MANAGING

COMMON
CHILDHOO
D

ILLNESSES


DEFINITION OF TERMS:
❖Health - is a state of
complete physical, mental
and social well-being and not
m e re ly th e a bse n c e of
disease or infirmity (WHO).
Illness 

- State in which a person’s physical,
emotional, intellectual, social,
developmental or spiritual functioning is
diminished or impaired. It is a condition
characterized by a deviation from a
normal, healthy state.

(Nola Pender)
 ROLES
IN
MANAGING
ILLNESS
 CAREGIVERS’ ROLE
1. IDENTIFY CHILDREN
WHO NEED ATTENTION BY:
• Careful and regular observation
Of children
• Communication between parents
and fellow caregivers
 CAREGIVERS’ ROLE

2. ENSURE PROPER
STEPS ARE TAKEN
3. PROTECT OTHER
CHILDREN IN THE HOME CARE
SETTING
PARENT’S ROLE:
- RESPONSIBLE
FOR ALL DECISIONS
CONCERNING
CARE OF THEIR CHILDREN
 SPECIAL
CONSIDERATIONS
1. CAREGIVERS
DON’T
DIAGNOSE
ILLNESS
 2. PARENTS ARE
RESPONSIBLE
FOR SEEKING
MEDICAL
ATTENTION
FOR THEIR CHILD
 3. EVERY CHILD MINDER
SHOULD KNOW
HOW TO CONTACT:
➢S O U R C E O F H E L P I N
URGENT SITUATIONS
➢THE PARENTS
 PHYSICIAN’S ROLE
-NEEDS TO BE INFORMED
ABOUT THEIR LOCAL
PUBLIC HEALTH AND
PROVINCIAL/
TERRITORIAL CHILDCARE
REGULATIONS
 PUBLIC HEALTH’S
ROLE:
- MUST BE AVAILABLE
TO THE COMMUNITY
IN CASES OF OUTBREAKS OF ILLNESS

- RESPONSIBLE IN THE
PROVISION OF INFORMATION
ON UPDATED HEALTH PRACTICES
AND POLICIES
 PHYSIOLOGIC DIFFERENCES
DURING ILLNESS

1. CHILDREN
NEED
MORE NUTRIENTS
PER POUND OF
BODY WEIGHT
 Recommended Energy Nutrient Intakes
• 1 cup of milk has 8 grams of
protein
• A 3-ounce piece of meat has
about 21 grams of protein
• 1 cup of dry beans has about
16 grams of protein
• An 8-ounce container of
yogurt has about 11 grams of
SOURCE: FNRI
 Vitamin C
• Strawberries, fresh, sliced,
½ cup 49mg
• Orange juice, ¾ cup 93mg
• Thiamin (B1)- lean pork,
sunflower seeds,
macadamia nuts, wheat
bread, green peas SOURCE: FNRI
• Orange 55mg
Calcium
• Skim milk 300mg
Calcium
• Foods fortified with
Ca+
SOURCE: FNRI
 2. FLUID AND
ELECTROLYTES
- BODY WATER IS IMPORTANT
SINCE THE BIOCHEMICAL
REACTIONS THAT ENABLE THE
FUNCTIONING OF CELLS
TAKE PLACE AMONG
THE SUBSTANCES DISSOLVED
IN BODY WATER
Minimum Daily Requirements
for Water

SOURCE: FNRI
Minimum Daily Requirements for
Electrolytes

For nerve impulse

and
muscle contraction
SOURCE: FNRI
3. CHILDREN TEND TO
RESPOND TO ILLNESS
SYSTEMICALLY
RATHER
THAN LOCALLY
 4. CHILDREN ARE
SUSCEPTIBLE TO
SOME DISEASES
THAT DON’T AFFECT
ADULTS
DUE TO
THEIR GROWTH
REQUIREMENTS
AND IMMATURITY
 PSYCHOLOGICAL
And
EMOTIONAL EFFECTS of
ILLNESS
 SEPARATION
ANXIETY
AMONG INFANTS
IN TODDLERS/PRESCHOOLERS:

SEPARATION ANXIETY

FEAR OF THE
DARK

FEAR OF INTRUSIVE
PROCEDURES
IN SCHOOL AGE/ADOLESCENCE:
FEAR OF LOSS
OF BODY
PARTS /INTRUSIVE
PROCEDURES

FEAR OF LOSS
OF FRIENDS
CHILDHOOD
DISEASES
 SUDDEN INFANT
DEATH SYNDROME
(SIDS)
 ALSO KNOWN AS:

