infections

Respiratory tract
Common Pediatric

ROTA 3 TETUAN | BSN 2B

SUBMITTED TO: ANTONIETA B. DICEN, RN, MN

 Common Pediatric
Respiratory tract infections

Hadjiri, Haneeza P. & Go, Valenshien I. Cystic Fibrosis

Pulalon, Ayang Rishya G. & Warad, Nurhaliza A. Pneumonia

Jailani, Aisha Y. & Julaili, Muhammad Bin Muadh Y. Bronchitis

Isnani, Afralyn M. & Jul-Alfad, Al-Jhea F. Asthma

Usman, Allysa Ellen Jhain R. & Sahibad, Shayera Radina L. Tonsillitis

SUBMITTED TO: ANTONIETA B. DICEN, RN, MN

ROTA 3 TETUAN | BSN 2B
 Cystic
Fibrosis
Lifelong disease that affects the lungs and
digestive system and can be life-threatening,
and people with the condition tend to have a
shorter-than-normal life span.

This disease is caused by a defective gene

that makes the body produce very thick, sticky
mucus. This mucus:

 Clogs the lungs and leads to lung infections

 Blocks the pancreas and prevents the

Signs and normal breakdown and use of food by the

body

symptoms


Salty-tasting skin
Daily cough, at times with mucus
Lab Diagnosis
 Lung infections Most people are diagnosed with CF at birth
 Shortness of breath or wheezing with newborn screening, or before 2 years of
 Poor growth or slow weight gain even age.
with a good appetite
 Sweat test is the most common test
 Frequent greasy, bulky, foul-smelling
used to diagnose CF, It is a painless
stools or trouble having a bowel
test.
movement
 Nasal polyps, or small, fleshy growths  Genetic tests these tests are mainly
found in the nose used to find out if a person carries the
 CF's obstruction of the lungs increases CF gene, but they can also be used to
the risk of lung infections such as confirm a CF diagnosis following an
bronchitis and pneumonia, as it creates unclear sweat test result.
optimal conditions for the growth of
pathogens.
 Obstruction in the pancreas can lead to
malnutrition and poor growth. It has also
been associated with an increased risk of
diabetes and osteoporosis.
 Treatment and Management
There is currently no cure for CF. Treatment can manage the symptoms of the disease, however, and
improve quality of life. Symptoms can vary and treatment plans will be individualized.
 Airway clearance
 Inhaled medication
 Antibiotics
 Other drugs, such as ibuprofen and azithromycin
People with CF can also help reduce their risk of lung infection by taking the following steps:
 washing the hands frequently
 getting a flu shot every year
 not smoking and avoiding second-hand smoke
 avoiding unnecessary contact with people who have colds or other contagious illnesses

Nutritional therapy CF Newborn Screening

for digestive If a baby had a positive newborn screen for CF

symptoms
 It is important to know that most babies who
screen positive for cystic fibrosis (CF) do not
have it.

 Before you took your newborn baby home from

 A different kind of diet or additional
supplements, such as pancreatic
enzyme supplements, salt, or
vitamins, may be needed to
balance the absorption of nutrients.
the hospital, a small amount of blood was taken
from his or her foot as part of Newborn Screening
Program. One of your baby’s test results showed
a need for a second test called a sweat test.

 CF can lead to impaired growth. A

high-calorie, high-fat diet is
essential for normal growth and
development in children with CF. It
can help adults to maintain optimal
health.

 Good nutrition is vital, as

individuals with CF need to
maintain a robust defense against
an increased risk of lung infection.

