Bronchopneumonia- Inflammation due to the infection of the lungs, bronchial tubes, and bronchioles.

Also known as = "community acquired pneumonia". Common in women. Causes: bacteria Virus fungi 2 common bacteria; o Streptococcus pneumoniae (pneumococcus) o Mycoplasma pneumoniae

Risk factors:

elderly

Hospitalization

Immobilization

Immune Deficiency

Long Term Illness

Smoking

Symptoms:

Cough with greenish or yellow mucus

Rapid, shallow breathing

Shortness of breath

Treatment:

Intravenous

Hospitalization

Antibiotic Therapy

Oxygen Therapy

Rest

Complications:

emphysema

Diagnostics: CBC ABG CXR

Demographic Data: 1 yr old September 16. 2010 January 16, 2012 Calamba City Makiling, calamba Laguna Cough, fever & Difficulty of Breathing Bronchopneumonia Filipino

Baby K

Source and Reliability of the Information:

Medical findings

JP Rizal

Reason for seeking Care

Has chief complaint of:

Her mother gave her

Baby K

but still the secretions is present, thats why theyve decided to admit her in the hospital.

History of Present Illness

3 days prior to admission experience:

On and off fever associated with cough and colds Become weak

So her mother decided to rush her to hospital for medical check up but the attending physician advised the mother for hospitalization of her child for close observation and proper treatment of her illness

Because she cannot eat and sleep well at night.

Past medical History

Complete vaccine

Baby K doesnt have any history of allergies. She has never been hospitalized. According also to the patients mother whenever Baby K has fever, cough and colds she only gives carbocistein and paracetamol tempra. And sometimes she also gave an herbal meds for cough.

Family History:

Functional Assessment
HEALTH PERCEPTION / HEALTH MAINTENANCE

OR

Whenever Baby K is sick her mother

she buys medicines like carbocistein and paracetamol

But if the symptoms persist for more than 2 to 3 days thats the time they will go to hospital for check up.

According to Eriksons theory, as the child gains control over eliminative functions and motor abilities, they begin to explore their surroundings. The parents still provide a strong base of security from which the child can venture out to assert their will. The parents patience and encouragement help foster autonomy in the child. Highly restrictive parents, however, are more likely to instill the child with a sense of doubt and reluctance to attempt new challenges. As they gain increased muscular coordination and mobility, toddlers become capable of satisfying some of their own needs. They begin to feed themselves, wash and dress themselves, and use the bathroom. If caregivers encourage self-sufficient behavior, toddler develops a sense of autonomy a sense of being able to handle many problems on their own. But if caregivers demand too much too soon, refuse to let children perform tasks of which they are capable, or ridicule early attempts at self sufficiency, children may instead develop shame and doubt about their ability to handle problems

ACTIVITY/EXERCISE PATTERN

Baby K is a playful child.

Wiping displays

She always plays with her neighbors. Her mom also said that every time her cousins go to their house, Baby C is always active playing

SLEEP/REST PATTERN Before hospitalization she usually wakes up at 8am in the morning and then eats her Breakfast at 8:30. After eating she is watching cartoons on television or sometimes her playmates will go to their house and play with her. After eating lunch at 11:30 in the morning she will again watch tv then go to sleep for 3 to 4 hrs. Then baby K will play again her toys. At 6pm they will eat their dinner. Baby K usual sleeping time is 10 pm because before sleeping she is always playing first her toys or sometimes watching. Baby K can consume 8 hrs on her sleeping time and has a scheduled at least one nap a day. While during hospitalization baby K takes a nap 20 to 30 mins 3 times a day and at night she sleeps 3 to 5 hrs, because she is always crying.

NUTRITIONAL/ELIMINATION
Before Baby K was hospitalized she eats meals 3 times a day she commonly. But during her hospitalization she only drinks formulated milk 3 to 4 times a day in small bottle. Because the child has no appetite. Baby K normally consumes 4 to 5 diapers daily, during hospitalization she only consumes 2 to 3 diapers and defecates ones a day. drinks milk, eats rice

SEXUALITY/REPRODUCIVE According to Freuds Theory, the childs pleasure in defecation is connected to his or her pleasure in creating something of his or her own, a pleasure that for a women is later transferred to child-bearing..

INTERPERSONAL RELATIONSHIP Baby K is a loving daughter. According to her mother, she is a good kid and she also always follows what her mother says. Her dad usually gives everything baby k loves. She is well-loved by her grandmothers and grand fathers. There are no conflicts between baby k and her brothers and sisters.

COPING STRESS MANAGEMENT/TOLERANCE PATTERN Whenever feel bored, doing nothing or she already finished Watching cartoons only plays her toys at home sometimes she will play with her neighbors which she considers as her playmates.

While during her confinement her parents brings some toys, coloring books so that she has something to do in hospital.

And when Baby K is crying her mother will only carry her then baby K will stop crying for the mean time.

Personal Habits Under Erik Erikson, Psychosocial Theory the child falls on toddlerhood which has the task of autonomy versus shame and doubt. The child always explores her surroundings. Wanted to play alone, and answer no whenever she was asked.