❖INFANT CRIB DEATH

• the sudden death of an
apparently healthy infant under
1 year of age during sleep that
remains unexplained after a
complete autopsy and review of
history
FAST FACTS

❑ Unknown cause
❑ 2:1000 live births
❑ Feeding habits insignificant
❑ Mild respiratory illness
often precedes death
RISK FACTORS: (INFANTS)
PREMATURITY
LOW BIRTH WEIGHT
TWIN/TRIPLET BIRTH
RACE (NATIVE AMERICANS, BLACKS,
HISPANIC, WHITE, ASIAN)
MALE GENDER
2-4 MOS. OLD
WINTER
RISK FACTORS: (MOTHER/FAMILIAL)
➢ Mother aged <20 years old

➢ History of smoking
and drug use

➢ Anemia
CLINICAL FINDINGS
❑ PULMONARY EDEMA AND
INTRATHORACIC HEMORRHAGE
❑ EVIDENCE OF STRUGGLE OR
CHANGE IN POSITION
❑ PRESENCE OF FROTHY,
BLOOD-TINGED
SECRETIONS FROM THE
MOUTH AND NARES
 NURSING/
CAREGIVER’S
MANAGEMENT
 DO’S
❑KNOW THE SIGNS OF SIDS
❑SAY NOTHING THAT COULD INSTILL
GUILT TO THE PARENTS
❑BE NON-JUDGMENTAL
❑REASSURE PARENTS
❑BE EMPATHETIC AND PROVIDE SUPPORT
❑RE-INFORCE THAT AN AUTOPSY SHOULD
BE DONE
❑REFER PARENTS TO A SIDS PARENT
GROUP
 PREVENTION
∗ PLACE INFANTS IN SUPINE POSITION TO
SLEEP
∗ PROVIDE A FIRM SLEEP SURFACE AND
AVOID EXCESSIVE BLANKETS AND PILLOWS
∗ AV O I D M AT E R N A L S M O K I N G A N D
EXPOSURE OF INFANT TO SECOND-HAND
SMOKE
∗ ENSURE THAT INFANT SLEEPS SEPARATELY
FROM PARENTS
∗ HOME APNEA MONITOR
 CYSTIC
FIBROSIS
GENETIC DISORDER CAUSED BY MUTATIONS IN
THE CFTR RESULTING TO ALTERATIONS IN
RESPIRATORY, GASTROINTESTINAL,
INTEGUMENTARY, MUSCULOSKELETAL, AND
REPRODUCTIVE SYSTEMS

• PREDOMINANT IN WHITE
CHILDREN
∗ CHARACTERIZED BY WIDESPREAD
DYSFUNCTION OF OUTWARD SECRETING
GLANDS CAUSING SWEAT GLAND TO
PRODUCE SALTY SWEAT, MUCUS
GLANDS TO SECRETE THICK, GLUEY
MUCUS WHICH CLOGS THE TINY
BRONCHIOLES OF THE LUNGS AND STOPS
AT THE DUCT OF PANCREAS AND OTHER
ORGANS OF THE BODY
 ∗ AUTOSOMAL RECESSIVE TRAIT

FATHER MOTHER
(Carrier) (Carrier)

OFFSPRINGS
25 % CHANCE TO INHERIT DISEASE
25% CHANCE NOT TO INHERIT DISEASE
50% CHANCE THERE WILL BE CARRIERS
 SIGNS and SYMPTOMS:
➢ DIARRHEA: LARGE, BULKY OR STICKY STOOLS
WITH BAD ODOR
➢ VORACIOUS APPETITE
➢ POOR GROWTH AND FAILURE TO THRIVE
➢ CHRONIC COUGH AND SPITTING
➢ SALTY SWEAT
➢ SEVERE VOMITING AND ABDOMINAL PAIN
➢ CLUBBING OF FINGER
➢ BARREL CHEST
BARREL CHEST
 CONFIRMATORY 

DIAGNOSTIC

PILOCARPINE IONTOPHORESIS
(SWEAT TEST)
!Repeated sweat chloride
values of greater than 60
mEq/L


MEDICAL TREATMENT:

> ANTIBIOTICS

> VITAMIN SUPPLEMENTS

> PILLS (WITH MISSING PANCREATIC ENZYMES)

