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Acute respiratory infections
in children
Factors affecting type of illness and
the response to illness
Nature of infectious agent
 Size and frequency of dose
 Age of the child
 Size of the child
 Ability to resist invading organisms
 Disease conditions
 Disorders affecting respiratory tract
 season
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Etiology
Viruses
 Bacteria
-beta hemolytic streptococcus
-staphylococcus
-Hemophilus influenza
-Pneumococci
 Fungus
 Aspiration of foreign substance
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Pnemonia
Localised acute inflammation of the lung
tissue.
 May occur as aprimary disease,a
complication of another illness or
aspiration of foreign substance
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Pathologic changes in tissues
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Pnemococci cause consolidation of all or part of
lobe in lobar pneumonia or cause consolidation
of scattered lobules in bronchopneumonia
Staphylococci tend to destroy tissue producing
small abscesses
H.infleunza cause excessive destruction of the
epithelia of small airway ,interstitial inflammation
and hemorrhagic edema
Virus/ S.viridans destroy mucosa and cause
interstitial lesions
M.pnemonia attach to cell surface and cause
ulcers and sloughing of mucosa
Forms of infectious pneumonia
1. anatomic distribution

lobar pneumonia :all or a large segment of
one or more of lobe is affected .

bronchopneumonia: begins in the terminal
bronchioles, which become clogged with
mucopurulent exudates to form consolidated in
nearby lobules. also called lobular pneumonia
 Interstitial pneumonia:the inflammatory process
is more or less confined within alveolar walls
and the peribronchial and inter lobular tissues.
Forms of infectious pneumonia
2.Causative organism
 Bacterial
 Viral
 Other infections
bacterial pneumonia
Clinical manifestations of
pneumonia
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Fever
Cough: unproductive to productive
Tachypnea
Breath sounds: ronchi or fine crackles
Dullness with percussion
Chest pain
Retractions
Nasal flaring
Pallor to cyanosis
X-ray shows diffuse or patchy infiltration with peribronchial
distribution
Behavior: irritable, lethargic or restless
Gastro intestinal: anorexia, vomiting, diarrhea and abdominal pain
Medical management of
pneumonia
Most of children can be treated at home

bed rest

antibiotic therapy

oral fluid intake

antipyretics
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antitussives
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oxygen therapy
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Nursing assessment
Assess for : fever,malaise,cough,chills
 Rapid ,shallow respiration:
-60 / minute for a baby less than 2
months
- 50/mt for a baby up to 12 months
- 40 /mt for a baby upto 5 years
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Severe pneumonia
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Retractions
Very severe pneumonia
 Grunting
 Not able to drink
 Sleep problems
 Stridor in a calm child
 Severe malnutrition
Nursing care plan
Ineffective breathing pattern related
to inflammatory process ,pain
Goal:child will exhibit normal respiratoy function
Intervention:
 Allow position of comfort
 Promote rest
 Maintain patent airway
 Provide high humidity environment
 Reduce anxiety and apprehension
 Organize activities to reduce energy expenditure
Ineffective airway clearance r/t
mechanical obstruction, increased
secretion
Goal 1. The child will maintain patent airway
 Intervention:
 Suction secretion as and when needed
 Position to drain secretion
 Assist in expectorating sputum
 Nebulise as prescribed
 Keep NPO until stable
Expected outcome:
Airway remains clear
Breathes easily ,respiration within normal limits
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Fear /anxiety r/t hospitalisation
,dyspnea
Goal:child will be relieved of anxiety
 Explain unfamiliar procedure and equipments
 Remain with the child
 Hold and cuddle the child
 Be aware of rest and sleep pattern
 Provide security objects
 Try to avoid intrusive procedure
 Encourage the parents to be with the child
Expected outcome:
-child responds positively to comforting measures
-parents relate positively
Child is calm and cooperate
Risk for infection/actual infection r/t
presence of infective organism and
inflammation
Goal 1.:child exhibit no sign of infection
Interventions
 Administer antibiotics and
antiinflammatory drugs
 Provide adequate nutrition a/c to childs
preferences and limitations
 Expected outcome:
The child exhibit no signs of infection
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Goal 2.
The child will not spread infection to others
Interventions
 Employ appropriate infection control measures
 Instruct others in precautionary measures
 Assess home situation administer antimicrobial
medication
 Administer pneumococcal vaccine to susceptible
children
 Support body,s natural defence mechanism

Ineffective airway clearance…
Goal 2:the child will expectorate secretion
adequately
 Ensure adequate fluid intake
 Provide humidified atmosphere
 Assist in deep breathing and coughing
 Suction as necessary
 Expected outcome:
Expectorate secretion without stress or fatigue