ENVIRONMENTAL HAZARDS
The child lives along the road and always exposed to pollution. Their House is clean but the outside environment is unfavorable for the child. The people outside their home dont have concern to their health. They didnt go to hospital if they are sick.

Anatomy and Physiology

A respiratory system functions to allow gas exchange. The gases that exchanged, the anatomy or structure of the exchange system and the precise physiological uses of the exchanged gases vary depending on the organism. In humans and other mammals, for example, the anatomical features of the respiratory system include airways, lungs, and the respiratory muscles. Molecules of oxygen and carbon dioxide and passively exchanged, by diffusion, between the gaseous external environment and the blood. This exchange process occurs in the alveolar region of the lungs.

THE NOSE Air enters thorough two openings. The external nares or nostrils. Just inside each nostril is an expanded vestibule containing coarse hairs. A midsagittal nasal septum divides the nasal cavity. The maxillary, nasal, frontal, ethmoid, and sphenoid bones from lateral and superior walls of the nasal cavity. The hard and soft palate forms the floor of the cavity. (The posterior part of the soft palate is the uvula) The external portion of the nose is composed of cartlage that forms the bridge and the tip of the nose. The superior, middle and inferior nasal cochae are bony shelves that project form the lateral walls of the nasal cavity. The spaces between the conchae are the meatuses. Posteriorly the internal nares open into the nasopharynx.

THE PHARYNX It is a chamber shared by the digestive and respiratory system. It extends between the external nares and the entrances to the larynx and esophagus. A stratified squamous epithelium lines and the pharynx. The throat of the pharynx is divided in three regiuons: 1. Upper naso-pharynx 2. Middle oropharynx 3. Lower laryngopharynx THE NASOPHARYNX Lies superior to the soft palate Serves a passageway for airflow from nasal cavity It contains the pharyngeal tonsils (adenoids) in posterior wall, and the opening of the eustaquian tubes (auditory tube)

THE OROPHARYNX Extends front soft palate down to the epiglottis (base of the tongue) It contains the palatine and lingual tonsils THE LARYNGOPHARYNX The narrow zone between the hyoid bone and entrance to the esophagus.

THE LARYNX Joins the laryngopharynx with the traches It consist of cartilage It is called the voice box The three main cartilage are: thyroid cartilage (Adams apple), epiglottis, and the cricoid cartilage Other cartilage is: arytenoids cartilage, corniculate cartilage, and cuneiform cartilage The epiglottis is a piece of elastic cartilage that falls over the opening (GLOTTIS) during swallowing to prevent ingested food from entering the respiratory tract The corniculate cartilage are involve the opening and closing of the epiglottis, and in the production of sounds Two pairs of folds span are glottal opening. The ventricular folds (false voacal cords) are inelastic but the tension in the vocal cords can be adjusted by voluntary muscle movements. During expiration air flowing through the larynx vibrates the vocal cords (true vocal cords) and produces sound waves. Coughing and laryngeal spasm are protective reflex that protect the glottis and trachea from objects and irritants.

THE TRACHEA o Extends from te level of the sixth cerebral vertebra, at the base of the larynx, to the level of the fifth thoracic vertebra. o It is tubular structure with 4.25 inch length and 1 inch in diameter o As its caudal limit thetrachea divides to form primary bronchi o Lies anterior to the esophagus o Along the length of the trachea are 15-20 c-shapes in pieces of hyaline cartilage (tracheal cartilages) o The tracheal muscle holds the two sides of the c-shaped c o Trachea is lined with pseudo stratified ciliated columnar epithelium o The trachea branches within the mediastum, frming the left and right bronchi. (extra pulmonary rhonci) o Each bronchus enters a lung at groove, The Hilus. o Each bronchus branches increasingly smaller passageway to conduct air to the lungs o The primary bronchi branch into as many as secondary bronchi (intrapulmonary bronchi) As there are lobes in each lung o The smallest passageway in the bronchioles

THE LUNGS Is pair of cone shaped organs lining in the pleural cavity The apex is the conical top of each lung, and the broad inferior portion is the base Each lung has hilus, a medical slits as the bronchial tubes, vascularization, lymphatic, and nerves reach the lungs Each lining is divided by oblique fissure into superior and inferior lobes Right lung is divided into three lobes (superior, middle, inferior) Superior and middle lobes are separated by horizontal fissure and The oblique fissure separates inferior and middle lobes THE PLEURAL CAVITIES The thoracic cavity is bounded by the ribcage and the muscular diaphragm The mediastinum divides the region into TWO LEURAL CAVITIES The pleural cavity is lined with serous membrane, THE PLEURA Parietal pleura line the thoracic wall, diaphragm and mediatinum Visceral pleura cover the surfaces of the lungs The alveolar walls are made of simple squamous pulmonary epithelium Scattered among epithelium are surfactant cells that secretes oil coating to prevent the alveoli from sticking together after exhalation Also the alveolar walls are macrophages that phagocytes debris or potential pathogens

Pathophysiology

DIAGNOSTIC & LABRATORY PROCEDURES

DRUG STUDY

Problem LIst

Discharge Planning