>BRONCHODILATORS

>OXYGEN

>INSULIN INJECTIONS

>SALT

 POSSIBLE OPTIONS
∗GENE THERAPY - carry
healthy genes to the damaged
cells and correct defective CF
cells.
∗DOUBLE LUNG
TRANSPLANTATION
 NURSING
/CAREGIVER
MANAGEMENT
• ENSURE THAT CHILD EATS A WELL-BALANCED
DIET AND INCREASE ORAL FLUID INTAKE
• GIVE MEDICATIONS AS PRESCRIBED
• FOLLOW INSTRUCTIONS ON HOW TO
ADMINISTER OXYGEN
• PERFORM CHEST PHYSIOTHERAPY
• TEACH BREATHING EXERCISES
• DISCUSS WITH PARENTS ANY RELEVANT
CHANGE IN A CHILD’S ACTIVITY
EQUIPMENTS FOR O2 ADMINISTRATION

O2 mask

OXYGEN REGULATOR
OXYGEN TANK
O2 cannula
 CHEST PHYSIOTHERAPY
INCLUDES:
➢ POSTURAL DRAINAGE
➢ CHEST PERCUSSION AND VIBRATION
 DEEP BREATHING EXERCISES

(DBE)
HELPS PEOPLE INHALE MORE AIR WITH LESS
EFFORT THAN THEIR USUAL TYPE OF BREATHING
1.DIRECT CLIENT TO BREATHE IN DEEPLY THROUGH
THE NOSE
2.DIRECT CLIENT TO BLOW OUT THROUGH THE
MOUTH WITH LIPS “PURSED” (LIKE BLOWING A
CANDLE)
REPEAT STEPS 10X; 2-3 TIMES IN A DAY
CONTROLLED COUGHING EXERCISES

SPECIAL CONSIDERATIONS
Effective coughing is the best means of
removing secretions from the airways.
It is contraindicated for the patient who
has had eye, ear, brain, or neck surgery.
STEPS
• Place patient in upright position with upper body
slightly forward, and auscultate breath sounds.
• Ask patient to take 2 to 3 slow, deep breaths,
inhaling through the nose and exhaling through the
mouth.
• Instruct patient to inhale deeply and hold for 5
seconds, then lean forward and cough rapidly
using abdominal, thigh, and buttock muscles.
STEPS
• Instruct patients with pulmonary disease to exhale
through pursed lips and to cough early in
exhalation.
• Remember to support any incision with a pillow held
tightly on top of it.
• Encourage patient to keep coughing if cough is
productive.
 EMERGENCY:
VOMITING WITH
ABDOMINAL PAIN
1. CALL THE PARENTS
2. IF SEVERE, CALL A
PHYSICIAN OR
AMBULANCE
 EYE
DISORDE
INFECTIOUS CONJUNCTIVITIS
- inflammation of the
conjunctiva caused by a
contagious infection
(bacterial/viral)
 SIGNS and SYMPTOMS

PINK/RED
SCLERA

ITCHING/
YELLOW/WHITE BURNING
DISCHARGE SENSATION
CRUSTY EYELIDS MILD PHOTOPHOBIA
 CAUSATIVE AGENTS
• VIRUS
• Adenoviruses
• Picornaviruses, such as enterovirus 70 and coxsackievirus A24
• Rubella virus
• Rubeola (measles) virus
• Herpesviruses, including
• Herpes simplex virus
• Varicella-zoster virus, which also causes chickenpox and shingles
• Epstein-Barr virus, which also causes infectious mononucleosis
(mono)
BACTERIA
∗Staphylococcus aureus
∗Haemophilus influenzae
∗Streptococcus pneumoniae
∗Moraxella catarrhalis
∗Chlamydia trachomatis
 INCUBATION PERIOD

∗BACTERIAL
-24-72 hours

∗VIRAL
- 12 hours – 3 days
 TRANSMISSION
▪Contact with discha rges fro m
conjunctivae or upper respiratory tracts
of infected persons contaminated
fingers clothing and other articles
especially those coming in close
contact with the eyes (i.e. make-up
a p p l icato rs , m u lt i p l e d ose eye
medication applicators).
 Period of Communicability
∗DEPENDS ON THE
CAUSE SOMETIMES,
up to 14 days after
onset
 EXCLUSION/ATTENDANCE
▪Academy of Pediatrics advises that
children with purulent conjunctivitis
(defined as pink or red conjunctiva
with white or yellow discharge,
often with matted eyelids after
sleep and eye pain or redness of
the eyelids or skin surrounding the
eyes) be excluded until examined by
a health care provider and approved
for readmission.
 EXCLUSION/ATTENDANCE

