Unit 5 Respiratory Infections

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Presentation transcript:

Unit 5 Respiratory Infections 7/11/05

Young Children & Respiratory infections Susceptibility Immune system immature Smaller & shorter airways Small chest and large abdomen Less aveoli Abdominal breathing

Acute Respiratory infections Epiglottis Acute larynogotracheobronchitis (LTB) Pertussis Bronchiolitis / RSV Pnemonia Many others

Assessment LOC Respiratory rate Work of breathing Color (perfusion) Retractions Nasal flaring Stridor, Grunting, Wheening Color (perfusion) Breath sounds

Intervention Monitor closely - pulse oximetry Maintain airway – may need intubation Oxygen and mist therapy Chest physiotherapy Positioning Maintaining fluids and nutrition Medications Antibiotics (if appropriate) Nebulizer treatments: bronchodilators Others

Epiglottitis Bacterial (Haemohilus influenzae) older children (1-8yr) above the glottitis painful throat drooling muffled voice high fever Lateral neck

Epiglottitis Position Tripod position Leans forward Restless, anxious Progressive airway obstruction can occur DO NOT MANIPULATE BACK OF THROAT!

Bronchiolitis/ RSV

Bronchiolitis Rare over 2 years of age (peak age 2-5 mo.) Maximum effect at the bronchiolar level 80% caused by the respiratory syncytial virus (RSV) Bronchiole mucosa swelling, mucus and exudate. Degree of obstruction especially on expiration. Hyperinflation of lungs atelectasis Highest incidence: Begins in the fall and peaks in the winter. Other 20% adenoviruses and parainfluenza viruses. RSV is a paramyxovirus containing a single strand of RNA. There are two subgroups A & B. A is more virulent. Higher incidence in nursery school children Younger the child the higher the probability of requiring hospitalization. Severity decreases with age

Diagnosis Symptoms: Diagnostic tests: URI Wheezing, retractions crackles, dyspnea Diagnostic tests: Nasal or nasopharyngeal IFA or rapid immunofluorescent antibody (IFA) ELISA URI- early signs after incubation of 5-8 days Rhinorrhea, conuunctivitis Infants may not have symptoms except slight lethargy poor feeding or irritability. Cough Dx Tests: ELISA: enzyme linked immunosorbent assay to defect RSBB antigen Lower airway- as listed also diminished BS

Nursing Infection control Handwashing Gloves & gown Assigned to RSV patients only No pregnant women assigned if receiving Ribavirin.