LIFE

THREATENING
DISORDERS IN
CHILDREN
ACUTE RESPIRATORY
CONDITIONS
 BRONCHITIS

• BRONCHITIS IS THE INFLAMMATION OF THE LINING OF THE BRONCHIAL TUBE

(BRONCHI).
 TYPES OF BRONCHITIS

• THERE ARE TWO TYPES OF BRONCHITIS:

• ACUTE BRONCHITIS WHICH DEVELOPS FROM A COLD OR OTHER RESPIRATORY
INFECTION. IT IS A MORE COMMON SYMPTOM THAT LASTS FOR A FEW WEEKS,
BUT IT DOES NOT USUALLY CAUSE PROBLEMS PAST THAT TIME.
• CHRONIC BRONCHITIS WHICH IS MORE SERIOUS, IT KEEPS COMING BACK OR
DOESN’T GO AWAY.  
 POSSIBLE CAUSES OF BRONCHITIS

• VIRUSES THAT GIVE THE COLD OR THE FLU CAUSE ACUTE BRONCHITIS.
• BACTERIAL ORGANISMS SUCH AS HAEMOPHILUS PNEUMONIA
• FUNGAL ORGANISMS SUCH AS ASPERGILLUS CAUSE ACUTE BRONCHITIS
• CHEMICAL IRRITATION FROM NOXIOUS FUMES AND GASES
• AIR CONTAMINATION MAY INDUCE ACUTE BRONCHITIS
• BREATHING SECONDHAND SMOKE FOR A LONGTIME 
 SIGNS AND SYMPTOMS OF BRONCHITIS

• FEVER
• CHILLS
• A DRY, IRRITATING AND NON-PRODUCTIVE COUGH
• COUGH PRODUCES MUCOPURULENT SPUTUM
 MEDICAL CARE AND NURSING CARE
BRONCHITIS
• BED REST FOR THE CHILD
• NUTRITIOUS DIET SUCH AS WARM SOUP, FRUITS AND VEGETABLES AND WHOLE
GRAINS.
• PLENTY OF FLUID
• HUMIDIFIERS TO HELP MOISTEN THE AIR
• ANTIBIOTICS AND SALICYLATES ARE GIVEN SOMETIMES TO TREAT THE
INFECTION
 BRONCHIOLITIS

• BRONCHIOLITIS IS A VIRAL RESPIRATORY INFECTION RESULTING IN

INFLAMMATION OF THE BRONCHIOLES (IT CAUSES INFLAMMATION AND
CONGESTION IN THE SMALL AIRWAY).
• POSSIBLE CAUSES
• RESPIRATORY SYNCYTIAL VIRUS (RSV)
• OTHER VIRUSES ASSOCIATED WITH THE DISEASE ARE PARAINFLUENZA VIRUS
AND ADENOVIRUSES
BRONCHIOLITIS
 SIGNS AND SYMPTOMS BRONCHIOLITIS

• RUNNY  NOSE
• COUGH OR NASAL DISCHARGE
• DRY PERSISTENT COUGH
• EXTREMELY SHALLOW RESPIRATION
• AIR HUNGER (CYANOSIS)
• COLD 
 MEDICAL AND NURSING CARE
BRONCHIOLITIS
• HIGH HUMIDITY BY MIST TENT
• BED REST FOR THE CHILD
• INCREASED FLUID AND IV FLUID AS NECESSARY
• OXYGEN THERAPY
• PATIENT POSITIONING PROMOTES COMFORT AND RIBAVIRIN (VIRACOLE IS AN ANTIVIRAL DRUG USED
TO TREAT RSV
• SUCTION AS NECESSARY TO CLEAR AIRWAY
• ANTIPYRETICS LIKE ACETAMINOPHEN MAY BE GIVEN FOR FEVER OR PAIN
• DEEP BREATHING HELPS OPEN AND CLEAR BRONCHIOLES EFFECTIVE FOR OLDER CHILDREN
 PNEUMONIA

• PNEUMONIA IS AN INFLAMMATORY PROCESS AFFECTING THE BRONCHIOLES AND

ALVEOLI. THE MOST COMMON FORM IN INFANTS AND CHILDREN ARE BACTERIAL
PNEUMONIA.
• POSSIBLE CAUSES ARE BACTERIA, VIRUSES, FUNGAL AND CHEMICAL
 SIGNS AND SYMPTOMS PNEUMONIA