▪BACTERIAL- exclusion
until 24 hours after
starting topical
antibiotic therapy
 MANAGEMENT
∗ APPLICATION OF COLD COMPRESS
OVER AFFECTED AREA MAY RELIEVE
DISCOMFORT
∗ TELL PATIENT TO WEAR DARK GLASSES
∗ INSTRUCT PATIENT TO AVOID RUBBING
EYES
∗ Encourage frequent hand-washing and
prompt disposal of used tissues  
 TREATMENT

➢ANTIBIOTIC EYE DROPS

(FOR BACTERIAL INFECTION)
➢ANTIHISTAMINES
(IF CAUSED BY ALLERGY)
 HOW TO ADMINISTER EYE DROPS
1. WASH HANDS
2. Warm the eye drops.  Pour warm water
into a cup. Drop the eye drop container
in the cup of warm water, and allow it to
sit for 5 minutes
3. Lay the child down (FLAT)
4. Tip your child's head back slightly.  It
helps to put a small pillow under her
neck. 
5. Ask child to squeeze his eyes shut.
 HOW TO ADMINISTER EYE DROPS
6. Drop one to two eye drops into the inside
corner of your child's eye
7. Request child open his eyes.  The eye drops
caught in the corner of the eyelid should drain
into the eye.
8. Tell your child to blink several times. Blinking
helps the eyes absorb the medicine and restore
your child's vision to normal.
9. Clean the eye dropper tip.  Wipe the tip of
the eye dropper with a cotton ball soaked in
rubbing alcohol.
 PREVENTION
∗HANDWASHING
∗ENVIRONMENAL
SANITATION
∗DISINFECTION OF EYE
EQUIPMENTS
 EAR

DISORDERS
FAST FACTS
TYMPANIC MEMBRANE
MIDDLE EAR

EUSTACHIAN
TUBE

EXTERNAL AUDITORY CANAL

FAST FACTS

DURING SUCKING, YAWNING AND

EUSTACHIAN
OTHER MOVEMENTS,
THE TUBE OPENS TUBE
FOR
MILLISECONDS ALLOWING FREE
-connects
PASSAGE OF AIR BETWEEN THE
NASOPHARYNX AND nasopharynx
THE MIDDLE to
the middle ear
EAR Shorter,
Wider and straighter
In infants
 FAST FACTS

∗EXTERNAL EAR CANAL IS SMALL AT BIRTH,

ALTHOUGH THE INTERNAL EAR AND THE
MIDDLE EAR ARE RELATIVELY LARGE

0THE TYMPANIC MEMBRANE IS

CLOSE TO THE SURFACE AND
CAN BE EASILY INJURED
 OTITIS MEDIA

-- INFECTION OF
A common result
THE MIDDLE
of upperEAR
DUE TO BLOCKED
Respiratory tract
EUSTACHIAN
infection
TUBE PREVENTING
NORMAL DRAINAGE
 CAUSES

∗BACTERIA
∗VIRUS
 SIGNS and SYMPTOMS

∗ FEVER
∗ IRRITABILITY
∗ RESTLESSNESS
∗ LOSS OF APPETITE
∗ ROLLING OF HEAD FROM SIDE TO SIDE, PULLING
OR RUBBING EAR
∗ EAR PAIN
∗ PURULENT DISCHARGE
 MANAGEMENT

∗ ENCOURAGE ORAL FLUID INTAKE

∗ ENCOURAGE PATIENT TO AVOID CHEWING
∗ ADMINISTER PAIN RELIEVER, ANTIBIOTIC,
NASAL DECONGESTANTS AND EARDROPS AS
PRESCRIBED
∗ INSTRUCT PARENTS APPROPRIATE PROCEDURE
OF
INSTILLING EAR DROPS
∗ MYRINGOTOMY
Myringotomy (myringa "eardrum")

- a surgical procedure in which a
tiny incision is created in
the eardrum to relieve pressure
caused by excessive buildup of
fluid, or to drain pus from
the middle ear.
0POST-MYRINGOTOMY
INSTRUCTIONS:
keep ear dry
wear ear plugs during bathing,
swimming and shampooing
no diving or snorkling
 COMPLICATION

