Acute Respiratory Infections (ARI) And Nursing Care Plan

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Acute Respiratory Infections (ARI)
– It is an acute infection of the ear ,nose, throat, larynx, trachea, bronchi, bronchioles or lung.
1- Acute upper respiratory tract infection :-acute infection of the nose,
pharynx(throat) and middle ear.
2- Acute lower respiratory tract infection:-acute infection of the epiglottis ,larynx,
trachea ,bronchi ,bronchioles or lung.
– ARI is the commonest cause of death in developing countries in children mainly
in infants.
– Pneumonia is responsible for almost all ARI deaths particularly in young infants.
– Most cases of severe pneumonia are bacterial usually Streptococcal pneumonia.
influenzae ,Staph.aureus.
Pneumonia
It is an acute infection of the lungs, it is classified according to the severity based on clinical signs.
1- In the child age( 2 months-5 years):
a – Severe pneumonia :-cough or difficult breathing with chest indrawing.
B – Pneumonia :-cough or difficult breathing with fast breathing but no chest
indrawing.
2- Age( less than 2months):
Any of these clinical signs can mean severe pneumonia or very severe disease in young infant less than 2 months:
1- stopped feeding well.
2- Stridor in calm child.
3- Convulsions.
4- Abnormaly sleepy or difficult to wake.
5- Weezing.
6- Fever or low body temperature.
7- Severe chest indrawing .
8- Fast breathing.
Stridor: A harsh noise when the child breaths in ,it occurs when there is narrowing of the larynx,trachea or epiglottis, it can be due to a croup or a foreign body.
Wheeze: A soft musical noise when the child breaths out ,it may be caused by a swelling and narrowing of the small airways of the lungs or by a contraction of the smooth muscles surrounding the airways in the lung.
Croup: Narrowing of the larynx,trachea or epiglottis which interferes with air entering the lungs, it can be caused by a viral or bacterial infection.

Risk factors in ARI :
1- lack of immunization.
2- Malnutrition.
3- Vit A deficiency.
4- Low birth weight.
5- Young age.
6- Crowding.
7- Cold weather.
8- Exposure to pollution.
9- High incidence of nasopharyngeal carrier of pathological bacteria.
Proper management of ARI is important for these reasons :
1- Relieve suffering.
2- Reduce the incidence of sequelae such as deafness.
3- Help the mother care for the child during illness.
4- Reduce the inappropriate use of antibiotics so will reduce the incidence of antibiotic resistance.
Treatment
– Advice the mother to give home care :
– Home care is very important for the child with ARI,and most children you
manage will be treated with it. Good home care means the mother will :
1- Feed the child to avoid weight loss. weight loss can contribute to malnutrition.
2- Increase fluids to avoid dehydration. dehydration can weaken the child and
make the child even sicker.
3- Relieve the child’s sore throat and cough.
4- Most important, watch for signs that the child is getting sicker so she knows
when to bring the child to health worker.
Treatment : assess initial response to a rapid acting bronchodilator such as nebulized salbutamol and assess response after 15 minutes you can repeat it if respiratory distress persist.
Signs of improvement :
1- Less respiratory distress.
2- Less chest indrawing.
3- improved air entry.
If the condition is not improved after 30 minutes:
1- Admit to hospital.
2- Continue nebulized salbutamol every 4 hours.
3- Add aminophyllin if bronchospasm is not adequately controlled with nebulized
salbutamol.
4- As the severity of attack decrease change to oral salbutamol,observe the child for at least 8 hours before discharge.

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Posted in Nursing Care Plans, Nursing Intervention, Respiratory

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