8Sn ll 2

C8Cu 3
Alfaro Cladys kaLe M
Algas An[ellna
AlLar ken Lmerson 8
Apull Marle Clmcsa
8aLo ancho lll L
8auLlsLa !usLln nlleLLe L
8enedlLo karl 8
8ueno !oberL !ohn
8usLamanLe nlno
Munoz Ma Lourdes C






IN1kCDUC1ICN

8ronchopneumonla or bronchlal pneumonla (noL Lo be confused wlLh lobular pneumonla) ls a Lype of
pneumonla characLerlzed by mulLlple focl of lsolaLed acuLe consolldaLlon affecLlng one or more pulmonary
lobes

lL ls one of Lwo Lypes of bacLerlal pneumonla as classlfled by gross anaLomlc dlsLrlbuLlon of consolldaLlon
(solldlflcaLlon) Lhe oLher belng lobar pneumonla 8ronchopneumonla ls less llkely Lhan lobar pneumonla Lo be
assoclaLed wlLh SLrepLococcus

1he bronchopneumonla paLLern has been assoclaLed wlLh hosplLalacqulred pneumonla and wlLh speclflc
organlsms such as SLaphylococcus aureus klebslella L coll and seudomonas

ln bacLerlal pneumonla lnvaslon of Lhe lung parenchyma by bacLerla produces an lnflammaLory lmmune
response 1hls response leads Lo a fllllng of Lhe alveolar sacs wlLh exudaLe 1he loss of alr space and lLs
replacemenL wlLh fluld ls called consolldaLlon ln bronchopneumonla or lobular pneumonla Lhere are mulLlple
focl of lsolaLed acuLe consolldaLlon affecLlng one or more pulmonary lobes

lL should be noLed LhaL alLhough Lhese Lwo paLLerns of pneumonla lobar and lobular are Lhe classlc
anaLomlc caLegorles of bacLerlal pneumonla ln cllnlcal pracLlce Lhe Lypes are dlfflculL Lo apply as Lhe paLLerns
usually overlap 8ronchopneumonla (lobular) ofLen leads Lo lobar pneumonla as Lhe lnfecLlon progresses 1he
same organlsm may cause one Lype of pneumonla ln one paLlenL and anoLher ln a dlfferenL paLlenL lrom Lhe
cllnlcal sLandpolnL far more lmporLanL Lhan dlsLlngulshlng Lhe anaLomlcal subLype of pneumonla ls ldenLlfylng
lLs causaLlve agenL and accuraLely assesslng Lhe exLenL of Lhe dlsease

C8ILC1IVLS

W 1o relaLe Lhe paLhophyslology and manlfesLaLlons of lower resplraLory LracL lnfecLlons and lnflammaLlon
W Compare and conLrasLs Lhe eLlology rlsk facLors and vulnerable populaLlons for lower resplraLory LracL
lnfecLlons and oLher dlsorders
W uescrlbe lnLerdlsclpllnary care and Lhe nurslng role ln healLh promoLlon and carlng for cllenLs wlLh lower
resplraLory lnfecLlons
W uescrlbe Lhe nurslng lmpllcaLlons and medlcaLlons used Lo LreaL resplraLory dlsorders











NUkSING nIS1Ck

a LkSCNAL DA1A

l aLlenLs lnlLlal 8C
ll Age 1 year and 2 monLhs
lll Sex Male
lv Address 8aLaan
v uaLe of blrLh SepLember 13 2008
vl oslLlon ln Lhe famlly ?oungesL
vll unlL nCP 8esplraLory Ward
vlll uocLor ur CaboLa[e
lx uaLe of ConsulLaLlon november 18 2009
x uaLe of Admlsslon november 18 2009
xl ulagnosls neumonla Cerebral alsy (8n wlLh
ModeraLe ulsLress)