∗CONDUCTIVE DEAFNESS
**to prevent this, tympanic
membrane buttons (tube) in
each ear drum to act as drain
 DISORDERS OF THE
RESPIRATORY SYTEM
 PEDIATRIC ANATOMY

and PHYSIOLOGY DIFFERENCES

of the RESPIRATORY

SYSTEM
Epiglottis
 ALLERGIC
RHINITIS

- AN INFLAMMATION
OF THE LINING OF
THE NOSE
SIGNS and SYMPTOMS:
• Nasal congestion
• Rhinorrhea
• Sneezing
• Itching
MANAGEMENT:
∗ENVIRONMENTAL CONTROL
∗CORRECT MEDICATIONS
 ACUTE
TONSILLOPHARYNGITIS
∗ THROAT INFECTION
∗ USUALLY
SIGNS and CAUSED BY
SYMPTOMS:
➢FEVER STREPTOCOCCAL
INFECTION
➢HEADACHE
COMPLICATIONS:
➢DYSPHAGIA
➢RHEUMATIC FEVER
➢CERVICAL LYMPHADENOPATHY
➢NEPHRITIS
CERVICAL LYMPHADENOPATHY
 MANAGEMENT:

∗ AVOID SPICY FOODS

∗ ENCOURAGE ORAL FLUID
INTAKE (COOL DRINKS)
∗ GARGLE WITH WARM, SALT
WATER
 MUMPS

(PAROTITIS)

-inflammation
of the parotid gland
(salivary)
CAUSE:
> PARAMYXOVIRUS
COMMON AMONG
10-14 Y/O
 SIGNS and SYMPTOMS

∗SWELLING OF THE PAROTID GLANDS

∗LOW FEVER
∗KIDNEY DISEASE
∗WEAKNESS
∗STIFF NECK
∗PHOTOPHOBIA
 MANAGEMENT
∗REASSURE CHILDREN THAT FACIAL
SWELLING WILL GO AWAY
∗MAINTAIN RESPIRATORY ISOLATION
OF PT. WHILE CONTAGIOUS
∗GIVE NON-ASPIRIN ANALGESIC AND
ANTIPYRETIC
FOR FEVER AND PAIN
 MANAGEMENT
∗ ENCOURAGE FLUID INTAKE
∗ PROVIDE SCROTAL SUPPORT
∗ PROVIDE BELL OR ANY ATTENTION-
GETTING DEVICE
∗ APPLY WARM/COOL COMPRESS
∗ BE ALERT FOR SIGNS OF COMPLICATIONS
∗ ENCOURAGE DIVERSIONAL ACTIVITIES
 COMPLICATIONS

∗ ORCHITIS, OOPHORITIS
∗ KIDNEY DISEASE
∗ DEAFNESS
∗ PANCREATITIS
∗ ENCEPHALITIS
∗ ASEPTIC MENINGOENCEPHALITIS
Signs and symptoms
 DIPHTHERIA

∗A C U T E F E B R I L E
INFECTION OF THE
TONSILS, THROAT, NOSE
OR A WOUND MARKED
BY A PATCH OF GRAYISH
MEMBRANE FROM
WHICH THE DIPHTERIA
BACILLUS IS READILY
CULTURED
 DIPHTHERIA

0CAUSE
- CORYNEBACTERIUM DIPHTERIAE
∗TRANSMISSION
-- DIRECT CONTACT WITH INFECTED
PATIENTS OR WITH ARTICLES SOILED
WITH DISCHARGES OF INFECTED
PERSONS
 DIPHTHERIA

∗INCUBATION PERIOD
: Usually 2-5 days

∗COMMUNICABILITY
:usually 2 weeks or less and
seldom more than 4 wks.
 MANAGEMENT

∗PREVENTIVE EDUCATION
∗PROPER DISPOSAL OF
RESIDUALS
∗ISOLATION
 LOWER
RESPIRATORY
TRACT
DISORDERS
 BRONCHITIS

- ACUTE INFLAMMATION
OF TRACHEA AND MAIN
BRONCHI
RESULTING FROM
AIRWAY INJURY
 BRONCHITIS

Signs and Symptoms:

➢COARSE, HACKING COUGH
➢APPEARS TIRED
➢SORE CHEST AND RIBS
➢WHEEZING
➢OCCASIONAL SOB
➢COARSE AND FINE MOIST RALES
 MANAGEMENT
∗ REST
∗ HUMIDIFICATION
∗ INCREASE ORAL FLUID INTAKE
∗ DON’T GIVE EXPECTORANTS/
ANTIHISTAMINES
∗ ISOLATION
∗ OXYGENATION
∗ HAND WASHING
 BRONCHIOLITIS

