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,单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Respiratory Dysfunction,Respiratory Dysfunction,Anatomy and Physiology of the Childhood Respiratory System,Upper respiratory tract,Nose,Pharynx,Larynx,Epiglottis,Lower respiratory tract,Trachea,Bronchi,Bronchioles and alveoli,Anatomy 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 area,Anatomy and Physiology of the Childhood Respiratory System,The Upper Airway differences:,Pneumonia,Pneumonia,Definition,An inflammation or infection of the,bronchioles and alveolar spaces of the lungs,Pneumonia,Definition 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,Introduction occur: in infan,Lobar pneumonia,Bronchopneumonia (lobular pneumonia),Interstitial pneumonia,Pneumonia,classification,Morphological classification,Pneumonia classificationM,Etiologic Agent,Infectious,virus bacterial,Mycoplasma,(,支原体肺炎,),chlamydial,（衣原体肺炎）,fungi pneumocystis,(,肺囊虫),Noninfectious,foreign body aspiration,Pneumonia,classification,Etiologic Agent Noninfectious,Course Agent,Acute 3 months,Pneumonia,classification,Course Agent Pneumonia class,State of Illness,Mild,Severe,Pneumonia,classification,State of IllnessPneumonia clas,the clinical manifestations of bronchopneumonia,Mild 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 rales,Pneumonia,the clinical manifestations of,the clinical manifestations of bronchopneumonia,Severe bronchopneumonia,circulation system,manifestations of myocarditis,signs of heart failure,nervous system,gastrointestinal,Chest:X-ray film,Pneumonia,the clinical manifestations of,Severe bronchopneumonia,Circulation system,myocarditis, congestive heart failure,pathogens,invading the myocardium and produce toxin,toxic myocarditis,hypoxia,pulmonary artery hypertension,CHF,Pneumonia,manifestation,Severe bronchopneumonia,Severe bronchopneumonia,manifestations of myocarditis,pale,tachycardia,diminished cardiac sound and arrhythmia,ST slowing down,T wave updown,Pneumonia,manifestation,Severe bronchopneumonia,Severe bronchopneumonia,Signs of heart failure,Restless obvious cyanosis grey faces,Tachypnea:RR 60ts/m,Tachycardia:HR 160-180bpm,Sweating dyspnea cervical vein distention,oliguria or anuria face/lower limbs edema,Hepatomegaly progressively,Pneumonia,manifestation,Severe bronchopneumoni,Severe bronchopneumonia,Nervous system,:,dysphoria(,烦躁,) irritable,alert/stuporous,convulsion,somnolence(,嗜睡,),intracranial hypertension,Pneumonia,manifestation,Severe bronchopneumonia Pne,Severe bronchopneumonia,Gastrointestinal,anorexia vomiting,abdominal,distention,toxic enteritis hemorrhage of GI,absent intestinal sound bloody stool,Pneumonia,manifestation,Severe bronchopneumonia,Severe bronchopneumonia,Chest:X-ray film,diffuse or patchy infiltration,small spotted shadow of the right middle,Pneumonia,manifestation,Severe bronchopneumonia sm,Therapeutic Management,principle,antimicrobial therapy,supportive measures,Pneumonia,therapy,Therapeutic ManagementPneumoni,principle,control infection,promote oxygenation and comfort,prevent complication,fever management,fluid intake,family support,Pneumonia,therapy,principlePneumonia therapy,Antimicrobial therapy,PG given by IM or IV,PG-allergic: erythromycin clindamycin,PG-resistent: cephalosporin,PG and cephalosporin-resistent: vancomycin,Pneumonia,therapy,Antimicrobial therapy,Supportive Measures,control cough and dyspnea,keep airway clear,give oxygen,position: semi-reclining,Pneumonia,therapy,Supportive Measures contr,Nursing Diagnosis,Impaired gas exchange,collection mucous in airway,Ineffective airway clearance,mechanical obstruction, inflammation,and increased secretions,Pneumonia,Nursing Diagnosis Impaired,Anticipated goals,The child will show normal respiratory function,will receive optimum oxygen supply,The child will maintain patent airway,will expectorate secretions adequately,Pneumonia,Anticipated goalsThe child wil,Nursing Intervention,Nursing Intervention,Restore Optimal Respiratory Function,Maintain Airway Cleaning,Provide Adequate Rest and Nutrition,Observation,Prevent Infection,Nursing Intervention,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,Restore Optimal Respiratory,Maintain Airway Cleaning,Institute suctioning of airway, cough effectively and postural drainage,Provide nebulization,Chest Physiotherapy,Administer medications,Maintain Airway Cleaning I,Provide 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,Provide Adequate Rest and Nutr,observation,Temperature:prevent hyperthermia seizure,Signs of heart failure,Signs of intracranial hypertention,Signs of toxic enteroplegia and GI blood,observationTemperature:prevent,Signs 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,Signs of heart failure us,Signs of intracranial hypertension,Alert or stuporous,Seizure,coma,irregular respiration,observation,Signs of intracranial hyperten,Signs of toxic enteroplegia and GI blood,abdominal distention,treatment: supply potassium, dietary restriction,placing nasogastric tube, inject neostigmine.,Bowl sound,Vomiting,Blood stool,observation,Signs of toxic enteroplegia an,Prevent 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,Prevent Infection Assess s,Before treatment,After treatment,Before 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,Intercostal,Subcostal,Suprasternal,Pneumonia,several special types,several special types of pneumonia,Staphylococcal pneumonia,（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,several special types of pne,several special types of pneumonia,Mycoplasmal pneumonia,(,支原体肺炎,),age: 5-12 years,season: fall and winter,symptom: dry, hacking cough, fever,extrapulmonary complications: blood, heart, CNS,Pneumonia,several special types of,several special types of pneumonia,Chlamydial,pneumonia,（衣原体肺炎）,age: 6 months,symptom: cough,scattered inspiration rales,wheeze rarely no fever,Pneumonia,several special types of pne,Thank You,Thank You,
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