CnILI CCMLAIN1

l nolsy breaLhlng

n nIS1Ck CI A1ILN1 ILLNLSS

l 1hls ls a case of 8C a 1 year and 2 monLhs old male paLlenL wlLh chlef complaln of nolsy breaLhlng
assoclaLed wlLh fever for 2 days LhaL prompLed consulaLlon

ll resenL condlLlon sLarLed 2 monLhs 1A when paLlenL had hypoglycemla dlagnosed by local docLor ln
8aLaan and was glven AnLlbloLlcs for 7 days aL a local hosplLal ln 8aLaan paLlenL was well unLll he had
spasLlc eplsode wlLh nolsy breaLhlng and also noLed Lo have moLor delay buL no consulL was done Lo
rehabllaLaLlon nor Lo neuro speclallsL docLor

lll ?ear has passed Lhe local docLor aL 8aLaan where Lhey had Lhelr regular check up advlsed Lhe moLher Lo
have Lhe consulLaLlon aL naLlonal Chlldren's PosplLal as Lhls can provlde furLher managemenL and
LreaLmenL Lhus paLlenL admlLLed

ast Mena| nstory of the atent

(+) PosplLallzaLlon before aL nCP aL local hosplLal aL 8aLaan (name of Lhe hosplLal and daLe unrecalled)

e Iam|y nstory
nypertenson Asthma neart Dsease DM Cthers
Materna| () () () () ()
aterna| () () () () ()

f ersona| an Sona| nstory of the Iam|y

CccupaLlon of Lhe faLher ConsLrucLlon worker
CccupaLlon of Lhe moLher Pousewlfe
no of slbllng/s 1
Pouse sanlLaLlon
Pouse and LoL 8enL
number of rooms 1 room only for Lhe famlly
venLllaLlon oor
WaLer Supply deep well
LnvlronmenLal sanlLaLlon oor as Lo waLer supply excreLa dlsposal lnsecL conLrol
































CLINICAL AkAISAL
DLC 1 2009
Genera| hysna|
Appearanne
Norma| resent Conton Snfnanne
A Vta| Sns 136337 c
880140
882040
366c
129bpm
27breaLhs per mlnuLe
normal
8 Skn no presence of leslon and
hemaLoma
sllghLly warm Lo Louch
good skln Lurgor
normal skln color
puncLure on lumbar area

warm Lo Louch
rapldly back
plnklsh skln color
due Lo CSl LesL

normal
normal
normal
C nea absence of leslons
scalp ls noL dry
absence of mass and
nodules
halr color
LexLure of halr
no leslon
noL dry
no mass and nodules

brownlsh and llghL
sofL and smooLh
normal
normal
normal

normal
normal
D Lyes sclera whlLe ln color
anlcLerlc sclera
pupll equal round reacLlve
Lo llghL
whlLe

2mm paplllary Lo slze and
reacLlve Lo llghL
normal

normal

L Nose no nasal dlscharge

alr moves freely upon
breaLhlng
no nasal flarlng
wlLh nasal dlscharge
yellowlsh Lo greenlsh
wlLh uC8

wlLh nasal flarlng
due Lo lnfecLlon ln nasal
cavlLy
due Lo presence of
secreLlon
due Lo dlfflculLy of
breaLhlng
I Mouth llps plnk smooLh molsL
no presence of oral Lhrush
absence of leslon
no lnflammaLlon of Lhe
gums
presence of LeeLh
plnk ln color and molsL
no oral Lhrush
no leslon
no lnflammaLlon

8 LeeLh are presenL
normal
normal
normal
normal

normal
G 1hroat clear passage dlfflculLy of swallowlng and
breaLhlng
due Lo presence of mucus
n Luns resplraLory raLe (2040)
absence of breaLh sounds
no lnLercosLals
reLracLracLlon
absence of cough
27 breaLhs per mln
wheezes
wlLh lnLercosLals reLracLlon

wlLh producLlve cough
yellowlsh Lo greenlsh
normal
blockage ln alrway
dlfflculLy ln breaLhlng

due Lo lnfecLlon
I Na|s nalls flrm
skln under nalls plnk
caplllary reflll back rapldly
flrm
plnk
caplllary reflll back wlLhln 1
second
normal
normal
normal