∗ INFLAMMATION
OF THE
BRONCHIOLES
 SIGNS and SYMPTOMS

∗WHEEZES ∗PALLOR
∗SIMPLE COLD ∗IRRITABILITY
WITH LOW ∗TACHYCARDIA
GRADE FEVER ∗BARREL CHEST
∗NASAL FLARING ∗
INCREASED RR
∗CYANOSIS
BARREL CHEST
 2 MOS-12 MOS: 50 bpm
12 MOS -5 YEARS: 40 bpm
 MANAGEMENT
∗ HAND WASHING
∗ REST
∗ ELEVATE INFANT’S HEAD TO 30-40
DEGREES ANGLE
∗ INFANTS SHOULD BE PLACED IN THE
SNIFF POSITION WITH THE HEAD
THRUST FORWARD
∗ PREPARE SUCTION MACHINE/
EQUIPMENTS
 TREATMENT
∗OXYGEN
∗IVF
∗ANTIBIOTICS

***INTUBATION AND VENTILATION

if respiratory failure occurs
 ASTHMA
∗ A.k.a: BRONCHIAL ASTHMA
∗ CHARACTERIZED BY WIDESPREAD
NARROWING OF THE BRONCHIAL AIRWAYS
**due to contraction of the smooth
muscles, vascular congestion, edema and
secretions**
∗ CAUSE: allergic reaction to immunologic
and non-immunologic stimulants
 Signs and SYMPTOMS

∗PRODUCTIVE COUGH
∗EXPIRATORY WHEEZING
∗SUDDEN DYSPNEA (panting)
∗USE OF ACCESSORY MUSCLES
∗RAPID PULSE AND RESPIRATION
∗EASY FATIGABILITY
EXTERNAL INTERCOSTALS

DIAPHRAGM
 COMPLICATIONS
***STATUS ASTHMATICUS
(refractory asthma)
-Attack may continue for
several days at night
-Death may occur
 MANAGEMENT
∗MAINTAIN AIRWAY PATENCY
∗INCREASE ORAL FLUID INTAKE
∗PROMOTE REST
∗AVOID EXPOSURE TO PATIENTS
WITH VIRAL INFECTIONS
 TREATMENT

∗BRONCHODILATORS
∗OXYGENATION
∗STEROIDS
 PNEUMONIA

- I N F L A M M AT I O N A N D
INFECTION OF THE
BRONCHIOLES AND
ALVEOLAR SPACES OF THE
LUNGS
 TYPES OF
PNEUMONIA CAUSATIVE AGENT
ACCDG.
TO PATHOGEN
1. VIRAL RESPIRATORY
SYNCYTIAL VIRUS (RSY)
ADENOVIRUS
2. BACTERIAL STREPTOCOCCUS
MYCOPLASMA
3. ASPIRATION Secretions or foreign
material
Respiratory Syncytial Adenovirus
Virus (RSV)

I r r i t a b i l i t y, s l i g h t Sore throat, fever,

sputum production, c o u g h , c h i l l s ,
fever, severe malaise, m a l a i s e , s m a l l
cough, poor feeding, a m o u n t s of
tachypnea mucoid sputum,
Treatment: retrosternal chest
Antimicrobial pain
Complete recovery
b. Bacterial Pneumonia- they
circulate through the blood
stream to the lungs where they
damage cells

a. Streptococcal Pneumonia
(streptococcus pneumoniae)
b. Mycoplasma Pneumonia
 Community-Acquired Pneumonia

∗ occurs either . in the community

setting or within the first 48 hours of
hospitalization or institutionalization.
∗ Chest x-rays may reveal multilobar,
patchy bronchopneumonia or areas of
consolidation (tissue that solidifies
as a result of collapsed alveoli or
pneumonia).
0CAUSES: bacteria, fungi, viruses,
and protozoa
0BACTERIA
- Streptococcus Pneumoniae
(alcoholism, COPD/smoking,
- Staphylococcus Aureus (lung disease
like bronchiectasis)
- Haemophilus Influenzae (COPD/
smoking)
0BACTERIA
-Klebsiella Pneumoniae
-Pseudomonas Aeruginosa
-Mycoplasma Pneumoniae
-Chlamydia Pneumoniae
-Legionella (Stay in hotel or
on cruise ship in previous 2
weeks)
∗VIRUS:
- Hantaviruses (Travel to
southwestern United States)
- Metapneumoviruses
- Coronavirus
- Influenza viruses
- Adenoviruses
- Respiratory syncytial viruses
 FAST FACTS: (US DATA)
∗CAP results in more than 600,000
hospitalizations, 64 million days
of restricted activity, and 45,000
deaths annually

