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Name: Sumbad, Mark Bhen E.

NBA-2

ACTIVITY 3
NURSING CARE OF THE HIGH-RISK NEWBORN (RESPIRATORY

ALTERATIONS) INSTRUCTIONS: READ AND UNDERSTAND THE TOPIC.

REFERENCE: Pillitteri, Adele. Maternal and Child Health Nursing: Care of the
Childbearing and Childbearing Family. 6th edition. Wolters Kluwer, 2010.
1. Listed below are respiratory disorders. Describe the nursing care involved when
children have these disorders. Please give concise or exact answers.
a) PNEUMOTHORAX
- NURSING CARE
 Oxygen Therapy to relieve respiratory distress.
 A thoracotomy catheter or needle may be placed in the pleural space and
atmospheric air aspirated or low-pressure suction with water-seal
drainage applied to remove accumulated air.
b) HYPOXEMIA
- NURSING CARE
 Expectorant Therapy o Liquefying Agents- Instilling saline nose drops or
using saline nasal sprays can be effective in moistening and loosening
dried mucus in the nose
o Humidification- vaporizers and nebulizers.
 For Coughing o Encourage coughing rather than suppress it in children
o Changing a child’s position and suggesting mild exercise or deep
breathing are helpful techniques to initiate coughing.
 Mucus-Clearing Devices o A mucus-clearing device (a Flutter device)
can be used to aid in the removal of mucus.
 Chest Physiotherapy o Three techniques are involved with chest
physiotherapy (CPT) to further loosen mucus for expectoration: postural
drainage, percussion, and vibration.
 Pharmacologic Therapy o Metered-Dose Inhalers- is a hand-held device
that provides a route for medication administration directly to the
respiratory tract.
c) CHOANAL ATRESIA
- NURSING CARE
• Nurse should Consider CA in newborn/child with symptoms of nasal
obstruction, so proper physical examination should be done.
• There is high association of choanal atresia with other congenital defects,
nurse must look for other defects also.
 Provide oxygen in case of dyspnea and cyanosis • All drugs to be
administered keeping in mind five steps of drug administration
• Suction the nasal stents so that they don’t get blocked up
• Nurse must teach how to keep nose clean & how to give your baby nose drops • Make
sure clients nasal passage is patent before starting feed.

2. Describe the symptoms of these disorders: Please give concise or exact answers.
a) ACUTE
NASOPHARYNGITIS -
SYMPTOMS:
 Symptoms begin with nasal congestion, a watery rhinitis, and a low-grade
fever.
 Infants also may develop secondary symptoms, such as vomiting and
diarrhea, as a general response. Because they cannot suck and breathe
through their mouth at the same time, they refuse feedings.
b) RETROPHARYNGEAL
ABSCESS - SYMPTOMS:
 May drool because they cannot swallow saliva past the obstruction in the
back of their throat.
 Sore throat for a few days
 They refuse to eat.
 They develop a high fever
 They “snore” with respirations as the pharynx becomes further occluded.
 To allow themselves more breathing space, they may hyperextend the head.
 Enlargement of the regional lymph nodes.
 Laboratory studies will reveal leukocytosis
c) TONSILLITIS
- SYMPTOMS:
 The main symptoms of tonsillitis are inflamed and swollen tonsils, sometimes
severe enough to make it hard to breathe through your mouth.
 Throat pain or tenderness

 Red tonsils
 A white or yellow coating on your tonsils
 Painful blisters or ulcers on your throat
 Headache
 Loss of appetite
 Ear pain
 Trouble swallowing
 Swollen glands in your neck or jaw
 Fever and chills
 Bad breath
 A scratchy or muffled voice
 Stiff neck