I osture no malformaLlons lmpalred sLrengLh due Lo muscle weaknesses
k 8oy Iat Lqual dlsLrlbuLlon lack of faL under Lhe skln due Lo malnuLrlLlon
L Lnery Leve| LnergeLlc laLlgue lrrlLablllLy due Lo hls lllness
CCML1LNCILS

Crtera Norma| resent Conton Snfnanne
hyso|ona| physlcal growLh ls rapld
body Lemp sLablllzed
erupLlon of LeeLh beglns
posLerlor fonLanel closes
anLerlor fonLanel closes
eyes begln Lo focus
bones ln exLremlLles grow
ln lengLh
()
(+)
(+)
(+)
() sllghLly depressed
()
(+)
due Lo malnuLrlLlon
normal
normal
proLecL lnfanL's skull
12 Lo 18 monLh normal
normal
normal

Motor walk
run
Lalk
eaL solld food
conLrol ellmlnaLlon of wasLe
roll over volunLarlly
crawls
slLs alone
grasplng ob[ecL gradually
responds Lo care glver's volce
becomes more coordlnaLed
()
()
()
(+)
()
()
()
()
()
(+)
()
delayed developmenL
delayed developmenL
delayed developmenL
normal
delayed developmenL
sllghLly and mlnlmal
delayed developmenL
delayed developmenL
delayed developmenL
normal
delayed developmenL
synhosona| oral sLage recelves pleasure
Lhrough mouLh llps and
Longue
anal sLage recelves pleasure
from conLracLlon and
relaxaLlon of sphlncLer muscle
learnlng Lo Lalk
parallel play
(+)


(+)


()
()
normal


normal


delayed developmenL
due Lo lmpalred sLrengLh
Contve use of reflexes
becomes aware of exLernal
envlronmenL
lnlLlaLe acLs Lo change
envlronmenL
can follow slmple lnsLrucLlon
can make Lwo syllable word
(+)
()

()

()
()
normal
delayed developmenL

delayed developmenL

delayed developmenL
delayed developmenL
Mora| concenLraLes on whaL ls besL
for self
selflsh
dependenL on oLhers

knows whaL ls rlghL and
wrong
()

()
(+)

()
delayed developmenL

delayed developmenL
noL normal as a 14 monLhs
old cllenL
delayed developmenL

Sprtua| lmlLaLes parenLal behavlours
and aLLlLude abouL splrlLuallLy
and rellglon
has no real undersLandlng of
splrlLual concepL
()


(+)
delayed developmenL


normal


1nLCkL1ICAL IkAMLWCkk

ILCkLNCL NIGn1INGALL

1he acL of uLlllzlng Lhe envlronmenL of Lhe paLlenL Lo asslsL hlm ln hls recovery"
nlghLlngale's LnvlronmenLal 1heory
O venLllaLlon and warmLh
O LlghL
O Cleanllness
O PealLh of houses
O nolse
O 8ed and beddlng
O ersonal cleanllness
O varleLy
O ChaLLerlng hopes and advlces
O 1aklng food
O eLLy managemenL
O CbservaLlon of Lhe slck
ML1AA8AulCM ln nu8SlnC
nu8SlnC She always consldered LhaL nurslng ls very essenLlal for everybody's well belng
L8SCn She vlewed Lhe essence of a person as a paLlenL
PLAL1P She deflned dlsease as a reparaLlve process LhaL naLure lnsLlLuLed from a wanL of aLLenLlon"
Lnvl8CnMLn1 She belleve LhaL Lhe slck poor people would beneflL from envlronmenLal lmprovemenLs LhaL
addressed Lhelr physlcal and menLal aspecLs