• COUGH AND PAIN

• VOMITING OR DIARRHEA
• FEVER
• CHILLS
• FLARING OF THE NOSTRILS
• LOSS OF APPETITE
• CIRCUMORAL CYANOSIS (BLUE DISCOLORATION AROUND THE MOUTH)
 MEDICAL AND NURSING CARE

• PLENTY OF BED REST

• INCREASED FLUIDS 
• COOL MIST HUMIDIFIER
• ACETAMINOPHEN FOR FEVER AND DISCOMFORT
• ANTIBIOTICS 
 ACUTE PHARYNGITIS

• ACUTE PHARYNGITIS IS AN INFLAMMATION OF THE BACK OF THE THROAT (PHARYNX),

IT IS ALSO REFERRED TO AS SORE THROAT. 
• POSSIBLE CAUSES OF ACUTE PHARYNGITIS
• IT IS CAUSED BY A VIRAL INFECTION OR A BACTERIAL INFECTION.
• EXPOSURE TO SMOKE AND AIRBORNE IRRITANTS
• COMMON COLD OR FLU
• CANCERS
• SINUS INFECTION
• ALLERGIES SUCH AS HAY FEVER
 SIGNS AND SYMPTOMS ACUTE PHARYNGITIS

• SORE THROAT
• PAIN OR DIFFICULTY SWALLOWING OR TALKING
• RED THROAT AND RED, SWOLLEN TONSILS
• WHITE OR GREY PATCHES ON BACK OF THE THROAT
• FEVER OR CHILLS
• TROUBLE BREATHING OR SNORING
• EAR PAIN 
• HEADACHE 
 MEDICAL AND NURSING CARE ACUTE
PHARYNGITIS
• ENSURE PLENTY OF FLUID IS GIVEN TO AVOID DEHYDRATION
• ENSURE BED REST FOR THE CHILD
• ENCOURAGE WARM BEVERAGE IS GIVEN
• ANALGESICS AND ANTIPYRETICS MAY BE USED FOR RELIEF OF PAIN OR PYREXIA
• ACETAMINOPHEN OR IBUPROFEN IN LIQUID OR PILL FORM FOR PAIN
• GARGLING WITH SALT WATER (FOR OLDER CHILDREN)
• SUCKING ON THROAT DROPS OR HARD CANDIES (FOR OLDER CHILDREN)
 EAR INFECTION

• WHEN BACTERIA OR VIRUS INFECT AND TRAP FLUID BEHIND THE CHILD EARDRUM,
AND CAUSES PAIN AND SWELLING BULGING OF THE EARDRUM. EAR INFECTIONS
MAY BE MORE COMMON IN CHILDREN. CHILDHOOD EAR INFECTIONS, WHICH ARE
OFTEN MINOR AND PASS QUICKLY.
• CAUSES: EAR INFECTIONS OFTEN OCCUR WHEN A CHILD HAS A COLD, SINUS
INFECTION OR ALLERGIES. MANY TIMES IT'S BECAUSE OF (SORE THROAT) INFECTED
OR SWOLLEN ADENOIDS (TISSUE NEAR YOUR TONSILS THAT TRAPS HARMFUL
BACTERIA AND VIRUS), EXCESS MUCUS, CHANGES IN AIR PRESSURE(BAROMETRIC
PRESSURE).
 TYPES OF EAR INFECTIONS
• THERE ARE THREE TYPES OF EAR INFECTION:
1. INNER EAR INFECTION
• THIS CAUSED BY AN INNER EAR INFECTION MAY ACTUALLY BE A CASE OF
INFLAMMATION, AND NOT AN ACTUAL INFECTION. IN ADDITION TO EAR PAIN,
SOME SYMPTOMS ARE:
• DIZZINESS
• NAUSEA
• VOMITING
 TYPES OF EAR INFECTIONS CONT’D

