ACUTE RESPIRATORY INFECTION IN CHILDREN-ENGLISH
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Acute
Respiratory Infections-
•
ARIs
in children take a heavy toll on life, especially where medical care is not
available or is not sought. ARI is a leading cause of childhood morbidity and
mortality.
•
Acute respiratory infections (ARIs) are defined
as acute infections of any part of respiratory tract or adjuescent structures.
Theses are classified as upper respiratory tract infections (URIs) or lower
respiratory tract infections (LRIs).
Upper
Respiratory infection-
•
URIs are the most common infectious diseases.
They include rhinitis (common cold), sinusitis, ear infections, tonsillitis,
acute pharyngitis or tonsillo-pharyngitis, epiglottitis, and laryngitis—of
which ear infections and pharyngitis cause the more severe complications
(deafness and acute rheumatic fever, respectively).
•
Rhinitis is inflammation and swelling of the
mucous membrane of the nose, characterized by a runny nose and stuffiness and
usually caused by the common cold or a seasonal allergy. Colds and allergies
are the most common causes of rhinitis.
•
Sinusitis is a common inflammation of the
paranasal sinuses, the cavities that produce the mucus necessary for the nasal
passages to work effectively. It can be acute or chronic, and it can be caused
by viruses, bacteria, fungi & allergies.
•
Acute ear infection is caused by swelling and infection of
the middle ear (otitis media) . The middle ear is located just behind the
eardrum. An acute ear infection starts over a short period and is painful.
Anything that causes the eustachian tubes to become swollen or blocked makes
more fluid build up in the middle ear behind the eardrum (middle ear).
•
Tonsillitis is inflammation of the tonsils, two
oval-shaped pads of tissue at the back of the throat — one tonsil on each side.
Signs and symptoms of tonsillitis include swollen tonsils,
sore throat, difficulty swallowing and tender lymph nodes on the sides of the
neck
•
Acute pharyngitis is an inflammatory syndrome of the pharynx
and/or tonsils caused by several different groups of microorganisms.
Pharyngitis can be part of a generalized upper respiratory tract infection or a
specific infection localized in the pharynx.
•
Most
cases are caused by viruses and occur as part of common colds and influenzal
syndromes.
•
Epiglottitis is inflammation of the epiglottis—the
flap at the base of the tongue that prevents food entering the trachea
(windpipe). Symptoms are usually rapid in onset and include trouble swallowing
which can result in drooling, changes to the voice, fever, and an increased
breathing rate.
•
Laryngitis is an inflammation of voice box (larynx)
from overuse, irritation or infection. With laryngitis, the vocal cords
become inflamed or irritated. This makes the vocal cords swell, which distorts
the sounds produced by air passing over them. As a result, voice sounds hoarse. In some cases of
laryngitis, your voice can become almost undetectable.
Lower
Respiratory infection-
•
The
common LRIs in children are pneumonia, bronchiolitis and sometimes influenza.
The respiratory rate is a valuable clinical sign for diagnosing acute LRI in
children who are coughing and breathing rapidly. The presence of lower chest
wall indrawing identifies more severe disease
•
Both
bacteria and viruses can cause pneumonia. Bacterial pneumonia is often
caused by Streptococcus pneumoniae (pneumococcus) or Haemophilus
influenzae, mostly type b (Hib), and occasionally by Staphylococcus
aureus or other streptococci. Other pathogens, such as Mycoplasma
pneumoniae and Chlamydia pneumoniae, cause atypical
pneumonias.
•
Bronchiolitis occurs predominantly in the first year of
life and with decreasing frequency in the second and third years. The clinical
features are rapid breathing and lower chest wall indrawing, fever in one-third
of cases, and wheezing. Inflammatory obstruction of the small airways, which
leads to hyperinflation of the lungs, and collapse of segments of the lung
occur.
•
Even
though influenza viruses usually cause URIs in adults, they are
increasingly being recognized as an important cause of LRIs in children. For
most people, influenza resolves on its own. But sometimes, influenza and its
complications can be deadly such as young children under age 5, and especially
those under 12 months
Sign
and symptoms of ARI-
•
Common
sign and symptoms of ARI are-
•
congestion,
either in the nasal sinuses or lungs
•
runny
nose
•
cough
•
sore
throat
•
body
aches
•
fatigue
•
fever
over 103˚F (39˚C) and chills
•
difficulty
breathing
•
dizziness
•
loss
of consciousness
Diagnositc
investigations-
Main
diagnostic examination for ARI includes-
•
Auscultation
•
Nasal
swab examination
•
Sputum
examination
•
X-ray
Examination
•
CBC
blood test.
Management-
•
Almost
all ARIs can be managed medically in OPD. But in severe cases the child may
need hospitalization.
•
Bacterial
cases may need antibiotics.
•
Oxygen
inhalation may be needed in severe cases.
•
Antipyretics
and antitussive bronchodilators may help as supportive treatment.
Nursing
Management-
Ø
-Observation
of respiratory status is very important nursing care in severe ARI.
Ø
-Breathing
pattern should be noted for retractions, nasal flaring use of accessory muscles
etc.
Ø
-
Steam inhalation may be ordered, it should be provided with care to clear
lungs.
Ø
-
All the medications and Nebulization should be given as per schedule. Some times postural
drainage may be prescribed, so act accordingly.
Ø
-
The baby is observed for cyanosis if it occur head end of the bed should be
raised and inform to pediatrician.
Ø
-
Oxygen inhalation may be prescribed and should be administered as per
recommendation.
Ø
-
Provide psychological support to parents to reduce their anxiety.
Ø
-
Signs and symptoms of dehydration should be noted and iv fluids may be given to
correct it .
Ø
-
Nursing management of fever is done in case of pyrexia which is often seen in
severe ARI.
Ø
- Regular diet and more fluids should be given
so that nutritional status and water balance is maintained.
Ø
Breathing exercises and habits should be
explained and encouraged to follow instructions.
Ø
Other Nursing interventions – includes all nursing
care of hospitalized child that we have discussed in previous lecture under
heading Nursing care of hospitalized child in the lecture “Child Health
Nursing”.
Thank you sir
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