assisting the child with his activities.
Provide rest to the child between activities.
To check if the child has any type of breathing difficulty during the activity.
If breathing difficulty is found, stop the child’s activity and provide rest.