2. MIDDLE EAR INFECTION

• THE MIDDLE EAR IS THE AREA RIGHT BEHIND YOUR EARDRUM. A MIDDLE EAR INFECTION
IS ALSO KNOWN AS OTITIS MEDIA. IT’S CAUSED BY FLUID TRAPPED BEHIND THE
EARDRUM.
3. OUTER EAR INFECTION
• THE OUTER EAR IS THAT PART OF YOUR EAR THAT EXTENDS OUT FROM YOUR EARDRUM
TO THE OUTSIDE OF YOUR HEAD. AN OUTER EAR INFECTION IS ALSO KNOWN AS OTITIS
EXTERNA. AN OUTER EAR INFECTION OFTEN STARTS AS AN ITCHY RASH. AND MAY
APPEAR: PAINFUL, TENDER AND RED
 SIGNS AND SYMPTOMS OF EAR INFECTION
• EAR PAIN, ESPECIALLY WHEN LYING DOWN.
• TUGGING OR PULLING AT AN EAR. 
• TROUBLE SLEEPING. CRYING MORE THAN USUAL. 
• FUSSINESS.
• TROUBLE HEARING OR RESPONDING TO SOUNDS.
• LOSS OF BALANCE.
• FEVER OF 100F(38C) OR HIGHER.
• DRAINAGE OF FLUID FROM THE EAR. 
• HEADACHE
• LOSS OF APPETITE 
 EPIGLOTTITIS
• EPIGLOTTITIS IS AN ACUTE INFLAMMATION OF THE EPIGLOTTIS
(THE CARTILAGINOUS FLAP THAT PROTECTS THE OPENING OF THE
LARYNX).
• CAUSES OF EPIGLOTTITIS IS THE BACTERIA HAEMOPHILUS
INFLUENZAE TYPE B
 SIGNS AND SYMPTOMS EPIGLOTTITIS

• SORE THROAT
• DYSPHAGIA (DIFFICULTY SWALLOWING)
• HIGH FEVER
• ABSENCE OF COUGH
• DROOLING OF SALIVA
 MEDICAL AND NURSING CARE EPIGLOTTITIS

• MONITOR OXYGEN WITH PULSE OXIMETRY

• ENDOTRACHEAL INTUBATION ( IS A PROCEDURE WHICH A TUBE IS PLACED INTO THE
WINDPIPE (TRACHEA) THROUGH THE MOUTH OR NOSE TO ASSIST WITH BREATHING)
OR TRACHEOSTOMY (A PROCEDURE THAT INVOLVES CREATING AN OPENING IN THE
NECK IN ORDER TO PLACE A TUBE INTO THE WINDPIPE (TRACHEA).
• MOIST AIR ADMINISTRATION (HUMIDIFIER)
• MONITOR ADEQUATE FLUID INTAKE. HYDRATION HELPS REDUCE THICK MUCUS  
• ANTIBIOTICS ARE ADMINISTERED INTRAVENOUSLY (IV)
 TONSILLITIS

• TONSILLITIS IS THE INFLAMMATION OF THE PHARYNGEAL TONSILS; THE

INFLAMMATION USUALLY EXTENDS TO THE ADENOID AND THE LINGUAL
TONSILS. IT IS A COMMON ILLNESS IN CHILDHOOD RESULTING FROM
PHARYNGITIS. TONSILLITIS MOST OFTEN OCCUR IN CHILDREN; HOWEVER, THE
CONDITION RARELY OCCURS IN CHILDREN YOUNGER THAN 2 YEARS.
• CAUSES: VIRUS SUCH AS THE ADENOVIRUS, THE FLU, EPSTEIN-BARR VIRUS
(MONO) OR BACTERIA SUCH AS GROUP A STREPTOCOCCUS (STREP THROAT) AND
IMMUNOLOGIC FACTORS LEAD TO TONSILLITIS AND ITS COMPLICATIONS.
TONSILLITIS
 SIGNS AND SYMPTOMS TONSILLITIS

• FEVER. THE CHILD MAY PRESENT WITH A FEVER OF 101°F (38.4°C) OR MORE.

• SORE THROAT. THE CHILD MAY ALSO MANIFEST A SORE THROAT, OFTEN WITH
DYSPHAGIA OR DIFFICULTY SWALLOWING.
• HYPERTROPHIED TONSILS. INDIVIDUALS WITH ACUTE TONSILLITIS PRESENT
WITH TENDER AND INFLAMED TONSILS; EXUDATE MAY ALSO BE VISIBLE ON THE
TONSILS.
• AIRWAY OBSTRUCTION. AIRWAY OBSTRUCTION MAY MANIFEST AS MOUTH
BREATHING, SNORING, SLEEP DISORDERED BREATHING, NOCTURNAL
BREATHING PAUSES, OR SLEEP APNEA.
 MEDICAL AND NURSING CARE TONSILLITIS
• TREATMENT OF ACUTE TONSILLITIS IS LARGELY SUPPORTIVE AND FOCUSES ON MAINTAINING ADEQUATE HYDRATION
AND CALORIC INTAKE AND CONTROLLING PAIN AND FEVER.
• TREATMENT DEPENDS ON WHETHER THE TONSILLITIS IS CAUSED BY:
• A VIRUS, IN WHICH CASE THE BODY WILL FIGHT THE INFECTION ON ITS OWN
• BACTERIA, IN WHICH CASE THE DOCTOR WILL PRESCRIBE AN ANTIBIOTIC. HELP YOUR CHILD TAKE THE ANTIBIOTIC
EXACTLY AS DIRECTED. THIS HELPS SYMPTOMS CLEAR UP QUICKLY AND PREVENTS SPREADING THE INFECTION TO
OTHERS.

