儿童呼吸系统疾病英ppt课件

Respiratory Dysfunction儿童呼吸系统疾病英1u Respiratory Dysfunction儿童儿童Anatomy and Physiology of the Childhood Respiratory SystemUpper respiratory tract NosePharynxLarynxEpiglottisLower respiratory tractTracheaBronchiBronchioles and alveoli儿童呼吸系统疾病英2uAnatomy and Physiology of the The Upper Airway differences:shorter and narrow 4 mm 20 mm nose breather airway resistance loosely mucous membranes and soft tissue The Lower Airway differences:right bronchus is more wider,shorter,vertical less alveolar surface areaAnatomy and Physiology of the Childhood Respiratory System儿童呼吸系统疾病英3u The Upper Airway differences:Pneumonia儿童呼吸系统疾病英4uPneumonia儿童呼吸系统疾病英儿童呼吸系统疾病英4Definition An inflammation or infection of the bronchioles and alveolar spaces of the lungsPneumonia 儿童呼吸系统疾病英5uDefinition An inflammation or Introduction occur:in infants and young children recovery:children sooner than adults exist type:disease or complication season:late winter and early spring Pneumonia 儿童呼吸系统疾病英6uIntroduction occur:in infan Lobar pneumonia Bronchopneumonia(lobular pneumonia)Interstitial pneumoniaPneumonia classificationMorphological classification儿童呼吸系统疾病英7u Pneumonia classificationMEtiologic Agent Infectiousvirus bacterial Mycoplasma(支原体肺炎支原体肺炎)chlamydial（衣原体肺炎）（衣原体肺炎）fungi pneumocystis(肺囊肺囊虫虫)Noninfectious foreign body aspirationPneumonia classification儿童呼吸系统疾病英8uEtiologic Agent Noninfectious Course Agent Acute 3 months Pneumonia classification儿童呼吸系统疾病英9uCourse Agent Pneumonia classState of Illness Mild Severe Pneumonia classification儿童呼吸系统疾病英10uState of IllnessPneumonia clasthe clinical manifestations of bronchopneumoniauMild bronchopneumonia fever:irregular fever cough:dry,hacking,non-productive to productive cough tachypnea:RR4080ts/m nasal flaring,sighing respiration,three depression signs and cyanosis fixed fine moist ralesPneumonia 儿童呼吸系统疾病英11uthe clinical manifestations ofthe clinical manifestations of bronchopneumoniauSevere bronchopneumonialcirculation systemmanifestations of myocarditissigns of heart failurelnervous systeml gastrointestinall Chest:X-ray filmPneumonia 儿童呼吸系统疾病英12uthe clinical manifestations ofSevere bronchopneumonia Circulation system myocarditis,congestive heart failure pathogens invading the myocardium and produce toxintoxic myocarditishypoxia pulmonary artery hypertensionCHFPneumonia manifestation儿童呼吸系统疾病英13uSevere bronchopneumonia Severe bronchopneumonia manifestations of myocarditis pale tachycardia diminished cardiac sound and arrhythmia ST slowing down T wave updown Pneumonia manifestation儿童呼吸系统疾病英14uSevere bronchopneumonia Severe bronchopneumoniaSigns of heart failure Restless obvious cyanosis grey facesTachypnea:RR 60ts/mTachycardia:HR 160-180bpmSweating dyspnea cervical vein distentionoliguria or anuria face/lower limbs edemaHepatomegaly progressively Pneumonia manifestation儿童呼吸系统疾病英15u Severe bronchopneumoniSevere bronchopneumonia Nervous system:dysphoria(烦躁烦躁)irritable alert/stuporous convulsion somnolence(嗜睡嗜睡)intracranial hypertension Pneumonia manifestation儿童呼吸系统疾病英16uSevere bronchopneumonia PneSevere bronchopneumonia Gastrointestinal anorexia vomiting abdominal distention toxic enteritis hemorrhage of GI absent intestinal sound bloody stoolPneumonia manifestation儿童呼吸系统疾病英17uSevere bronchopneumonia Severe bronchopneumonia Chest:X-ray film diffuse or patchy infiltration small spotted shadow of the right middlePneumonia manifestation儿童呼吸系统疾病英18uSevere bronchopneumonia smTherapeutic Management principle antimicrobial therapy supportive measuresPneumonia therapy儿童呼吸系统疾病英19uTherapeutic ManagementPneumoniprinciple control infection promote oxygenation and comfort prevent complication fever management fluid intake family support Pneumonia therapy儿童呼吸系统疾病英20uprinciplePneumonia therapy儿童呼吸儿童呼吸Antimicrobial therapy PG given by IM or IV PG-allergic:erythromycin clindamycin PG-resistent:cephalosporin PG and