RESPIRATORY DISORDER

CROUP SYNDROME
It is Laryngeotracheobronchitis
.Risk group 3 month-5 years
Causeallergy/ Para influenza virus.mycoplasma, respiratory synctyl virus ( droplet infection)
 Clinical Features
Mild fever
Barking cough due to
laryngeal edema
.Wheezing
.Diaphoresis
Stridor

Types
Typical Symptoms more at night
Atypical>Symptoms more at day
Management
Maintain patent airway 6
6o
Administer humidified oxygen nuJov
he chd
(02)
Monitor stridor inhle
Have resuscitation
equipment available at the bed side Free eY (eouYe
open
Drugs
Administer nebulization with adrenaline. It will
ts eApose wilbh cold
help to decrease edema
Administer corticosteroid to decrease inflammation
Avoid cough syrup and cold medicine.
Nursing Diagnosis
Ineffective airway cleararce related to laryngeal edema
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 Respiratory Management
To
give Not to give
1. more water. 1. Steam inhalation
2. Chest physiotherapy 2. Cough suppressant
3. Nebulization with tobramycin
4. Bronchodilator
5. Flutter mucous clearance device
6. Vaccine- pneumococci and influenza

G.I Management
Administer Amylase +lipase((Pancreatic enzyme) along with each meal
Balanced diethigh calorie, high protein and multivitamin
Ensure adequate saBt and water
Administer dornasealfa medicine it will help to loosening the secretion.

122
 RESPIRATORY DISTRESS SYNDROME ( hayaline membrane disease )
1. Severe breathing difficulty especially in pre-tierm new born
2. Causedeficiency of surfactantScy (eauovl J C ipo roGein
3. Clinical feature
Nasal flaring
Cole Qrolutel by pe l calveolas
Tachypnea the
Expiratory grunting. epishedicl GUueJ. G Tccucos Ghe
Decreased breath sound
Suscee enion sih in b t
Sea saw respiration
Cyanosis
Diagnostic Evaluation

Assessmeni of Severity
Modified O ns Scorng Systen
SILVERMAN ANDERSON SCORE
Score>7-respiratory failure
Score 4-7-respiratony distress
ioWER NARES EXP.
CHEST RETRACT EELAT HNT
Respiraxtory Rate <60 60-80
(ate/cmin)
Cyenc:s None in roomair No cyanosis wtà Cyanosis in spite eYRAKT

CKygen supcert DAgea suport

Retractiors Noe hoderat: to

Severe

Grunting None Auxdble nith Audible withot

Stethosrope Stedhoscope Jeng

r e : Fte Sti verman score fer assessing tine mmaijritud: öt respirdor

Air Entry Good Decreased Barely Aucdicle distrs. {ros Avery, M,, And Metciner, 3.D ne LungJnd
D i s d e r s in t i 2 N e w b r Puladesphia, W.B. Saunter (ATDa/1y, 1 3 76

(Courtsy co w.A. SiHVerman)

123
 of respiratory
distress in neonacd
Result Both score are widely used for the categorization
denotes clinical RD and
4 or more for at least 2 hours during
the first 8 hours of life indication for
Score
of a physician. An RD
score of 6 or
more is an
require assessment of the infant by
ventilator support.

3. ABG Respiratory acidosis

Efbe,
Management ber surlalban thro-1gh
nclmini3 netG Lb hou
hOuYS
Priority for airway clearance ANoicl SCuclion,föv
Administer 02 cafler aclmin jJbeviy surlcqlonb.
to
in preterm babies for prevent retinal
Administer oxygen at the lowest possible concentration especially
damage. AUMiniJGraUiov o Ge c iley ncn
Mechanical ventilation CCue Citulabory Over AOCcA anc
inside the lungs thYough E.T tube.
Drug of choice -

Administer surfactant directly

bredycerelia
Prevention
labor for eariy
Administer Betamethasone to the pregnant ladies those who are expecting preterm
maturity offetal lung.
Nursing Diagnosis
Impaired gas exchange R/To deficiency of surfactant.
TONSILTIS

1. Inflammation oftonsils
2. Cause
.Group A. Beta hemoiyticstreptococi
.Pneumococcal, H. influenza
3. Clinical Feature
Redness, pain, swallowingdiffäculty
Enlargement of lymph nodes
Mouth breathing and unpleasant mouth odor.

4. Management

Antibiotics (eg:- Azithromycin or erythromycin)

.Liquiddiet
Garglingonly pre-operatively
.Surgery
Tonsillectomy (During surgery provide Rose position)

Post-operativeintervention
Position
Prone or lateral position
Avoid supine position
I fbreathing difficuty occur to give semi fowlers position

124
 Child having frequent swallowing it means bleeding from the surgical site.
Can be old dried blood clot in vomits is normal.
seen

Post operatively give clear cold water or ice and

chips. It will help to decrease pain bleeding.
Post operatively avoid
» Milk or milk product
> Ice-cream
Red color food
Citrus fruit and carbonated beverages
> Gargling
Discourage coughing
Monitor complication
Eustachian tube obstruction
> Ear pain