VIkGINIA nLNDLkSCN

14 8aslc needs
O 8reaLhlng normally
O LaLlng and drlnklng adequaLely
O LllmlnaLlng body wasLe
O movlng and malnLalnlng a deslrable poslLlon
O Sleeplng and resLlng
O SelecLlng sulLable cloLhes
O MalnLalnlng body LemperaLure
O keeplng Lhe body clean and well groomed Lo proLecL Lhe lnLegumenL
O Avoldlng dangers ln Lhe envlronmenL
O CommunlcaLlng wlLh oLhers ln expresslng emoLlons needs fears or oplnlons
O Worshlpplng accordlng Lo one's falLh
O Worklng ln such a way LhaL one feels a sense of accompllshmenL
O laylng or parLlclpaLlng ln varlous forms of recreaLlon
O Learnlng dlscoverlng or saLlsfylng Lhe curloslLy LhaL leads Lo a normal developmenL and healLh and uslng
avallable healLh faclllLles
ANA1CM AND nSICLCG

numan kespratory System

1he resplraLory sysLem conslsLs of all Lhe organs lnvolved ln breaLhlng 1hese lnclude Lhe nose pharynx
larynx Lrachea bronchl and lungs 1he resplraLory sysLem does Lwo very lmporLanL Lhlngs lL brlngs oxygen lnLo
our bodles whlch we need for our cells Lo llve and funcLlon properly and lL helps us geL rld of carbon dloxlde
whlch ls a wasLe producL of cellular funcLlon 1he nose pharynx larynx Lrachea and bronchl all work llke a
sysLem of plpes Lhrough whlch Lhe alr ls funnelled down lnLo our lungs 1here ln very small alr sacs called
alveoll oxygen ls broughL lnLo Lhe bloodsLream and carbon dloxlde ls pushed from Lhe blood ouL lnLo Lhe alr
When someLhlng goes wrong wlLh parL of Lhe resplraLory sysLem such as an lnfecLlon llke pneumonla lL makes
lL harder for us Lo geL Lhe oxygen we need and Lo geL rld of Lhe wasLe producL carbon dloxlde Common
resplraLory sympLoms lnclude breaLhlessness cough and chesL paln

1he Upper Arway an 1ranhea

When you breaLhe ln alr enLers your body Lhrough your nose or mouLh lrom Lhere lL Lravels down your
LhroaL Lhrough Lhe larynx (or volcebox) and lnLo Lhe Lrachea (or wlndplpe) before enLerlng your lungs All Lhese
sLrucLures acL Lo funnel fresh alr down from Lhe ouLslde world lnLo your body 1he upper alrway ls lmporLanL
because lL musL always sLay open for you Lo be able Lo breaLhe lL also helps Lo molsLen and warm Lhe alr before
lL reaches your lungs



1he Luns

1he lungs are palred coneshaped organs whlch Lake up mosL of Lhe space ln our chesLs along wlLh Lhe
hearL 1helr role ls Lo Lake oxygen lnLo Lhe body whlch we need for our cells Lo llve and funcLlon properly and
Lo help us geL rld of carbon dloxlde whlch ls a wasLe producL We each have Lwo lungs a lefL lung and a rlghL
lung 1hese are dlvlded up lnLo lobes or blg secLlons of Llssue separaLed by flssures or dlvlders 1he rlghL lung
has Lhree lobes buL Lhe lefL lung has only Lwo because Lhe hearL Lakes up some of Lhe space ln Lhe lefL slde of
our chesL 1he lungs can also be dlvlded up lnLo even smaller porLlons called bronchopulmonary segmenLs
1hese are pyramldalshaped areas whlch are also separaLed from each oLher by membranes 1here are abouL 10
of Lhem ln each lung Lach segmenL recelves lLs own blood supply and alr supply
Pow Lhey work
Alr enLers your lungs Lhrough a sysLem of plpes called Lhe bronchl 1hese plpes sLarL from Lhe boLLom of Lhe
Lrachea as Lhe lefL and rlghL bronchl and branch many Llmes LhroughouL Lhe lungs unLll Lhey evenLually form
llLLle Lhlnwalled alr sacs or bubbles known as Lhe alveoll 1he alveoll are where Lhe lmporLanL work of gas
exchange Lakes place beLween Lhe alr and your blood Coverlng each alveolus ls a whole neLwork of llLLle blood
vessel called caplllarles whlch are very small branches of Lhe pulmonary arLerles lL ls lmporLanL LhaL Lhe alr ln
Lhe alveoll and Lhe blood ln Lhe caplllarles are very close LogeLher so LhaL oxygen and carbon dloxlde can move
(or dlffuse) beLween Lhem So when you breaLhe ln alr comes down Lhe Lrachea and Lhrough Lhe bronchl lnLo
Lhe alveoll 1hls fresh alr has loLs of oxygen ln lL and some of Lhls oxygen wlll Lravel across Lhe walls of Lhe
alveoll lnLo your bloodsLream 1ravelllng ln Lhe opposlLe dlrecLlon ls carbon dloxlde whlch crosses from Lhe
blood ln Lhe caplllarles lnLo Lhe alr ln Lhe alveoll and ls Lhen breaLhed ouL ln Lhls way you brlng ln Lo your body
Lhe oxygen LhaL you need Lo llve and geL rld of Lhe wasLe producL carbon dloxlde