“Sweat Test”
Best way of checking for cystic fibrosis (CF).
The sweat test will measure how much salt is
in your baby’s sweat.
Sweat test takes about one hour using a
special machine causes a small part of the
baby’s arm or leg to sweat
 Negative Result: means that a normal
amount of salt was found in the sweat.
 Positive Result: means that your baby
probably has CF. Sweat is saltier than
normal. A second sweat test done to
confirm a CF diagnosis.
 Borderline Results: Your baby will need
another sweat test, and perhaps an exam
and blood test
 “QNS” (Quantity Not Sufficient): QNS
means there was not enough sweat
collected.
“Carriers”
What does it mean to be a CF carrier?
CF carriers are healthy, and their sweat test
results usually are normal. A CF carrier has
one gene for CF, but doesn’t have the two
genes required to cause CF. If your baby is
a CF carrier, then one of the parents must
also be a CF carrier. And there is the
possibility that both parents are CF carriers.
This means that they could have a child with
CF in the future.
The genetic counselor meets with you while
your baby’s sweat test is done. The
counselor answers questions about being a
CF carrier and gives you written information.
If two carriers have a child, there is a:
 25 percent, or 1 in 4, chance the child
will have CF
 50 percent, or 1 in 2, chance the child
will be a carrier but will not have CF
 25 percent, or 1 in 4, chance the child
will not be a carrier and will not have
CF
 Over 10 million Americans carry the
CF gene and are unaware.
 Pneumonia is an infection that inflames the air sacs
in one or both lungs. The air sacs may fill with fluid
or pus (purulent material.
The infection interferes with the delivery of oxygen
from the air sacs into the blood and the removal of
carbon dioxide from the blood

Pneumonia

Signs and symptoms Causes of



Chest pain when you breathe or cough
Confusion or changes in mental awareness (in
Pneumonia
adults age 65 and older) Many germs can cause pneumonia. The most
 Cough, which may produce phlegm common are bacteria and viruses in the air
 Fatigue we breathe. Your body usually prevents these
 Fever, sweating and shaking chills germs from infecting your lungs. But
 Lower than normal body temperature (in adults sometimes these germs can overpower your
older than age 65 and people with weak immune immune system, even if your health is
systems) generally good.
 Nausea, vomiting or diarrhea
 Shortness of breath
 Types of Pneumonia
According to the types of germs that cause it
Complications
 Bacteria in the bloodstream (bacteremia) - from
and where you got the infection. your lungs can spread the infection to other
 Community-acquired Pneumonia - most organs, causing organ failure.
common type of pneumonia, occurs outside  Difficulty breathing
of hospitals or other health care facilities. It  Fluid accumulation around the lungs (pleural
may be caused by: effusion) – fluid buildup in the thin space
 Bacteria (e.g. Streptococcus between layers of tissue that line the lungs and
pneumoniae may affect one part chest cavity (pleura)
(lobe) of the lung, a condition called  Lung abscess - An abscess occurs if pus forms
lobar pneumonia) in a cavity in the lung.
 Bacteria-like organisms (e.g.
Mycoplasma pneumoniae causes
walking pneumonia)
 Fungi - most common in people with
chronic health problems or weakened
immune systems found in soil or bird
droppings.
 Viruses - most common cause of
pneumonia in children younger than 5
years.
 Hospital-acquired pneumonia - can be
serious because the bacteria causing it may
be more resistant to antibiotics and because
the people who get it are already sick.
 Health care-acquired pneumonia - bacterial
infection that occurs in people who live in
long-term care facilities
 Aspiration pneumonia - occurs when you
inhale food, drink, vomit or saliva into your
Who’s at risk?
lungs.  Children who are 2 years old or younger
 People who are age 65 or older
 Being hospitalized – ICU patient or with
ventilator
 Chronic disease - asthma, chronic
obstructive pulmonary disease (COPD) or
heart disease.
 Smokers
 Weakened or suppressed immune system -
HIV/AIDS, who've had an organ transplant,
or who receive chemotherapy or long-term
steroids are at risk.
 When to go to the
hospital?
Babies under 6 months old are more likely to be
admitted to hospital.

Your doctor will take into account if your child:

 has difficulty breathing
 is dehydrated because they won’t feed or
drink
 can’t take antibiotics through their mouth
 is breathing very fast
 has low oxygen levels in their blood
 is not responding to the prescribed antibiotics
(this may be the case if they still have a fever
after about 2 days of antibiotic treatment)
 has another lung, heart or immune deficiency
condition

Treatment and Prevention

 Oral antibiotics (e.g. amoxicillin) for common infections for maximum of 14 days to clear up
completely
 Sleep and lots of hydration with water
 Humidify room or nebulize to rid of mucus Get vaccinated - Doctors recommend a different
pneumonia vaccine for children younger than age 2 and for children ages 2 to 5 years who are at
particular risk of pneumococcal disease. Doctors also recommend flu shots for children older than 6
months.
 Practice good hygiene - Wash your hands regularly or use an alcohol-based hand sanitizer.
 Don't smoke
 Keep your immune system strong - Get enough sleep, exercise regularly and eat a healthy diet.

