1. Unit 5 Respiratory Infections
7/11/05

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

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

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

5. 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

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

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

8. Bronchiolitis/ RSV

9. 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

10. 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

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