8|oo Supp|y
1he lungs are very vascular organs meanlng Lhey recelve a very large blood supply 1hls ls because Lhe
pulmonary arLerles whlch supply Lhe lungs come dlrecLly from Lhe rlghL slde of your hearL 1hey carry blood
whlch ls low ln oxygen and hlgh ln carbon dloxlde lnLo your lungs so LhaL Lhe carbon dloxlde can be blown off
and more oxygen can be absorbed lnLo Lhe bloodsLream 1he newly oxygenrlch blood Lhen Lravels back Lhrough
Lhe palred pulmonary velns lnLo Lhe lefL slde of your hearL lrom Lhere lL ls pumped all around your body Lo
supply oxygen Lo cells and organs

A1nCnSICLCG

kLDISCSING IAC1Ck kLCII1A1ING IAC1CkS
AGL (1 year and 2 monLhs) LNVIkCNMLN1
younger paLlenLs can have greaLer Lhls facLor helps ln promoLlng
means of enLry of paLhogens lnLo enLry of paLhogens lnLo Lhe lungs
Lhe lungs conLalnlng mlcrobes depressed lmmune sysLem
CCk IMMUNL SS1LM LIILS1LL


sLrepLococcus pneumonlae


lnfecLlon may spread Lo Lhe lungs
Lhrough Lhe blood sLream


PosL defense lncrease by Lhe organlsms or vlrulence


lnflammaLory lmmune response ls lnlLlaLed


AnLlgen anLlbody response ls released by some organlsms
LhaL can damage bronchlal and alveolar mucous membranes


lnflammaLlon wlLh vascular congesLlon and edema


lnfecLlous debrls and exudaLes flll Lhe alveoll


lnLerferlng wlLh venLllaLlon and gas exchange


neumonla







LA8CkA1Ck IINDINGS

CCMLL1L 8LCCD CCUN1 Novemer 18 2009
1LS1 8LlL8LnCL vALuLS (Sl unl1) 8LSuL1 SlCnlllCAnCL
Pemoglobln 140180 120g/L uue Lo Lhe slde effecL of Lhe drug
Lhe 11hemoglobln whlch carrles
Lhe oxygen Lo Lhe body decreased
PemaLocrlL 040034 036 1hls ls caused by vlLamln and
mlneral deflclency
W8C CounL 1yr Cld 813 143 x10
9
/L 1here ls a sllghL lncrease due Lo
lnflammaLlon

DIIILkLN1IAL CCUN1 Novemer 18 2009
1LS1 8LlL8LnCL vALuLS(Sl unl1) 8LSuL1 SlCnlllCAnCL
neuLrophll 040073 037 Low neuLrophll counL ls a slde
effecL of a cerLaln medlcaLlon
LymphocyLes 020043 063 lncrease counL of lymphocyLes l
due Lo a vlral lnfecLlon
laLeleL counL 130430 381 x10
9
/L WlLhln Lhe normal reference values