Bronchitis
Bronchitis occurs when there is
swelling of the lining of the large
airways called bronchi within the lungs.
This swelling due to inflammation,
irritation and infection leads to more
mucus formation than normal. This
blocks the airflow through the lungs
and may damage the lung eventually.
 Has two main types: acute and chronic

In children, the most common cause of acute

bronchitis is a virus. The illness may develop
after a cold or other viral infection in the nose,
mouth, or throat (upper respiratory tract).
Such illnesses can spread easily from direct
contact with a person who is sick Lab Diagnosis
 Chest x-ray - This test makes images of internal

Who’s at risk? tissues, bones, and organs.

 Sputum test - These tests can find the germ
causing an infection
 Chronic sinusitis
 Pulse oximetry. An oximeter is a small device
 Allergies
that measures the amount of oxygen in the blood
 Asthma
 Enlarged tonsils and adenoids

Treatment and
 Exposure to secondhand smoke

Signs and Prevention

In nearly all cases, antibiotics should not be used

symptoms
 Dry or mucus-filled cough
 Vomiting or gagging
 Runny nose, often before a cough starts
 Chest congestion or pain
 An overall body discomfort or not feeling
well
 Chills
 Slight fever
 Back and muscle pain
 Wheezing
 Sore throat
These symptoms often last 7 to 14 days. But
the cough may continue for 3 to 4 weeks.
These symptoms may look like other health
problems. Make sure your child sees his or
her healthcare provider for a diagnosis.
to treat acute bronchitis. That’s because most of
the infections are caused by viruses. Even children
who have been coughing for longer than 8 to 10
days often don't need antibiotics.
The goal of treatment is to help ease symptoms.
Treatment may include:
 Plenty of rest & Fluids
 Acetaminophen or ibuprofen for fever and mild
pain
 Cough medicine for children over 4 yrs. old
 Cool-mist humidifier
Don’t give aspirin or medicine that contains aspirin
to your a child younger than age 19 unless directed
by physician. Taking aspirin can put child at risk for
Reye syndrome. It most often affects the brain and
the liver.
 Tonsillitis
Tonsillitis is an infection of the tonsils, two masses of
tissue at the back of the throat.
Tonsils act as filters, trapping germs that could
otherwise enter the airways and cause infection. They
also make antibodies to fight infection. Tonsillitis is
common, especially in children. It can happen
occasionally or come back again and again in a short
period of time.
Signs and symptoms
The main symptoms of tonsillitis are
inflamed and swollen tonsils, sometimes
severe enough to make it hard to breathe
through your mouth. Other symptoms include:
 Throat pain or tenderness
 Red tonsils


A white or yellow coating on your
tonsils
Painful blisters or ulcers on your
throat
 Headache
 Loss of appetite
 Ear pain
 Trouble swallowing
 Swollen glands in your neck or jaw
 Fever and chills
 Bad breath
 A scratchy or muffled voice
 Stiff neck
Types
 Acute tonsillitis. These symptoms
usually last 3 or 4 days but can last up
to 2 weeks.
 Recurrent tonsillitis. This is when
you get tonsillitis several times in a
year.
 Chronic tonsillitis. This is when you
have a long-term tonsil infection.
In children, symptoms may also include:
 Upset stomach
 Vomiting
 Stomach pain
 Drooling
 Not wanting to eat or swallow
Who’s at risk?
 Young age. often occurs in children,
but rarely in those younger than age 2.
Tonsillitis caused by bacteria is most
common in children ages 5 to 15, while
viral tonsillitis is more common in
younger children.
 Frequent exposure to germs. School-
age children are in close contact with
their peers and frequently exposed to
viruses or bacteria that can cause
tonsillitis.