TEACH FAMILY THAT IT'S IMPORTANT TO FINISH THE ENTIRE PRESCRIPTION — EVEN IF THE CHILD FEELS BETTER IN A
FEW DAYS — OR THE INFECTION COULD COME BACK. THIS ALSO HELPS PREVENT A MORE SERIOUS HEALTH PROBLEM
THAT STREPTOCOCCUS CAN CAUSE, CALLED RHEUMATIC FEVER, WHICH CAN DAMAGE THE HEART.
• RARELY, A HEALTH CARE PROVIDER MIGHT RECOMMEND A TONISILLECTOMY (SURGERY TO REMOVE THE TONSILS) IF A
CHILD'S TONSILS GET INFECTED A LOT OR ARE SO BIG THEY MAKE IT HARD TO BREATHE AT NIGHT. TONSILLECTOMY
USED TO BE VERY COMMONLY DONE. NOW, EXPERTS USE GUIDELINES TO DECIDE IF TONSIL REMOVAL IS THE BEST
TREATMENT. IN GENERAL, TONSILLECTOMY MAY BE CONSIDERED IF A CHILD HAS SEVEN SORE THROAT EPISODES IN 1
YEAR, FIVE EPISODES 2 YEARS IN A ROW, OR THREE EPISODES 3 YEARS IN A ROW.
 ASTHMA

• ASTHMA IS A CHRONIC INFLAMMATORY DISEASE OF THE AIRWAYS THAT

CAUSES AIRWAY HYPERRESPONSIVENESS, MUCOSAL EDEMA, AND MUCUS
PRODUCTION. INFLAMMATION ULTIMATELY LEADS TO RECURRENT EPISODES OF
ASTHMA SYMPTOMS. PATIENTS WITH ASTHMA MAY EXPERIENCE SYMPTOM-FREE
PERIODS ALTERNATING WITH ACUTE EXACERBATIONS THAT LAST FROM
MINUTES TO HOURS OR DAYS. ASTHMA, THE MOST COMMON CHRONIC DISEASE
OF CHILDHOOD, CAN BEGIN AT ANY AGE.
 CAUSES OF ASTHMA

CAUSES:
• INHERITED TENDENCY TO DEVELOP ALLERGIES
• PARENTS WITH ASTHMA
• ALLERGY IS THE STRONGEST PREDISPOSING FACTOR FOR ASTHMA.
• CHRONIC EXPOSURE TO AIRWAY IRRITANTS: THESE IRRITANTS CAN BE SEASONAL (GRASS, TREE, AND
WEED POLLENS) OR PERENNIAL (MOLD, DUST, ROACHES, ANIMAL DANDER).
• EXERCISE: TOO MUCH EXERCISE CAN ALSO CAUSE ASTHMA.
• STRESS/ EMOTIONAL UPSET: THIS CAN TRIGGER CONSTRICTION OF THE AIRWAY LEADING TO ASTHMA.
• MEDICATIONS: CERTAIN MEDICATIONS CAN TRIGGER ASTHMA.
 SIGNS AND SYMPTOMS ASTHMA
• THE MOST COMMON SIGNS AND SYMPTOMS OF ASTHMA ARE COUGH (WITH OR WITHOUT MUCUS
PRODUCTION), DYSPNEA, AND WHEEZING (FIRST ON EXPIRATION, THEN POSSIBLY DURING INSPIRATION AS
WELL), CHEST TIGHTNESS OR PAIN, TROUBLE SLEEPING CAUSED BY SHORTNESS OF BREATH, COUGHING OR
WHEEZING, A WHISTLING OR WHEEZING SOUND WHEN EXHALING (WHEEZING IS A COMMON SIGN OF ASTHMA IN
CHILDREN), COUGHING OR WHEEZING ATTACKS THAT ARE WORSENED BY A RESPIRATORY VIRUS, SUCH AS A
COLD OR THE FL
• SIGNS THAT ASTHMA IS PROBABLY WORSENING INCLUDE:
• ASTHMA SIGNS AND SYMPTOMS THAT ARE MORE FREQUENT AND BOTHERSOME
• INCREASING DIFFICULTY BREATHING (MEASURABLE WITH A PEAK FLOW METER, A DEVICE USED TO CHECK
HOW WELL YOUR LUNGS ARE WORKING)
• THE NEED TO USE A QUICK-RELIEF INHALER MORE OFTEN
• FOR SOME CHILDREN, ASTHMA SIGNS AND SYMPTOMS FLARE UP IN CERTAIN SITUATIONS:
• EXERCISE-INDUCED ASTHMA, WHICH MAY BE WORSE WHEN THE AIR IS COLD AND DRY
• ALLERGY-INDUCED ASTHMA, TRIGGERED BY AIRBORNE SUBSTANCES (SMOKE), SUCH AS POLLEN, MOLD
SPORES, COCKROACH WASTE OR PARTICLES OF SKIN AND DRIED SALIVA SHED BY PETS (PET DANDER)
 MEDICAL AND NURSING CARE ASTHMA

