CYSTIC FIBROSIS BRONCHIOLITIS PNEUMONIA ASTHMA STATUS ASTHMATICUS PTB HISTOPLASMOSIS SIDS COPD

REVIEW
RESPIRATION the act of breathing in and

breathing out. Organ: LUNGS (R and L) Right side: 3 lobes Left side: 2 lobes Confirmatory test for lung problems: X-ray

Diagnostic tests
X-ray Sputum analysis: best time is early morning upon

waking up; volume 15 mL - No oral care a night before - Encourage patient to cough and deep breathe Mantoux test purified protein derivative; done in the intradermal (upper 2/3 of forearm); volume 0.1 mL) for PTB - Check for wheeling 46-72 hours

Result of mantoux test: - 10 mm: positive for PTB - 5-9 mm: exposed or probable for PTB - 0-4 mm: negative PTB

CYSTIC FIBROSIS
Multiple organ dysfunction Exocrine glands is commonly affected Problems: thick mucus

TOP 4 organs affected: 1. Respiratory system obstruction (fatal) 2. Integumentary system salty sweat 3. GI system toxicity (septicemia) 4. Reproductive system thick mucus and sterility

Diagnostic test for CF

1. Sweat chloride test

- 50 mg of sweat when using stationary bicycle 2. Stool enzyme analysis - 7 consecutive takings (+) ENZYME TRIPSIN - If skipped: repeat exam

management
Chest physiotherapy Increase fluid intake Oxygen administration DRUGS: antimicrobial

BRONCHIOLITIS
Acute viral illness common in children younger

than 2 years old. findings include inflammation of the bronchioles, often associated with bronchopneumonia. COMMON: 2 mos. 2 years old children Mode of transfer: hand transfer Manifestations: dyspnea, nasal flaring, rhinorrhea, fever, cough MGT: Virazole (Ribavirin) highly teratogenic drug

PNEUMONIA
Inflammation of the alveoli Alveoli gas exchange takes place Types: 1. Viral Pneumonia most common type and

hard to treat; cause: virus small particle than bacteria - manifestation: whitish sputum

2. Bacterial pneumonia starts from non-productive cough then hacking cough 3. Primary atypical Pneumonia starts from nonproductive cough, then productive and ends with hemoptysis (blood streak sputum) 4. Community acquired pneumonia acquired through overcrowded areas; due to poor hygiene Signs: RUSTY SPUTUM, dyspnea, productive cough, fever, cyanosis, weakness

Management for pneumonia

Drugs: antibiotics; antypyretics;

antimicrobials Chest physiotherapy Deep breathing or cough exercises Increase fluid intake Semi to high fowlers position Oxygen therapy Turn patient regularly

ASTHMA
-

Narrowing of the airways - Cardinal sign: wheezing - 2 factors that causes asthma: a. INTRINSIC FACTOR b. EXTRINSIC FACTOR

INTRINSIC FACTORS - Within self or system - Genetic - Autoimmune or self-destruction EXTRINSIC FACTOR - Dust - Pollens - Extreme temperatures - Food - Perfumes - Pets - Stress

Manifestations of Asthma
Dyspnea Wheezing sound Weakness or fatigue Cyanosis Non-productive cough Newborn: nasal flaring Restlessness or irritability

STATUS ASTHMATICUS
-

Untreated simple asthma A condition of severe, prolonged asthma. Asthma that lasts more than 24 hours Life-long already (no treatment or cure)

Management for Status Asthmaticus

1. DRUGS: brochodilators; steroids (last 2. 3. 4. 5. 6.

defense); SE: weight gain O2 administration semi to high fowlers position Position to comfort Decrease stimulant; avoid causative or offending agents (intrinsic and extrinsic fxs) Increase fluid intake for diaphoresis

PTB (Pulmonary Tuberculosis)

- Inflammatory, communicable, respiratory

disease or disorder. - Cause: mycobacterium tuberculosis - Most common among all types of TB - Risk factors: overcrowded places; poor hygiene; poor nutrition

Diagnostic tests for PTB

Chest x-ray Sputum analysis Mantoux test

Manifestations: AFTERNOON fever, NIGHT sweats; productive cough, hemptysis; weakness; fatigue, anorexia, weight loss

Management: drugs: RIPES

R rifampicin I isoniazid (intake with B6) P pyrazinamide E ethambutol S - streptomycin
Yellow-orange

discoloration of urine Peripeheral neuritis Gout (increase fluid intake to excrete uric acid) Optic neuritis (monthly eye checkup) Teratogenic; ototoxicity; nephrotoxicity

management
Family should have protective isolation Separate utensils Take vitamin c (500-1000 mg) Increase fluid intake CHON consumption (promote wound healing) Taking of drugs religiously Supportive management

HISTOPLASMOSIS
acquired by inhalation of spores of the fungus

in soil dust Lung problem brought about by birds feces or manure Agent: Histoplasma capsulatum

manifestations
Asymptomatic PTB/pneumonia-like manifestations Productive cough Joint pain Excessive fatigue

Dx tests
HISTOPLASMIN TEST (like mantoux test);

making use of histoplasmin drug Drug: Amphotericin B (antibiotic)

Health teaching: - prone: working in poultries - Wet the manure first - Wear mask during gardening or working

SIDS (sudden infant death syndrome)

Sudden death of an apparent healthy baby

less than one year old. Factors: 1. Maternal factors - Teenage pregnancy - Smoker (low birth weight or small for gestational age) - Drug addict or user

a. b. c.

Drugs used during pregnancy: Heroine baby looks normal Methadone severely ill baby Cocaine poor activity; poor feeding; expect mental retardation Other factors: sleeping with mother; sleeping with multiple pillows, thick blankets, stuff toys; heaters during winter

Manifestations when found

Cyanotic Nasal and oral bleeding Diapers full of feces and urine

MGT
Post mortem care Emotional support to the parents DX TEST: autopsy

Other factors: child abuse

Physical abuse Sexual abuse Neglect Emotional Verbal Baby shaken syndrome newest form of child

abuse that leads to blindness

COPD (chronic obstructive pulmonary disease)

A group of lung disorders affecting air in

entering and leaving the lungs.

types
1. Emphysema - A condition of the lung

characterized by increase beyond the normal in the size of air spaces distal to the terminal bronchiole (those parts containing alveoli), with destructive changes in their walls and reduction in their number. pink puffers: pink to red color Loss of lung elasticity (alpha 1 trypsin)

Cause: SMOKING Manifestations: cardinal sign: barrel chest - Short rapid breathing - Productive cough - Weakness or fatigue - Anorexia - Weight loss - Rales and wheezing

2. CHRONIC BRONCHITIS excessive cough and mucus production that last for 2 to 3 months and extends until 2-3 years - blue bloaters (cyanotic) - Pulmonary hypertension (lack of air in the lungs)

3. BRONCHIECTASIS - Chronic dilation of bronchi or bronchioles as a sequel of inflammatory disease or obstruction. - Overlaying of sputum - Manifestations: fetid breath; productive cough; excessive sputum; hemoptysis

4. ASTHMA - airway obstruction - HT: avoid smoking; avoid causative agents; drugs (antimicrobials, antipyretics, antimicrobials)