CCMLL1L 8LCCD CCUN1Novemer 24 2009
1LS1 8LlL8LnCL vALuLS(Sl unl1) 8LSuL1 SlCnlllCAnCL
Pemoglobln 140180 130g/L uue Lo Lhe medlclne glven Lo Lhe
paLlenL Lhere ls a sllghL
lmprovemenL ln lncreaslng Lhe
11hemoglobln level
PemaLocrlL 040034 039 1here ls an lmprovemenL due Lo
Lhe meds glven
W8C CounL 1 yrold 813 137 x10
9
/L 1here ls a sllghL lncrease due Lo
lnflammaLlon

DIIILkLN1IAL CCUN1Novemer 24 2009
1LS1 8LlL8LnCL vALuLS(Sl unl1) 8LSuL1 SlCnlllCAnCL
neuLrophll 040073 037 1here ls no change from Lhe lasL
laboraLory flndlngs
LymphocyLes 020043 063 Lhere ls no change ln laboraLory
flndlngs
laLeleL counL 130430 392 x10
9
/L WlLhln Lhe normal reference value

DA1L Novemer 22 2009
SLClMLnCSl #1
C8AM S1Aln no Mlcroorganlsm seen
uA1L november 22 2009
MAC8CSCClC 8LSuL1
Speclmen CSl
volume 3 ml
Color Colorless
1ransparency Clear

MlC8CSCClC 8LSuL1
1oLal 88C counL 41 x 10
6
/L
1oLal W8C counL 1 x10
6
/L

DIIILkLN1IAL CCUN1Novemer 222009
neuLrophlls lalled Lo flnd
LymphocyLes 1

CPLMlCAL 1LS1 8LSuL1
1oLal roLeln 843 mg/dl 144 mg/dl
Sugar 22383 mmol/l 232 mmol/l

























DISCnAkGL LANNING

MLDICA1ICN
W Clve medlcaLlons as Lo proper Llme and dosage wlLh proper healLh Leachlngs from Lhe nurses
W uouble check Lhe medlcaLlons before admlnlsLerlng Lo Lhe paLlenL (advlsed Lhe moLher)
W ConLlnue medlcaLlon as per uocLors Crder
W lnsLrucL Lhe paLlenL as Lo proper Llme dose and dosage ln glvlng medlcaLlon

LkLkCISL
W erform acLlveasslsLed range of moLlon exerclses Lo Lhe paLlenL as Lhls can reLard moLor delay
W Lncourage Lhe moLher Lo place Lhe chlld ln a poslLlon where ln maxlmum chesL expanslon promoLe so as
Lo relax Lhe chlld
W 1each Lhe moLher regardlng acLlve asslsLlve range of moLlon exerclse Lo reLard delayed growLh moLor
and developmenL

1kLA1MLN1
W Advlse Lhe moLher regardlng medlcal procedures LhaL wlll be requlre Lo her chlld Lo fasLen Lhe
LreaLmenLs

nLAL1n 1LACnING ] LDUCA1ICN
W 1each Lhe moLher regardlng Lhe mode of Lransmlsslon of Lhe dlseases
W LducaLe Lhe moLher as Lo ways ln prevenLlng furLher compllcaLlon of dlsease
W lnform Lhe moLher abouL envlronmenLal facLors LhaL could aggregaLe or Lrlgger Lhe condlLlon of paLlenL

CU1A1ILN1
W lnform Lhe paLlenL's moLher regardlng Lhelr followup check up and whaL are Lhe procedure Lo be done
per uocLors Crder

DIL1
W 1each Lhe moLher regardlng dleL LhaL was prescrlbed by Lhe nuLrlLlonlsL
W ulssemlnaLe Lo Lhe paLlenL's moLher whaL are Lhe foods Lo be Laken regardlng sofL dleL as Lhls was
prescrlbed by Lhe nuLrlLlonlsL
W LducaLe Lhe paLlenL's moLher regardlng dleL for age












DkUG S1UD

INDICA1ICNS CCN1kAINDICA1ICNS ADVLkSL LIILC1S NUkSING kLSCNSI8ILI1
Genern name
enlclllln C sodlum
(benzylpenlclllln sodlum)