• THERE'S NO CURE FOR ASTHMA, BUT IT CAN BE MANAGED TO PREVENT FLARE-UPS. ASTHMA TREATMENT INVOLVES TWO IMPORTANT
THINGS: AVOIDING TRIGGERS AND TAKING MEDICATION TO MANAGE FLAIR UPS.
• AVOIDING TRIGGERS
• THERE ARE MANY WAYS TO AVOID TRIGGERS. AFTER YOUR CHILD'S TRIGGERS ARE IDENTIFIED, THE DOCTOR WILL WORK WITH YOU TO
COME UP WITH A PLAN TO AVOID THEM.
• FOR EXAMPLE, IF PET DANDER OR MOLD IN YOUR HOME TRIGGER YOUR CHILD'S ASTHMA SYMPTOMS, YOU CAN MAKE YOUR
HOME ASTHMA-SAFE BY CHANGING THE LINENS OFTEN, VACUUMING REGULARLY, AND KEEPING THE FAMILY PET OUT OF YOUR CHILD'S
BEDROOM. IF OUTDOOR ALLERGIES (LIKE POLLEN) ARE A PROBLEM, YOUR CHILD SHOULD AVOID THE OUTDOORS ON DAYS WHEN
POLLEN COUNTS ARE HIGH.
• IF EXERCISE IS A TRIGGER, THE DOCTOR MAY PRESCRIBE A MEDICINE FOR YOUR CHILD TO TAKE BEFORE PHYSICAL ACTIVITY TO
PREVENT AIRWAYS FROM TIGHTENING UP. DOCTORS HELP PEOPLE WITH EXERCISE-INDUCED ASTHMA MANAGE PHYSICAL ACTIVITY, NOT
AVOID IT. EXERCISE CAN HELP PEOPLE STAY HEALTHIER OVERALL (IN FACT, MANY PRO ATHLETES HAVE ASTHMA!).
• GETTING A YEARLY FLU SHOT IS ALSO IMPORTANT, AS ILLNESSES LIKE THE FLU CAN TRIGGER ASTHMA FLARE-UPS.
 MEDICAL AND NURSING CARE CONT’D

• ASTHMA MEDICINES
• MOST ASTHMA MEDICINES ARE BREATHED DIRECTLY INTO THE LUNGS (INHALED), BUT SOME ARE PILLS OR LIQUIDS.
THERE ARE TWO TYPES OF ASTHMA MEDICINES:
• QUICK RELIEF MEDICINES - ACT FAST TO OPEN UP TIGHT AIRWAYS. THEY CAN BE USED AS NEEDED DURING A FLARE-
UP. QUICK-RELIEF MEDICINES ACT FAST, BUT THEIR EFFECT DOESN'T LAST LONG. THESE KINDS OF MEDICINES ARE
ALSO CALLED "FAST-ACTING" OR "RESCUE" MEDICINES.
• LONG TERM MEDICINES MANAGE ASTHMA BY PREVENTING SYMPTOMS FROM HAPPENING. THEY REDUCE
INFLAMMATION IN THE AIRWAYS, WHICH IS THE CAUSE OF THE SWELLING AND MUCUS. (QUICK-RELIEF MEDICINES
ONLY TREAT THE SYMPTOMS CAUSED BY THE INFLAMMATION.) LONG-TERM CONTROL MEDICINES — ALSO CALLED
"CONTROLLER" OR "MAINTENANCE" MEDICINES — MUST BE TAKEN EVERY DAY, EVEN WHEN KIDS FEEL WELL.. SOME
KIDS WITH ASTHMA ONLY NEED QUICK-RELIEF MEDICINE; OTHERS NEED BOTH KINDS OF MEDICINE TO KEEP THEIR
ASTHMA IN CHECK.
 MEDICAL AND NURSING CARE