∗INCIDENCE: 12–18 per 1000

among children <4 years of age
 MANIFESTATIONS:
∗ Frequently febrile with tachycardia
∗ May have a history of chills and/or sweats
∗ Cough may be either nonproductive or
productive of mucoid, purulent, or blood-
tinged sputum
∗ Pleuritic chest pain
∗ Crackles, bronchial breath sounds, and
possibly a pleural friction rub may be
heard on auscultation
 MANAGEMENT
∗Adequate hydration!
ENCOURAGE ORAL FLUID
INTAKE
∗Oxygen therapy for
hypoxemia
∗Assisted ventilation
 TREATMENT
∗ANTIBIOTICS
!After a CULTURE AND
SENSITIVITY (C and S)
! NOTE FOR ALLERGY TO
CERTAIN DRUGS ESPECIALLY
ANTIBIOTICS!!
 COMPLICATIONS

∗Respiratory failure
∗Shock
∗ Multi-organ failure
 PREVENTION
∗Main preventive measure is
VACCINATION
∗Frequent hand washing
∗Proper disposal of contaminated
residuals
∗Cover mouth when coughing
! UPDATE: Use upper arm
 Hospital-acquired pneumonia (HAP)

∗also known as nosocomiaL

pneumonia
∗o n s e t o f p n e u m o n i a
symptoms more than 48
hours after admission to
the hospital
 CAUSATIVE AGENTS:
∗Enterobacter species, Escherichia
coli, Klebsiella species,
∗Proteus, Serratia marcescens, P.
aeruginosa, and methicillin-
sensitive
∗m e t h i c i l l i n - r e s i s t a n t
Staphylococcus aureus.
 RISK FACTORS
∗ SEVERE ACUTE OR CHRONIC ILLNESS
! coma, malnutrition, prolonged
hospitalization,
hypotension, and metabolic disorders.
∗ Exposure to potential bacteria from
other sources
! respiratory therapy devices and
equipment, transmission of pathogens by
the hands of health care personnel
 COMPLICATIONS
∗Methicillin Resistant S. aureus (MRSA)
!Should be isolated in a private room
!Contact precautions
Gown
Mask
Glove
Antibacterial soap
 Pneumonia in the Immunocompromised
Host

∗Seen with greater frequency

because immunocompromised
hosts represent a growing
portion of the patient
population.
 Pneumonia in the Immunocompromised Host

∗ Immunocompromised states occur

with the use of corticosteroids or
other immunosuppressive agents,
chemotherapy, nutritional depletion,
use of broad-spectrum antimicrobial
agents, AIDS, genetic immune
disorders, and long-term advanced
life-support technology (mechanical
ventilation).
 CAUSATIVE AGENTS
∗Pneumocystis carinii
∗pneumonia (PCP), fungal
pneumonias, and
mycobacterium
∗tuberculosis
 Pneumonia in the compromised host

∗May be caused by the organisms

∗Also observed in CAP or HAP (S.
pneumoniae, S. aureus, H. influenzae,
P. aeruginosa, M. tuberculosis).
∗Has a subtle onset with progressive
dyspnea, fever, and a non-productive
cough.
 Aspiration pneumonia

∗Pulmonary consequences
resulting from the entry of
endogenous or exogenous
substances into the lower
airway.
∗COMMON PATHOGENS
!S. pneumoniae
!H. influenzae,
!S. aureus
∗May impair the lung defenses
! inflammatory Changes !
bacterial growth !
pneumonia
 PERTUSSIS/WHOOPING COUGH

∗CONTAGIOUS DISEASE OF
THE RESPIRATORY SYSTEM
PREDOMINANTLY AMONG
CHILDREN CAUSED BY
BORDETELLA PERTUSSIS
 Signs and SYMPTOMS
∗ RUNNY NOSE
∗ IRREGULAR, NONPRODUCTIVE
COUGH
∗ S E V E R E C O U G H AT N I G H T !
SPASMS OF PAROXYSMAL COUGH!
INSPIRATIONS OR STRIDORS OR
WHOOPING BY THE END OF 2ND
WEEK
∗TRANSMISSION:
- DIRECT CONTACT
- DROPLET
∗INCUBATION: 7-21 DAYS
∗COMMUNICABILITY:
5-7 DAYS AFTER THE INITIATION
OF ANTIBIOTIC THERAPY
 PREVENTION

∗VACCINATION
∗ANTIBIOTICS
∗ISOLATION
 MANAGEMENT
∗STRICT RESPIRATORY ISOLATION
∗HUMIDIFICATION
∗ANTIPYRETICS
∗REST
∗BALANCED DIET
∗HEALTH TEACHINGS
 TREATMENT