Causes
Tonsillitis may be caused by a bacterial or a viral infection.
Tonsillitis can spread from an infected person to others
through coughing, sneezing, or touching. The germs can
spread through kissing or sharing food and drinks. Germs
spread easily in schools and daycare centers and between
family members at home.
Diagnosis
 Examining throat for redness, swelling or white
spots on the tonsils
 Ask about other symptoms such as a fever,
cough, runny nose, rash or stomachache
 Look in ears and your nose for other signs of
infection
 Feel the sides of neck to see if the lymph nodes
are swollen and tender
 A throat culture/ Strep test - may show which
germ is causing your child's illness. A cotton
swab is rubbed against the back of your child's
throat.
 Blood tests may show if the infection is caused
by bacteria or a virus.
Treatment
Treatment may decrease your child's
signs and symptoms. Treatment also
may lower the number of times that
he gets tonsillitis in a year. Your child
may need any of the following:
 Acetaminophen decreases pain
and fever...
 Nonsteroidal anti-inflammatory
drugs (NSAIDs) , such as
ibuprofen, help decrease swelling,
pain, and fever.
If your child takes blood thinner
medicine, always ask if NSAIDs are
safe for him or her. Do not give these
medicines to children under 6 months
of age without direction from your
child's healthcare provider.
 Antibiotics help treat a bacterial
infection.
 A tonsillectomy is surgery to
remove your child's tonsils if he
has chronic or recurrent tonsillitis.
Surgery may also be done if
antibiotics are not working.
Prevention
The best way to prevent tonsillitis is
through good hygiene, including:
 Washing your hands often
 Not sharing food, drink, utensils,
or personal items like
toothbrushes with anyone
 Staying away from someone who
has a sore throat or tonsillitis
Asthma
Asthma is a chronic, inflammatory
Causes of Asthma
The exact cause of asthma is not completely
known. It is believed to be partially inherited, but
it also involves many other environmental,
disease in which the airways become infectious and chemical factors.
sensitive to allergens
 The lining of the airways become After a child is exposed to a certain trigger, the
swollen and inflamed body releases histamine and other agents that
 Muscles that surround the airways can cause inflammation in your child's airways.
tighten
 Production of mucus is increased,
leading to mucus plugs

Signs and symptoms Types of Asthma

The following are the most common symptoms of
 Allergic asthma
asthma. However, each child may experience
 Nonallergic asthma (intrinsic asthma) -
symptoms differently. Symptoms may include:
caused by irritants
 Coughing (either constant or intermittently)
 occupational asthma - triggered in the
 Wheezing (this is a whistling sound that may
workplace
be heard while your child is breathing)
 Exercise-induced bronchoconstriction (EIB)
 Trouble breathing or shortness of breath while
 Nocturnal asthma
your child is playing or exercising
 Cough-variant asthma (CVA) - characterized
 Chest tightness (your child may say his/her
by persistent, dry cough
chest hurts or does not feel good)
 Fatigue
 Nighttime cough
 Noisy breathing
Asthma Triggers
 Illness. Respiratory illnesses such as
the flu and pneumonia can trigger
asthma attacks.
 Exercise. Increased movement may
make breathing more difficult.
 Irritants in the air. People with asthma
may be sensitive to irritants such as
chemical fumes, strong odors, and
smoke.
 Allergens. Animal dander, dust mites,
and pollen are just a few examples of
allergens that can trigger symptoms.
 Extreme weather
conditions. Conditions such as very
high humidity or low temperatures may
trigger asthma.
 Emotions. Shouting, laughing, and
crying may trigger an attack.
Lab Diagnosis
Physicians rely on a combination of medical
history, physical examination and lab tests:
 Spirometry - assesses lung function
 Peak flow monitoring - measure the amount of
air a person can blow out of the lungs
 Chest x-rays
 Blood tests - analyze the amount of carbon
dioxide and oxygen in the blood
 Allergy tests
Who’s at risk?
Although anyone may have asthma, it most
commonly occurs in:
 Children by the age of 5
 Child with a family history of asthma
 Children who have allergies
 Children who have exposure to
secondhand tobacco smoke
Treatment
Treatments for asthma fall into three
primary categories:
 Breathing exercises
 Rescue or first aid treatments
 Rescue Inhalers
 Nebulizers
 Bronchodilators
 Anti-inflammatory
 Long-term asthma control medications
 Home Remedies
 Coffee or caffeinated tea
 Essential Oils
 Mustard oil
Prevention
 Avoiding triggers
 Reducing exposure to allergens
 Getting allergy shots - Allergen
immunotherapy
 Taking preventive medication