• PATIENT TEACHING IS A CRITICAL COMPONENT OF CARE FOR PATIENTS

WITH ASTHMA. TEACH PATIENT AND FAMILY ABOUT ASTHMA (CHRONIC
INFLAMMATORY), PURPOSE AND ACTION OF MEDICATIONS, TRIGGERS TO AVOID
AND HOW TO DO SO, AND PROPER INHALATION TECHNIQUE. INSTRUCT PATIENT
AND FAMILY ABOUT PEAK-FLOW MONITORIN
 ADENOIDITIS

• ADENOIDITIS IS AN INFLAMMATION OF THE ADENOIDS CAUSED BY INFECTION.

ADENOIDS ARE MASSES OF LYMPHATIC TISSUE THAT HELP THE BODY FIGHT
INFECTION. ADENOIDS ARE FOUND IN THE THROAT, ALSO CALLED THE PHARYNX,
JUST BEHIND THE NOSE. ALONG WITH THE TONSILS, ADENOIDS ARE THE FIRST
LINE OF DEFENSE AGAINST BACTERIA AND VIRUSES. THE LYMPHATIC SYSTEM
PERFORMS SEVERAL ROLES TO HELP PROTECT YOU FROM INFECTION. ADENOIDS
ARE PART OF THE LYMPHATIC SYSTEM. ADENOIDS STORE WHITE BLOOD CELLS
AND ANTIBODIES THAT HELP TO DESTROY POSSIBLE INFECTIONS THREATENING
YOUR HEALTH. IF THE ADENOIDS BECOME INFLAMED, THEY MAY NOT PERFORM
THEIR FUNCTION PROPERLY. IT IS MOST COMMONLY SEEN IN CHILDREN, BUT
SOMETIMES AFFECT ADULTS.
 ADENOIDITIS CAUSES
• IT IS CAUSED BY A BACTERIAL INFECTION, SUCH AS INFECTION WITH THE
BACTERIA STREPTOCOCCUS. IT CAN ALSO BE CAUSED BY A NUMBER OF VIRUSES,
INCLUDING EPSTEIN-BARR VIRUS, ADENOVIRUS, AND RHINOVIRUS.
 SIGNS AND SYMPTOMS ADENOIDITIS

• SYMPTOMS OF ADENOIDITIS CAN VARY DEPENDING ON WHAT IS CAUSING THE

INFECTION, BUT MAY INCLUDE: SORE THROAT, STUFFY NOSE, SWOLLEN GLANDS
IN THE NECK, EAR PAIN AND OTHER EAR PROBLEMS.
• WHEN THE NOSE IS STUFFY, BREATHING THROUGH IT CAN BE A CHALLENGE.
OTHER SYMPTOMS OF ADENOIDITIS RELATED TO NASAL CONGESTION INCLUDE:
BREATHING THROUGH THE MOUTH, SPEAKING WITH A NASAL SOUND, AS IF YOU
ARE SPEAKING WITH A PINCHED NOSE, DIFFICULTY SLEEPING, SNORING OR
SLEEP APNEA (A CONDITION WHERE YOU STOP BREATHING FOR A SHORT
AMOUNT OF TIME DURING SLEEP)
 MEDICAL AND NURSING CARE ADENOIDITIS
• IN MOST CASES, THE CHILD RECOVERS WITH SYMPTOMATIC TREATMENT. IF REQUIRED,
THE PAEDIATRICIAN WILL DECIDE THE BEST TREATMENT FOR YOUR CHILD, WHICH
DEPENDS ON THE NATURE, TYPE AND SEVERITY OF THE INFECTION, AS WELL AS THE
NUMBER OF TIMES THE CHILD HAS DEVELOPED INFECTIONS. IF THE CHILD HAS MIDDLE
EAR INFECTION OR SINUSITIS, TREATMENT IS INITIATED TO REDUCE PAIN IN THE EARS.
ANTIBIOTICS WOULD BE STARTED FOR YOUR CHILD IF DEEMED NECESSARY BY THE
DOCTOR.
• SOMETIMES, THE PAEDIATRICIAN REFERS THE CHILD TO AN EAR, NOSE, AND THROAT
(ENT) SURGEON TO HAVE THE ADENOIDS REMOVED BY A PROCEDURE KNOWN AS
ADENOIDECTOMY. ALONG WITH THE ADENOIDS, SOMETIMES THE TONSILS ARE ALSO
REMOVED AT THE SAME TIME.
 MEDICAL AND NURSING CARE CONT’D

