Question

Respiratory Attendance Questions
1. identify four risk factors for respiratory infections in the child. include rationale for each risk factors.
2. Discuss how prescribed inhalers and chest physiotherapy work to synergistically promote mucus clearance in the child with cystic fibrosis
3. Name and describe the severity classifications of asthma
4. Identify and describe four complications of Epstein Barr virus.
5. What are the clinical manifestations of otitis media and why is om common in the pediatric population?

Answer 1

1.Acute respiratory infection is an infection that may interfere with normal breathing. It can affect just upper respiratory system, which starts at the sinuses and ends at your vocal chords, or just the lower respiratory system, which starts at vocal chords and ends at your lungs.

Risk factors

Ageand sex

Children aged moretgan 12months, male children, are more prone to get respiratory infectiouns

Low birthweight

Children with low birth weight, doesn't have respiratory system development so the decrease surfactant in lungs cause respiratory infection

Malnourished children

Children who were inadequately breastfed and inadequately immunized, have more risk

Environmental factors such as exposure to wood smoke, cigarette smoke, and contact or living with cogh were found significantly increase the risk

2.Chest physical therapy (CPT or Chest PT) is an airway clearance technique (ACT) to drain the lungs, and may include percussion (clapping), vibration, deep breathing, and huffing or coughing.  With chest physical therapy (CPT), the person gets in different positions to use gravity to drain mucus (postural drainage) from the five lobes of the lungs.With postural drainage, the person lies or sits in various positions so the part of the lung to be drained is as high as possible. That part of the lung is then drained using percussion, vibration, and gravity.

When the person with CF is in one of the positions, the caregiver can clap on the person’s chest wall. This is usually done for three to five minutes and is sometimes followed by vibration over the same area for approximately 15 seconds (or during five exhalations). The person is then encouraged to cough or huff forcefully to get the mucus out of the lungs.

Inhalers medication helps to open the airway and it helps to loosen the thick mucus. So after inhalation if we are doing chest physiotherapy, it is easy to make come out secretion.

3.Asthma is a A condition in which a person's airways become inflamed, narrow and swell and produce extra mucus, which makes it difficult to breathe.
Asthma can be minor or it can interfere with daily activities. In some cases, it may lead to a life-threatening attack.Asthma is classified into four categories based on how often you have symptoms and how well you breathe. These categories are: mild intermittent; mild persistent; moderate persistent; and severe persistent.

Mild intermittent asthma

have symptoms fewer than three times a week, and nighttime symptoms fewer than two times a month.
Lung function tests are greater than 80% of predicted values based on your age, sex, and height.
don't need medication to control it.

Mild persistent asthma

have symptoms three to six times per week.
Lung function tests are greater than 80% of predicted values based on your age, sex, and height.
have nighttime symptoms three to four times a month.

Moderate persistent asthma

have symptoms daily.
have nighttime symptoms 5 or more times per month.
symptoms affect your activity, happen more than two times per week, and may last for days.
Lung function tests are 60% to 80% of predicted values based on your age, sex, and height.

Severe persistent asthma

have symptoms continuously, with frequent nighttime asthma.
activities are limited.
Lung function is less than 60% of predicted values based on your age, sex, and height.

4.Epstein-Barr virus (EBV) is a member of the herpesvirus family that can infect humans. EBV infections are very common. The condition that may associate EBV infection with is infectious mononucleosis, or mono.

In some cases, EBV infections can lead to complications, some mild and some serious.

These include:

rupture of the spleen
anemia
low platelet count (thrombocytopenia)
hepatitis
myocarditis
conditions affecting the nervous system, including encephalitis, meningitis, and Guillain-Barre syndrome.

Neurologic complications are rare but may include encephalitis, seizures, Guillain-Barré syndrome, peripheral neuropathy, viral meningitis, myelitis, cranial nerve palsies, and psychosis. Encephalitis may manifest with cerebellar dysfunction, or it may be global and rapidly progressive, similar to herpes simplex encephalitis, but is usually self-limited.

Hematologic complications are usually self-limited. They include

Granulocytopenia
Thrombocytopenia
Hemolytic anemia
Transient mild granulocytopenia or thrombocytopenia occurs in about 50% of patients; severe cases, associated with bacterial infection or bleeding, occur less frequently. Hemolytic anemia is often due to anti-i-specific cold-agglutinin antibodies.

Splenic rupture can have severe consequences. It can result from splenic enlargement and capsular swelling, which are maximal 10 to 21 days after presentation. A history of trauma is present only about half of the time. Rupture is usually painful but occasionally causes painless hypotension

Hepatic complications include elevated aminotransferase levels (about 2 to 3 times normal, returning to baseline over 3 to 4 weeks); they occur in about 95% of patients. If jaundice or more severe enzyme elevations occur, other causes of hepatitis.

5.Otitis media is an infection or inflammation of the middle ear. This
inflammation often begins when infections that cause sore throats,
colds, or other respiratory or breathing problems spread to the middle
ear. These can be viral or bacterial infections.

Clinical manifestation

Children
Signs and symptoms common in children include:

Ear pain, especially when lying down
Tugging or pulling at an ear
Trouble sleeping
Crying more than usual
Fussiness
Trouble hearing or responding to sounds
Loss of balance
Fever of 100 F (38 C) or higher
Drainage of fluid from the ear
Headache
Loss of appetite
Adults
Common signs and symptoms in adults include:

Ear pain
Drainage of fluid from the ear
Trouble hearing

There are many reasons why children are
more likely to suffer from otitis media than
adults. First, children have more trouble
fighting infections. This is because their
immune systems are still developing. Another
reason has to do with the child's eustachian
tube. The eustachian tube is a small passage-
way that connects the upper part of the throat
to the middle ear. It is shorter and straighter in
the child than in the adult. It can contribute
to otitis media in several ways.

One more factor that makes children more susceptible to otitis
media is that adenoids in children are larger than they are in adults.
Adenoids are composed largely of cells (lymphocytes) that help fight
infections. They are positioned in the back of the upper part of the
throat near the eustachian tubes. Enlarged adenoids can, because of
their size, interfere with the eustachian tube opening. In addition,
adenoids may themselves become infected, and the infection may
spread into the eustachian tubes.