Nursing care of newborn's with alteration on oxygen ventilation.
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Inhalation of a foreign object into the airway occurs most frequently in infants and toddlers
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Signs & Symptoms
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• Choking, hard, forceful coughing
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• Increased respiratory difficulty (stridor)
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Management
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• Subdiaphragmatic thrusts (Heimlich Maneuver)
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• Stand behind the child & place fist under diaphramgm
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• upside down with finger inside mouth, trust the back
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Recurrent diffuse, obstructive pulmonary disease process caused by airway inflammation and hyperreactivity. Occurs when children fail to respond
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Clinical Manifestation
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• Wheezing changes as disease progresses
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• Inspiratory & expiratory wheeze: airways obstructed
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• Little air movement heard (tight): complete obstruction
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• Retractions, hr & rr elevated, cyanosis, hypoxia
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• Prolonged expiratory phase
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Pathophysiology
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Smooth muscle spasm to mucosal edema leading to mucosal plugging causing obstruction, air trapping leading to hypoxemia
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Nursing Care
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• Aerosol administration of a bronchodilator (albuterol)
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• IV corticosteroids to reduce symptoms
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• O2 by face mask or nasal prongs
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• IV infusion for hydration
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• Monitor I &O : measure the specific gravity of urine
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• In severe attacks, ET intubation & mech. ve
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Diagnostic Tests
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• Chest radiography: detect foreign body, infiltration
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• Lab test: evaluate degree of acidosis & infection
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• Spirometry: to assess severity of disease
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• Pulse oximetry: reveals the low oxygen sat level.
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is a chronic, progressive, and frequently fatal. Caused by abnormality of chromosome 7 CFTR gene. genetic disease of the body's mucus glands. life span of 30 yrs
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CF affects
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Respiratory
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Increased mucus secretions
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Digestive
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Decreased pancreatic enzymes
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Sweat glands
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increase salt in sweat
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Reproductive
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Infertility
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Clinical Manifestation
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• productive cough, wheezing, hyperinflation of lungs
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• Clubbing of extremities, fat soluble deficiencies
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• Malnutrition, steatorrhea, strong salt in perspiration.
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Treatments
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• Preventing and controlling lung infections
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• Loosening and removing mucus from the lungs
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• Preventing and treating intestinal blockage
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• Providing adequate nutrition
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Medications
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• Antibiotics (gentamycin)
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• Mucus thinning drugs: cough up mucus
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• Bronchodilators: help keep the airways open
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• Oral pancreatic enzymes: help absorb nutrients
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Tests and Diagnosis
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Sweat test
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sweat saltier than normal
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Genetic test
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defect on chromosome 7
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Imaging test
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Damage to lungs or intestines
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Function test
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How much air, how fast, how well
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Sputum culture
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Analyzed bacteria
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Organ func.
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health of pancreas and liver
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Pathophysiology
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• viral infection of parainfluenza or H.influenza causes swelling of the laynx, trachea, and large bronchi.
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• Swelling due to infiltration of WBC causes airway obstruction thus, increased work of breathing. (stridor)
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Signs & Symptoms
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• Barking cough ( inspiratory stridor )
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• Marked retractions, temp is mildly elevated
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• Marked retractions, hoarseness
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• Difficulty breathing worsen at night
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Nursing Care
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• Assess airway obstruction by elev. respi status
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• Provide warm, moist envi. & give 02 for hypoxia
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• Corticosteroid (dexamethasone or epinephrine
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• IV therapy to keep child hydrated
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• Keep emergency equipment (tracheostomy, intubation)
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Health Teachings
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• bath with hot water to produce steam
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