• NURSING CARE INCLUDES:

• AIR WAY, BREATHING, CIRCULATION
• VITAL SIGNS, POSSIBLE CARDIAC MONITORING AND PULSE OXIMETRY
• REDUCE ANXIETY
• PATIENT TEACHING:
 AVOID NASAL TRAUMA, NOSE PICKING, FORCEFUL BLOWING, SPICY FOODS, TOBACCO, EXERCISE
 ADEQUATE HUMIDIFICATION TO PREVENT DRYNESS
 PINCH NOSE TO STOP BLEEDING; IF BLEEDING DOES NOT STOP IN FIFTEEN MINUTES, SEEK MEDICAL
ATTENTION
 TONSILLOPHARYNGITIS

• TONSILLOPHARYNGITIS IS USUALLY VIRAL, MOST OFTEN CAUSED BY THE COMMON COLD

VIRUSES (ADENOVIRUS, RHINOVIRUS, INFLUENZA, CORONAVIRUS, AND RESPIRATORY
SYNCYTIAL VIRUS), BUT OCCASIONALLY BY EPSTEIN-BARR VIRUS, HERPES SIMPLEX VIRUS,
CYTOMEGALOVIRUS, OR HIV. IN ABOUT 30% OF PATIENTS, THE CAUSE IS BACTERIAL.
• TONSILLOPHARYNGITIS IS THE ACUTE INFLAMMATION OF THE PHARYNX, TONSILS, OR BOTH
• CAUSED BY GRAM-POSITIVE COCCI KNOWN AS S PYOGENES
• THIS ORGANISM EXHIBITS BETA-HEMOLYSIS ON BLOOD AGAR PLATES
• THEY BELONG TO GROUP A LANCEFIELD CLASSIFICATION SYSTEM FOR BETA-HEMOLYTIC
STREP INFECTION
 SIGNS AND SYMPTOMS
TONSILLOPHARYNGITIS
• TONSILLAR SWELLING/EXUDATES
• TENDER ANTERIOR CERVICAL LYMPHADENOPATHY
• ABSENCE OF COUGH
• FEVER >38°C
 MEDICAL AND NURSING CARE
• SYMPTOMATIC TREATMENT
• ANTIBIOTICS FOR GROUP A BETA-HEMOLYTIC STREPTOCOCCUS (GABHS)- PENICILLIN V IS USUALLY
CONSIDERED THE DRUG OF CHOICE FOR GABHS TONSILLOPHARYNGITIS
• TONSILLECTOMY CONSIDERED FOR RECURRENT GABHS
• SUPPORTIVE TREATMENTS INCLUDE ANALGESIA, HYDRATION, AND REST. ANALGESICS MAY BE
SYSTEMIC OR TOPICAL. NSAIDS ARE USUALLY EFFECTIVE SYSTEMIC ANALGESICS.
• TONSILLECTOMY HAS OFTEN BEEN CONSIDERED IF GABHS TONSILLITIS RECURS REPEATEDLY (> 6
EPISODES/YEAR, > 4 EPISODES/YEAR FOR 2 YEARS, OR > 3 EPISODES/YEAR FOR 3 YEARS) OR IF ACUTE
INFECTION IS SEVERE AND PERSISTENT DESPITE ANTIBIOTICS. OTHER CRITERIA FOR
TONSILLECTOMY INCLUDE OBSTRUCTIVE SLEEP DISORDER, RECURRENT PERITONSILLAR ABSCESS,
AND SUSPICION OF CANCER.
 MEDICAL AND NURSING CARE CONT’D

