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Pneumonia is an acute respiratory infection affectingthe lungs that can be caused by viruses,
bacteria, or fungi
Although pneumonia can often be treated and cured, 1.1million children under the age of five
die due to pneumonia every year (18% of all deaths of children under five years old worldwide)
Pneumonia is treatable and preventable. owever, delays in recogni!ing pneumonia and
accessing appropriate care, as well as missed opportunities for immuni!ation, contribute to
pneumonia mortality
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Pneumonia affects children and adults everywhere, however most child deaths occur
in the world/s poorest regions with highest incidence in sub01aharan Africa and 1outh Asia
1treptococcus pneumonia, aemophilus influen!ae type b (ib) and respiratory syncytial virus
are the most common causes of pneumonia in healthy people. Pneumocystis 2iroveci
is one of the most common causes of pneumonia in immune compromised infant and
it is responsible for one 3uarter of all pneumonia deaths in #40infected infants
Pertussis and measles have also a respiratory tract component and can complicate with
5he Philippines is one of the 16 countries that together account for 76%of childhood
pneumonia cases worldwide. #n children aged under 6 years, pneumonia is the leading cause of
mortality with a mortality rate of 89.: ;1<<,<<< population recorded in 8<<=
#n -egions 4#, 4## and 4### of the Philippines, the total number of children under five years of
age with pneumonia that have been seen and given treatment from >anuary to $ecember
8<18were 8=,881 and86,=89, respectively
%a2or ris? factors for developing pneumonia are@
& a wea?ened immune system due to malnutrition or undernourishment (especially in infants
not e;clusively breastfed),#4 and
other pre0e;isting illnesses such as measles
o environmental factors including indoor air pollution (coo?ingAheating with wood, dung, or other
biomass fuels), living in crowded houses and parental smo?ing
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Pneumonia can be spread by@
& #nhalation of viruses and bacteria that are commonly found in a child/s nose or throat
o #nhalation of contaminated airborne droplets from someone else/s cough or snee!e
o +loodstream infections
o #n newborns, contact with organisms in the birth canal or contaminated substances contacted
during delivery
%ost organisms that cause pneumonia are commonly encountered during day0
to0day activities. ence, it is not recommended that otherwise healthy people wear mas?s to
protect themselves from pneumonia
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Pneumonia may have a range of symptoms depending on the age and the cause of
the infection
4iral and bacterial pneumonia have similar symptoms, although there may be more symptoms
with viral pneumonia
Bough and difficult and pain full breathing are ?ey symptoms of pneumoniaC fever
is also common
#n children under five years of age, difficult breathing manifests as@
& -apid breathing(D6< bpm for 8018 months oldC D:< bpm for D18 months 06years old)
o 'ower chest in drawing, where chest moves in or retracts during inhalation, also called
EretractionF(.igure 1)
o .laring of the nostrils with every breath
o (runtingwith every e;halation
o Ghee!ing, more commonly with viral infections
1everely ill infants may be unable to feed or drin? and may e;perience unconsciousness,
hypothermia, and convulsions
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Bhest ;0rays and laboratory test scan be used to confirm the presence of pneumonia and to
identify the causative pathogen
#n resource0poor environments, pneumonia diagnosis is based on clinical signs and
.igure 1@ chest indrawing in an infant. #n the image on the left, the infant is e;haling. #n the
image on the right, he is inhalingC note the triangular shadows at the borders of the ribcage on
the sides of the trun?.
5reatment of pneumonia is with antibiotics. 5reatment regimens need to be chosen based on
their efficacy in local settings (e.i. level of drug resistance) and accordingly to the patient ris?
factors (e.i. undernourished or #40positive children)
Bhildren under two months are at highest ris? for severe illnessAdeath and they should be
immediately referred to a hospital or clinic for treatment
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Public health interventions to prevent pneumonia include@
& #mmuni!ation against pathogens that directly cause pneumonia (1. pneumonia and
. influen!a type b) and pathogens that lead to pneumonia as complication of the infection (eg.