8ran name
CrysLapen

Anton
lnhlblLs cell wall synLhesls
durlng bacLerlal mulLlpllcaLlon

reparaton
ln[ecLlon 3 mllllon unlL vlal
ModeraLe Lo severe sysLemlc
lnfecLlon
ConLralndlcaLed ln paLlenLs
hypersenslLlve Lo drug or oLher
penlcllllns and ln Lhose on
sodlum resLrlcLed dleLs
CnS selzures leLhargy
halluclnaLlons anxleLy
confuslon aglLaLlon dlzzlness
faLlgue

Cv hearL fallure
LhrombophleblLls



Cl nausea vomlLlng
enLerocollLls

Cu neuropaLhy
PLMA1CLCClC hemolyLlc
anemla anemla



C1PL8 hypersenslLlvlLy
reacLlons anaphylaxls paln aL
ln[ecLlon slLe overgrowLh of
nonsuscepLlble organlsms
8efore glvlng drug ask paLlenL
or SC abouL allerglc reacLlons Lo
penlclllln


CbLaln speclmen for culLure
and senslLlvlLy LesLs before
glvlng flrsL dose 1herapy may
begln pendlng resulLs

Cbserve paLlenL closely


WlLh large doses and
prolonged Lherapy bacLerlal or
fungal superlnfecLlon may
occur especlally ln elderly
deblllLaLed or
lmmunosuppressed paLlenLs













INDICA1ICNS CCN1kAINDICA1ICNS ADVLkSL LIILC1S NUkSING kLSCNSI8ILI1
Genern name
AlbuLerol sulfaLe

8ran name
venLolln

Anton
8elaxes bronchlal uLerlne and
vascular smooLh muscle by
sLlmulaLlng beLa2 recepLors

reparaton
SoluLlon for lnhalaLlon 0083
03 063 mg/ml 123 mg/3
ml
Syrup 2 mg/ 3 ml
1ableLs 2 mg 4 mg
1ableLs (exLendedrelease) 4
mg 8 mg
1o prevenL or LreaL
bronchospasm ln paLlenLs wlLh
reverslble obsLrucLlve alrway
dlsease

1o prevenL exerclselnduced
broncospasm
ConLralndlcaLed ln paLlenLs
hypersenslLlve Lo Lhe drug or lLs
lngredlenLs
CnS Lremor nervousness
headache hyperacLlvlLy
lnsomnla dlzzlness weakness
CnS sLlmulaLlon hyperLenslon

Cv Lachychardla palplLaLlons
hyperLenslon

LLn1 dry and lrrlLaLed nose
and LhroaL wlLh lnhaled form
nasal congesLlon eplsLaxls
hoarseness

Cl nausea vomlLlng anorexla

MeLabollc hypokalemla

MusculoskeleLal muscle
cramps

8esplraLory bronchospasm
urug may decrease senslLlvlLy
of splromeLry used for
dlagnosls of asLhma

When swlLchlng paLlenL from
regular Lo exLendedrelease
LableLs remember LhaL a
regular 2 mg LableL every 6
hours ls equlvalenL Lo an
exLended release 4 mg LableL
every 12 hours







NUkSING CAkL LAN 1

ASSLSSMLN1 NUkSING DIAGNCSIS LANNING IN1LkVLN1ICN kA1ICNALL LVALUA1ICN
Sub[ecLlve
nahlhlrapan slyang
humlnga aL may plema
ang ubo nya aL hlndl nlya
mallabas" as verballzed
by Lhe paLlenL's moLher

Cb[ecLlve
27 breaLhs per mlnuLe
rapld shallow
uyspnea
(+) lnLercosLal reLracLlon
(+) producLlve cough buL
lneffecLlve expecLoraLlon
noLed
(+) nasal flarlng
(+) nasal dlscharge
(yellowlsh Lo green)
wheeze sound noLed
wlLh PL
vS366c
129 bpm
27 bpm

lneffecLlve alrway
clearance relaLed Lo
presence of secreLlon as
evldenced by mucus ln
nares
ShorL Lerm
AfLer 4 hour of nurslng
lnLervenLlon Lhe paLlenL
wlll
reduce cough
malnLaln alrway paLency