• ASSESSMENT OF THE CHILD WITH TONSILLOPHARYNGITIS INCLUDES:

• PREADMISSION ASSESSMENT. MUCH OF THE PREOPERATIVE OPERATIONS,
INCLUDING LABORATORY STUDIES, IS DONE ON A PREADMISSION OUTPATIENT
BASIS.
• HISTORY. ASK ABOUT ANY BLEEDING TENDENCIES BECAUSE POSTOPERATIVE
BLEEDING IS A CONCERN.
• VITAL SIGNS. TAKE AND RECORD VITAL SIGNS TO ESTABLISH A BASELINE FOR
POSTOPERATIVE MONITORING; THE TEMPERATURE IS AN IMPORTANT PART OF
THE DATA COLLECTION TO DETERMINE THAT THE CHILD HAS NO UPPER
RESPIRATORY INFECTION.
 MEDICAL AND NURSING CARE CONT’D
• POST OPERATIVE CARE OF THE NURSE AFTER A TONSILLECTOMY
• PREVENT ASPIRATION. PLACE THE CHILD IN A PARTIALLY PRONE POSITION WITH HEAD TURNED TO ONE SIDE UNTIL
THE CHILD IS COMPLETELY AWAKE; ENCOURAGE THE CHILD TO EXPECTORATE ALL SECRETIONS; DISCOURAGE THE
CHILD FROM COUGHING; AND KEEP THE HEAD SLIGHTLY LOWER THAN THE CHEST TO HELP FACILITATE DRAINAGE
OF SECRETIONS.
• RELIEVE PAIN. APPLY AN ICE COLLAR POSTOPERATIVELY; ADMINISTER PAIN MEDICATION AS ORDERED; ENCOURAGE
THE CAREGIVER TO REMAIN AT THE BEDSIDE TO PROVIDE SOOTHING REASSURANCE; CRYING IRRITATES THE RAW
THROAT AND INCREASES THE CHILD’S DISCOMFORT; THUS, IT SHOULD BE AVOIDED IF POSSIBLE.
• ENCOURAGE FLUID INTAKE. WHEN THE CHILD IS FULLY AWAKE FROM SURGERY, GIVE SMALL AMOUNTS OF CLEAR
FLUIDS OR ICE CHIPS; AVOID IRRITATING LIQUIDS SUCH AS ORANGE JUICE AND LEMONADE; MILK AND ICE CREAM
PRODUCTS TEND TO CLING TO THE SURGICAL SITE AND MAKE SWALLOWING MORE DIFFICULT; THUS THEY ARE POOR
CHOICES; AND RECORD INTAKE AND OUTPUT UNTIL ADEQUATE ORAL INTAKE IS ESTABLISHED.
• PROVIDE FAMILY TEACHING. INSTRUCT THE CAREGIVER TO KEEP THE CHILD RELATIVELY QUIET FOR A FEW DAYS
AFTER DISCHARGE; RECOMMEND GIVING SOFT FOODS AND NONIRRITATING LIQUIDS FOR THE FIRST FEW DAYS;
TEACH FAMILY MEMBERS TO NOTE ANY SIGNS OF HEMORRHAGE AND NOTIFY THE HEALTHCARE PROVIDER; AND
PROVIDE WRITTEN INSTRUCTIONS AND TELEPHONE NUMBERS BEFORE DISCHARGE.
 CONCLUSION
• IN CONCLUSION WE HAVE LOOKED AT SEVERAL LIFE-THREATENING CONDITIONS
THAT AFFECT CHILDREN SUCH AS ACUTE RESPIRATORY CONDITIONS
BRONCHITIS, BRONCHIOLITIS, PNEUMONIA , ACUTE PHARYNGITIS, EAR
INFECTION, EPIGLOTTITIS , TONSILLITIS, ASTHMA, ADENOIDITIS AND
TONSILLOPHARYNGITIS. WE HAVE DEFINED EACH CONDITION, STATED POSSIBLE
CAUSES, STATED THE SIGNS AND SYMPTOMS AND BRIEFLY DESCRIBED THE
MEDICAL AND NURSING CARE. WE HOPE THAT IT WAS INFORMATIVE AND WE
WILL PREVENT AND PROTECT OUR CHILDREN FROM THE DANGER OF DEATH, IF
LEFT UNTREATED OR IMPROPERLY TREATED. 
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