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1、Respiratory Dysfunction,儿童呼吸系统疾病英,1,Respiratory Dysfunction儿童,Anatomy and Physiology of the Childhood Respiratory System,Upper respiratory tract NosePharynxLarynxEpiglottisLower respiratory tractTracheaBronchiBronchioles and alveoli,儿童呼吸系统疾病英,2,Anatomy and Physiology of the,The Upper Airway differen
2、ces: 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,儿童呼吸系统疾病英,3,The Upper Airway
3、 differences:,Pneumonia,儿童呼吸系统疾病英,4,Pneumonia儿童呼吸系统疾病英4,Definition,An inflammation or infection of the bronchioles and alveolar spaces of the lungs,Pneumonia,儿童呼吸系统疾病英,5,Definition An inflammation or,Introduction,occur: in infants and young children recovery: children sooner than adults exist type:
4、disease or complication season: late winter and early spring,Pneumonia,儿童呼吸系统疾病英,6,Introduction occur: in infan,Lobar pneumonia Bronchopneumonia (lobular pneumonia) Interstitial pneumonia,Pneumonia,classification,Morphological classification,儿童呼吸系统疾病英,7,Pneumonia classificationM,Etiologic Agent,Infe
5、ctiousvirus bacterial Mycoplasma(支原体肺炎) chlamydial （衣原体肺炎）fungi pneumocystis(肺囊虫),Noninfectious foreign body aspiration,Pneumonia,classification,儿童呼吸系统疾病英,8,Etiologic Agent Noninfectious,Course Agent,Acute 3 months,Pneumonia,classification,儿童呼吸系统疾病英,9,Course Agent Pneumonia class,State of Illness,Mi
6、ld Severe,Pneumonia,classification,儿童呼吸系统疾病英,10,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 s
7、igns and cyanosis fixed fine moist rales,Pneumonia,儿童呼吸系统疾病英,11,the clinical manifestations of,the clinical manifestations of bronchopneumonia,Severe bronchopneumoniacirculation systemmanifestations of myocarditissigns of heart failurenervous system gastrointestinal Chest:X-ray film,Pneumonia,儿童呼吸系统
8、疾病英,12,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,儿童呼吸系统疾病英,13,Severe bronchopneumonia,Severe b
9、ronchopneumonia,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,14,Severe bronchopneumonia,Severe bronchopneumonia,Signs of heart failure Restless obvious cyanosis grey facesTachypnea:RR 60ts/mTach
10、ycardia: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,15,Severe bronchopneumoni,Severe bronchopneumonia,Nervous system: dysphoria(烦躁) irritable alert/stuporous convulsion somnolence(嗜睡) intr
11、acranial hypertension,Pneumonia,manifestation,儿童呼吸系统疾病英,16,Severe bronchopneumonia Pne,Severe bronchopneumonia,Gastrointestinal,anorexia vomiting abdominal distention toxic enteritis hemorrhage of GI absent intestinal sound bloody stool,Pneumonia,manifestation,儿童呼吸系统疾病英,17,Severe bronchopneumonia,Se
12、vere bronchopneumonia,Chest:X-ray film diffuse or patchy infiltration,small spotted shadow of the right middle,Pneumonia,manifestation,儿童呼吸系统疾病英,18,Severe bronchopneumonia sm,Therapeutic Management,principle antimicrobial therapy supportive measures,Pneumonia,therapy,儿童呼吸系统疾病英,19,Therapeutic Managem
13、entPneumoni,principle,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,20,rinciplePneumonia therapy儿童呼吸,Antimicrobial therapy,PG given by IM or IV PG-allergic: erythromycin clindamycin PG-resistent: cephal
14、osporin PG and cephalosporin-resistent: vancomycin,Pneumonia,therapy,儿童呼吸系统疾病英,21,Antimicrobial 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,22,Supportive Measures contr,Nursing Diagnosis,Impaired gas exchang
15、e collection mucous in airway Ineffective airway clearance mechanical obstruction, inflammation and increased secretions,Pneumonia,儿童呼吸系统疾病英,23,Nursing Diagnosis Impaired,Anticipated goals,The child will show normal respiratory function will receive optimum oxygen supplyThe child will maintain paten
16、t airway will expectorate secretions adequately,Pneumonia,儿童呼吸系统疾病英,24,Anticipated goalsThe child wil,Nursing Intervention,儿童呼吸系统疾病英,25,Nursing Intervention儿童呼吸系统疾病英2,Restore Optimal Respiratory Function Maintain Airway Cleaning Provide Adequate Rest and Nutrition Observation Prevent Infection,Nursi
17、ng Intervention,儿童呼吸系统疾病英,26,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,27,Restore Optimal Respiratory,Maint
18、ain 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,28,Maintain Airway Cleaning I,Provide Adequate Rest and Nutrition,Provide quiet environment darken room , schedule visiting time Bed r
19、est 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,29,Provide Adequate Rest and Nutr,observation,Temperature:prevent hyperthermia seizureSigns of heart failureSigns of intracranial hyp
20、ertentionSigns of toxic enteroplegia and GI blood,儿童呼吸系统疾病英,30,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,儿童呼吸系统疾
21、病英,31,Signs of heart failure us,Signs of intracranial hypertension,Alert or stuporousSeizurecoma irregular respiration,observation,儿童呼吸系统疾病英,32,Signs of intracranial hyperten,Signs of toxic enteroplegia and GI blood,abdominal distention treatment: supply potassium, dietary restriction, placing nasog
22、astric tube, inject neostigmine.Bowl soundVomitingBlood stool,observation,儿童呼吸系统疾病英,33,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 t
23、he patients Administer antibiotics,儿童呼吸系统疾病英,34,Prevent Infection Assess s,Before treatment,After treatment,儿童呼吸系统疾病英,35,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, t
24、achypnea, nasal flaring cyanosis, respiratory fatigue,IntercostalSubcostalSuprasternal,Pneumonia,儿童呼吸系统疾病英,36,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，cyano
25、sis and anxiety signs in infants: lethargic, irritable, toxic gastrointestinal disturbances,Pneumonia,儿童呼吸系统疾病英,37,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 co
26、mplications: blood, heart, CNS,Pneumonia,儿童呼吸系统疾病英,38,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,儿童呼吸系统疾病英,39,several special types of pne,Thank You,儿童呼吸系统疾病英,40,Thank You儿童呼吸系统疾病英40,