∗ANTIBIOTICS
∗CORTICOSTEROIDS
∗SUPPORTIVE CARE
 INFLUENZA (FLU)
∗a respiratory illness caused by
! Influenza A
! Influenza B viruses
∗Influenza season in Canada is
usually November through April
 Signs and symptoms
Fever
Cough, sneezing, runny nose
Headache
Body aches and pain
Exhaustion
Sore throat
Nausea, vomiting, and diarrhea
 TRANSMISSION

∗INHALATION OF
RESPIRATORY DROPLETS
INFECTED WITH
INFLUENZA VIRUS
▪Direct contact with
the hands of an
infected
person (e.g., shaking
hands, holding hands).
▪Contact with an object
contaminated with the
influenza virus (e.g., toys,
furniture, doorknob, taps,
computer keyboard,
telephone, shopping cart
handle).
 FAST FACTS
∗Influenza is most serious for
babies less than 2 years of age,
adults over 65 years of age, and
people with chronic illnesses.
∗Influenza viruses can live for
several hours on hard surfaces
 INCUBATION PERIOD

∗Usually 1 – 4
days from
contact with an
infected person
 COMMUNICABILITY
∗Usually from 1 day before
to 5 days after symptoms
develop
**up to 7 days after
symptoms develop for
young children
 PREVENTION

∗ISOLATION
∗HAND WASHING
∗PROPER DISPOSAL OF
RESIDUALS
∗VACCINATION
 Influenza vaccine is recommended
and provided free for:
• children 6 to 23 months of age
•household contacts and those
providing regular child care to
children
0 to 23 months of age
• children and adults with a health
condition that places them at high
risk for influenza.
 CROUP

∗an infection of the

throat and vocal cords
(larynx)
 FAST FACT
∗When children under 5
years of age have the
illness, it is called croup.
∗In older children, it is
called laryngitis.
 SIGNS AND SYMPTOMS
• Cold
• Raspy, hoarse voice
• Loud, barking cough
• High pitched noise when breathing in
• Any activity that makes the child breathe
faster could make the child sound worse
• Tiredness
• Symptoms of croup are often worse at
night
 TRANSMISSION

∗DIRECT CONTACT
∗INDIRECT CONTACT
 INCUBATION

∗USUALLY 1-10 DAYS

 MANAGEMENT
∗DIFFICULTY OF BREATHING
!Warm mist – run a warm
shower in a bathroom with the
door
∗KEEP THE CHILD WARM
∗KEEP THE CHILD CALM
 ROUTINE PRACTICES
∗Cover your mouth and nose with
a tissue when you cough or
sneeze
∗Teach children to sneeze or
cough into the inner arm
where the elbow flexes
∗Do not share personal items
∗Wear disposable gloves
anytime your hands may
come into contact with
blood or body Fluid.
∗Use household rubber
gloves when cleaning or
sanitizing.
∗Dispose of articles soiled with
discharge from nose and/or
mouth, vomit, or feces into a
disposal bin, ideally with a
pop-up lid.
∗Disinfect surfaces using a
diluted bleach solution
RECOMMENDED solution! 1:100 or 1:50 


1:100 is 1 part bleach to 100

parts water (5 ml bleach to 500
ml water)
! EFFECTIVE WITHIN 24 HOURS
1:50 is 1 part bleach to 50
parts water (10 ml bleach to
500 ml water).
! EFFECTIVE FOR 30 DAYS
∗ IN THE ABSENCE OF WATER AND SOAP FOR
HANDWASHING, ALCOHOL-BASED HAND RUBS
COULD BE USED

!At least 60% alcohol to be effective

!Don’t work if your hands are greasy or
visibly dirty
!Safe for children if used with supervision
!Children should not put their hands in
their mouths until the alcohol evaporates
(about 15 seconds)
! Alcohol-based hand rubs are flammable
 Methicillin-Resistant Staphylococcus Aureus

(MRSA)


∗ Infection with Staphylococcus

aureus bacteria that have become
resistant to certain antibiotics
!Methicillin
! Penicillin
!Amoxicillin
 Signs and symptoms
• Red, painful bumps under the skin
(i.e., boils or abscesses)
• Sores may be painful and may
contain pus or may be covered with
• a honey colored crust
• Sometimes, the sores look like
spider bites
• Fever and chills
 TRANSMISSION

∗ DIRECT SKIN-TO-SKIN CONTACT

∗ Contact with a surface or
object (e.g., doorknob,
faucet) that is contaminated
with MRSA bacteria