儿童呼吸系统疾病英文版.pptx

,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,Anatomy and Physiology of the Childhood Respiratory System,Upper respiratory tract,Nose,Pharynx,Larynx,Epiglottis,Lower respiratory tract,Trachea,Bronchi,Bronchioles and alveoli,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,Pneumonia,Definition,An inflammation or infection of the,bronchioles and alveolar spaces of the lungs,Pneumonia,Introduction,occur:,in infants and young children,recovery:,children sooner than adults,exist type:,disease or complication,season:,late winter and early spring,Pneumonia,Lobar pneumonia,Bronchopneumonia(lobular pneumonia),Interstitial pneumonia,Pneumonia,classification,Morphological classification,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,Course Agent,Acute 3 months,Pneumonia,classification,State of Illness,Mild,Severe,Pneumonia,classification,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 bronchopneumonia,Severe bronchopneumonia,circulation system,manifestations of myocarditis,signs of heart failure,nervous system,gastrointestinal,Chest:X-ray film,Pneumonia,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,manifestations of myocarditis,pale,tachycardia,diminished cardiac sound and arrhythmia,ST slowing down,T wave updown,Pneumonia,manifestation,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 bronchopneumonia,Nervous system,:,dysphoria(,烦躁,)irritable,alert/stuporous,convulsion,somnolence(,嗜睡,),intracranial hypertension,Pneumonia,manifestation,Severe bronchopneumonia,Gastrointestinal,anorexia vomiting,abdominal,distention,toxic enteritis hemorrhage of GI,absent intestinal sound bloody stool,Pneumonia,manifestation,Severe bronchopneumonia,Chest:X-ray film,diffuse or patchy infiltration,small spotted shadow of the right middle,Pneumonia,manifestation,Therapeutic Management,principle,antimicrobial therapy,supportive measures,Pneumonia,therapy,principle,control infection,promote oxygenation and comfort,prevent complication,fever management,fluid intake,family support,Pneumonia,therapy,Antimicrobial therapy,PG given by IM or IV,PG-allergic:erythromycin clindamycin,PG-resistent:cephalosporin,PG and cephalosporin-resistent:vancomycin,Pneumonia,therapy,Supportive Measures,control cough and dyspnea,keep airway clear,give oxygen,position:semi-reclining,Pneumonia,therapy,Nursing Diagnosis,Impaired gas exchange,collection mucous in airway,Ineffective airway clearance,mechanical obstruction,inflammation,and increased secretions,Pneumonia,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,Nursing Intervention,Restore Optimal Respiratory Function,Maintain Airway Cleaning,Provide Adequate Rest and Nutrition,Observation,Prevent Infection,Nursing Intervention,Restore Optimal Respiratory Function,Keep comfortable environment,Position child for maximum ventilation,semi-reclining position,Provide Oxygen:,mask nasal cannula,intubation mechanical ventilation,Maintain Airway Cleaning,Institute suctioning of airway,cough effectively and postural drainage,Provide nebulization,Chest Physiotherapy,Administer medications,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,observation,Temperature:prevent hyperthermia seizure,Signs of heart failure,Signs of intracranial hypertention,Signs of toxic enteroplegia and GI blood,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 intracranial hypertension,Alert or stuporous,Seizure,coma,irregular respiration,observation,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,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,Before treatment,After treatment,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 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 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 pneumonia,Chlamydial,pneumonia,（衣原体肺炎）,age:6 months,symptom:cough,scattered inspiration rales,wheeze rarely no fever,Pneumonia,Thank You,