cephalosporin-resistent:vancomycin Pneumonia therapy儿童呼吸系统疾病英21uAntimicrobial therapy Supportive Measures control cough and dyspnea keep airway clear give oxygen position:semi-reclining Pneumonia therapy儿童呼吸系统疾病英22uSupportive Measures contrNursing Diagnosis Impaired gas exchange collection mucous in airway Ineffective airway clearance mechanical obstruction,inflammation and increased secretions Pneumonia 儿童呼吸系统疾病英23uNursing Diagnosis ImpairedAnticipated goalsuThe child will show normal respiratory function will receive optimum oxygen supplyuThe child will maintain patent airway will expectorate secretions adequatelyPneumonia 儿童呼吸系统疾病英24uAnticipated goalsThe child wilNursing Intervention儿童呼吸系统疾病英25uNursing Intervention儿童呼吸系统疾病英儿童呼吸系统疾病英2 Restore Optimal Respiratory Function Maintain Airway Cleaning Provide Adequate Rest and Nutrition Observation Prevent InfectionNursing Intervention儿童呼吸系统疾病英26u Restore Optimal Respirator Restore Optimal Respiratory Function Keep comfortable environment Position child for maximum ventilation semi-reclining position Provide Oxygen:mask nasal cannula intubation mechanical ventilation儿童呼吸系统疾病英27u Restore Optimal Respiratory Maintain Airway Cleaning Institute suctioning of airway,cough effectively and postural drainage Provide nebulization Chest Physiotherapy Administer medications儿童呼吸系统疾病英28uMaintain Airway Cleaning IProvide Adequate Rest and Nutrition Provide quiet environment darken room,schedule visiting time Bed rest Appropriate diet high-protein and carbohydrate digestive,nutritional liquid and semi-liquid diet small frequent feeding enteral or parenteral nutrition 儿童呼吸系统疾病英29uProvide Adequate Rest and NutrobservationuTemperature:prevent hyperthermia seizureuSigns of heart failureuSigns of intracranial hypertentionuSigns of toxic enteroplegia and GI blood儿童呼吸系统疾病英30uobservationTemperature:preventSigns of heart failure use cardiac monitor vital signs oxygen saturation breath sounds,color of skin,intake and output,electrolyte levels side effect of medication heart failure signs observation儿童呼吸系统疾病英31uSigns of heart failure usSigns of intracranial hypertensionuAlert or stuporousuSeizureucoma uirregular respiration observation儿童呼吸系统疾病英32uSigns of intracranial hypertenSigns of toxic enteroplegia and GI blooduabdominal distention treatment:supply potassium,dietary restriction,placing nasogastric tube,inject neostigmine.nBowl soundnVomitingnBlood stoolobservation儿童呼吸系统疾病英33uSigns of toxic enteroplegia anPrevent Infection Assess signs of infection vital signs,temperature fluctuation sputum culture,sensitivity reports and WBC Maintain aseptic environment Limit visitors and isolate the patients Administer antibiotics儿童呼吸系统疾病英34uPrevent Infection Assess sBefore treatmentAfter treatment儿童呼吸系统疾病英35uBefore treatmentAfter treatmen several special types of pneumonia Viral pneumonia most common cause:RSV peak attack rate:2 age onset:acute or insidious symptom:fever,cough,tachypnea,nasal flaring cyanosis,respiratory fatigue IntercostalIntercostalSubcostalSubcostalSuprasternalSuprasternal Pneumonia 儿童呼吸系统疾病英36u several special types several special types of pneumonia Staphylococcal pneumonia（葡萄球菌肺炎）（葡萄球菌肺炎）season:October and May following:viral upper respiratory tract age:girls symptom:tachypnea，cyanosis and anxiety signs in infants:lethargic,irritable,toxic gastrointestinal disturbances Pneumonia 儿童呼吸系统疾病英37u several special types of pne several special types of pneumoniaMycoplasmal pneumonia(支原体肺炎支原体肺炎)age:5-12 years season:fall and winter symptom:dry,hacking cough,fever extrapulmonary complications:blood,heart,CNSPneumonia 儿童呼吸系统疾病英38u several special types of several special types of pneumoniaChlamydial pneumonia（衣原体肺炎）（衣原体肺炎）age:6 months symptom:cough scattered inspiration rales wheeze rarely no feverPneumonia 儿童呼吸系统疾病英39u several special types of pneThank YouThank You儿童呼吸系统疾病英40uThank You儿童呼吸系统疾病英儿童呼吸系统疾病英40