Long Lerm
AfLer 2 days of
lnLervenLlon Lhe paLlenL
wlll
uemonsLraLe absence
reducLlon of congesLlon
wlLh breaLh sounds clear
resplraLlon nolseless
lmproved oxygen
exchange

lndependenL
assess 88 every 4 hours

encourage Lo lncrease
fluld lnLake


encourage Lo poslLlon ln
semlfowlers by placlng
plllow under Lhe neck
sucLlon lf needed

asslsL Lhe paLlenL ln
nebullzlng

uependenL
admlnlsLer venLolln as
ordered by Lhe physlclan

Lo deLecL early slgns of
compromlse
Lo help llquefy
secreLlons lmprove
alrway clearance
lL relaxes Lhe lungs and
promoLes chesL
expanslon
Lo expelled secreLlon ln
Lhe nasal cavlLy
Lo be able Lo breaLhe
normally


ShorL Lerm
AfLer 1 hour Lhe paLlenL
demonsLraLe
reduced cough
malnLalned alrway
paLency

Long Lerm
AfLer 2 days of
lnLervenLlons Lhe paLlenL
demonsLraLes
Mlnlmal breaLh sounds
regular raLe depLh of
resplraLlon









NUkSING CAkL LAN 2

ASSLSSMLN1 NUkSING DIAGNCSIS LANNING IN1LkVLN1ICN kA1ICNALL LVALUA1ICN
Sub[ecLlve
nahlhlrapan slyang
humlnga aL may plema
ang ubo nya aL hlndl nlya
mallabas" as verballzed
by Lhe paLlenL's moLher

Cb[ecLlve
27 bpm rapld shallow
uyspnelc
(+) lnLercosLal reLracLlon
(+) producLlve cough buL
lneffecLlve expecLoraLlon
noLed
(+) nasal flarlng
(+) nasal dlscharge
Wheeze noLed

lneffecLlve 8reaLhlng
aLLern r/L collecLlon of
secreLlons ln alrway
passage

AfLer 30 mlnuLes of
lnLervenLlon paLlenL's
moLher wlll
verballze awareness of
Lhe paLlenL's moLher
regardlng causaLlve
facLor

WlLh regards Lo Lhe
healLh Leachlng Lhe
moLher wlll provlde rellef
of Lhe causaLlve facLors



Lxplaln Lo Lhe paLlenL's
moLher Lhe presence of
facLor





erform and lnsLrucL Lhe
moLher regardlng on how
Lo use Lhe sLem
lnhalaLlon for her son



ln order for Lhe moLher
Lo be aware abouL
causaLlve facLor so LhaL
Lhey can avold Lhose
causaLlve facLor LhaL
could acqulred of her son

Lo educaLe Lhe moLher
on how Lo uLlllzed Lhe
sLem lnhalaLlon LhaL can
be posslbly aL leasL Lhe
uC8



AfLer 30 mlns of
lnLervenLlon Lhe
paLlenL's moLher
Pad fully aware on
causaLlve facLor



know how Lo use Lhe
sLem lnhalaLor machlne













NUkSING CAkL LAN 3

ASSLSSMLN1 NUkSING DIAGNCSIS LANNING IN1LkVLN1ICN kA1ICNALL LVALUA1ICN
Cb[ecLlve
unable Lo walk
unable Lo sLand
unable Lo crawl
lmpalred muscle sLrengLh

uelayed growLh and
developmenL as evldence
by unable Lo perform ln
accordance wlLh hls age

ShorL Lerm
1o prevenL furLher dlsuse
aLrophy

Long Lerm
ln con[uncLlon wlLh Lhe
hyslcal 1herapy
managemenL ln
prevenLlon of furLher
compllcaLlons such as
aLrophy

erform acLlve asslsLlve
range of moLlon


WlLh Lhe hyslcal
1herapy

1o prevenL furLher
aLrophy

AfLer nurslng
lnLervenLlon Lhe
paLlenL's moLher can
perform Lhe movemenL
for her son ln prevenLlon
of furLher compllcaLlon