Case Study: Management of Upper Respiratory Disorders in Children

This case study focuses on the nursing care of a child with an upper respiratory disorder. It details the process of assessment, including physical examinations like inspection, auscultation, percussion, and palpation. The primary nursing diagnosis is ineffective airway clearance, addressed through interventions such as airway positioning, adequate nutrition, chest physiotherapy, and controlling ineffective breathing patterns. The case study also covers monitoring respiratory rate, administering oxygen, and assessing oxygen saturation levels. Further interventions include maintaining a clean environment to prevent secondary infections, administering antibiotics, and educating the family about the child's condition, including providing high-calorie, protein-rich foods. The case study also discusses the safe use of ibuprofen in infants based on body weight and age, referencing multiple research papers. The management of upper respiratory infections involves promoting relaxation, providing liquid foods, clearing mucus, using humidifiers, and avoiding exposure to irritants.

Running head: CASE STUDY
Case Study
Name of the Student
Name of the University
Author Note

1CASE STUDY
Care for a child with an upper respiratory disorder include assessment, nursing diagnosis,
planning, intervention and evalution. First perform physical examination of the child’s
respiratory system is performed which includes inspection and observation, auscultation,
percussion and palpation. The primary diagnostic approach is innefective airway
clearance(Chaves et al, 2016) which is related to increased secretion, mechanical obstruction
and increased work of breathing. The child should be positioned with the airway open which
will ensure adequate ventilation. The nurse should ensure that the child gets adequate food
(intravenous or oral) which will help in liquefying secretion for ease of clearance. Then chest
physiotherapy should be performed to mobilize secretion. Next diagnostic approach is to
control the ineffective breathing pattern which results due to nasal flaring. This will help the
child in adequate ventilation and easy work of breathing with clear breathing sound along
with sufficient aeration(Long et al, 2019). The nurse should assess the respiratory rate and
breathing sound of the child for ensuring progress of the treatment procedures, administer
oxygen for improving oxygenation, monitor oxygen saturation levels via pulse oxymetry for
detecting alterations in oxygenation. A chest tube can be inserted within the pleural cavity
which facilitates removal of air or fluid and result in lung expansion.
A proper aseptic, clean and hygienic environment should be maintained which will ensure
that the child shows no sign of secondary infection. This is done by practicing good
handwashing, use of disposable suction catheters which will prevent introduction to further
infectious agents(Ferreira et al, 2016). The nurse should also administer antibiotics to prevent
bacterial infection. The child should be kept in an isolated environment for preventing
nosocomeal infection and the child should be fed with proper nutrients, so that the body’s
immune system is capable of fighting infection(Morpeth et al, 2018). The signs for adequate
hydration should also be assessed such as urine output, moist mucosa. Other than these, the
child’s family should be educated about the risk factors and health complication of

2CASE STUDY
respiratory disorders, suggest them to provide high calorie protein rich food to the child for
optimal growth potential of the child, ask them not to expose the child to smoke and maintain
a healthy and safe environment for the child.
Usually ibuprofen is not recommended for infants below 6 months, however based on the
recent evidences, short term use of ibuprofen is considered safe for the baby older than 3
months of age with a body weight above 5-6 kgs, with a special attention given to the ability
of hydration of the child(Ziesenitz et al, 2017). So, ibuprofen should be prescribes to the
infants based on their body weight and the dose prescribed is around 5-10mg/kg. If the child
is below 2 years of age and have a body weight less than 5.6 kgs, then prescribing of
ibuprofen should be strictly done with the physician’s consulation(Mavura et al, 2018). The
management of upper respiratory infection in a child is done by putting the child in a relaxed
state, which will facilitate adequate aeration, giving the child liquid foods which will help the
mucus to loosen, it will also help to prevent dehydration. This is followed by clearance of
mucus from the nose with a bulb syringe. A humidifier may be used to improve aeration in
the lungs and lastly, the child should be restricted form getting exposed to smoke or dust,
which will further increase the risk of infection and cause respiratory trouble.

3CASE STUDY
REFERNCE
Chaves, D. B. R., Beltrão, B. A., Pascoal, L. M., de Souza Oliveira, A. R., Andrade, L. Z. C.,
dos Santos, A. C. B., ... & da Silva, V. M. (2016). Defining characteristics of the
nursing diagnosis “ineffective airway clearance”. Revista Brasileira de
Enfermagem, 69(1), 92-98.
Ferreira, A. M., da Rocha, E. D. N., Lopes, C. T., Bachion, M. M., de Lima Lopes, J., & de
Barros, A. L. B. L. (2016). Nursing diagnoses in intensive care: cross-mapping and
NANDA-I taxonomy. Revista brasileira de enfermagem, 69(2), 285.
Long, J. C., Williams, H. M., Jani, S., Arnolda, G., Ting, H. P., Molloy, C. J., ... &
Braithwaite, J. (2019). Assessing the appropriateness of the management of upper
respiratory tract infection in Australian children: a population-based sample
survey. BMJ open, 9(5), e026915.
Mavura, A., Sigalla, G. N., Malya, R., Nambunga, P. P., Sam, N., & Kajeguka, D. C. (2018).
Physician prescription practice of antibiotics for upper respiratory tract infection at
Kilimanjaro Christian Medical Centre Moshi, Tanzania.
Morpeth, S. C., Munywoki, P., Hammitt, L. L., Bett, A., Bottomley, C., Onyango, C. O., ... &
Scott, J. A. G. (2018). Impact of viral upper respiratory tract infection on the
concentration of nasopharyngeal pneumococcal carriage among Kenyan
children. Scientific reports, 8(1), 1-8.
Ziesenitz, V. C., Zutter, A., Erb, T. O., & van den Anker, J. N. (2017). Efficacy and safety of
ibuprofen in infants aged between 3 and 6 months. Pediatric Drugs, 19(4), 277-290.