measles and pertussis)
& 5he most important available vaccines to prevent pneumonia are pneumococcal con2ugate
vaccine, ib vaccine, measles and pertussis vaccine
o Ade3uate nutrition to improve natural defense and strength of respiratory muscles (which aid
in clearance of secretions)
o ";clusive breast feeding for the first si; months of life
o Hinc supplementation
#n children infected with #4, the antibiotic cotrimo;a!ole is given daily to decrease the ris? of
contracting pneumonia
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Acute respiratory infections (A-#) are range of respiratory disease that can affect the upper
respiratory tract or lower respiratory tract. 5he clinical manifestation of A-# (cough, colds
andAor sore throat with or without fever)is common for several diseases such as the common
cold, influen!a or pneumonia
1ince the typhoon there have been over 1<1,:17 consultations for A-# in the affected areas
5he following charts and tables show information from 1P""$ consultations for A-# in select
typhoon0affected areas (-egions 4# and 4###) from 1< *ov 8<19088 .eb 8<1:. -esults shown
are dependent upon facility reporting that varied over time
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#n -egion 4#, since 1< *ovember 8<19, there have been 88,:77consultations for acute
respiratory infections reported through 1P""$, mostly from the Bapi! province.
5he number of consultations for A-# pea?ed in the first wee? of $ecember. A-# consultations
have represented between 9<% and I<% of all consultations since 1< *ovember 8<19
-"(#&* 4 ###
#n -egion 4###, since 1< *ovember 8<19, there have been 78,=:<
consultations for A-# reported through 1P""$, mostly from 'eyte province. A steady
decrease in the proportion of A-# consultations has been reported in 'eyte since the typhoon
with some oscillations and as light increase in the last wee?. #n "aster 1amar the proportion of
A-# consultations has been relatively constant since the typhoon.
5his wee?ly "GA-* 1ummary is published by the Gorld ealth &rgani!ation (G&),
Philippines. #t is based on preliminary surveillance data from multiple sources, including the
1urveillance in Post0
";treme "mergencies and $isasters(1P""$) system, the Philippines #ntegrated $isease
1urveillance and -esponse 1ystem (P#$1-), and event0based reporting system. G&
surveillance contact@ haiyanopsJwpro.who.int Gee?ly 1ummaries are available at@
8<<8 L G&
- &ver 7<,<<< .ilipino children have died of diarrhea in span of seven years
- #n its study, which it co0conducted with the $epartment of ealth and ,nited *ations
Bhildren "mergency .und (,*#B".), G& said this figure ma?es diarrhea the fourth
leading cause of deaths among children less than five years old and the third leading
cause of illness among the children.
- 5he study showed that if the trend continues, it is e;pected to cause 1<,<<< deaths
every year.
$r. %aria -icardo, health specialists revealed that the Philippines ran?s second among
19 countries included in the census in terms of the number of diarrhea cases.
8<<8 *$1 Philippines *ational $emographic and ealth 1urvey with *1&
- $uring the two wee?s before the survey, =% of
.ilipino children under five had diarrhea. 5he rate was highest (1I%) among children 18L89
months. -oughly one0third of children with diarrhea were ta?en to a health facility or sought
treatment from a provider. Bhildren with diarrhea should drin? more fluids, particularly oral
rehydration salts (&-1). 5he ma2ority of mothers (=8%) ?now about &-1. #n the two wee?s
before the survey, 6=% of children with diarrhea were treated with &-1 or recommended home
fluids, but 17% received less fluid or no fluids at all. &verall, 1I% of children with diarrhea
received no treatment
'ac? of clean water and poor hygiene habits contribute significantly to child ailments that cause
.ilipino children to miss school.
#n the country, diarrhea is the 9rd leading cause of child illness and the :th leading cause of
deaths among children less than 6 years. #t is estimated to cause 18% or almost 1<,<<< deaths
a year. A 8<<: ,*#B". assisted study on the prevalence of soil transmitted helminthes,
estimates that almost 7< % of pre schoolchildren are host to at least one type of intestinal
helminth infection and that 7 out of 1< children (aged 9018) suffer from intestinal worms.
Leading Causes of Child Mortality
&ther causes
Mey measures to prevent diarrhea include@
Access to safe drin?ing0water
,se of improved sanitation
and washing with soap
";clusive breastfeeding for the first si; months of life.
(ood personal and food hygiene
ealth education about how infections spreadC and
-otavirus vaccine
$iarrhea is defined by the Gorld ealth &rgani!ation as having three or more loose or li3uid
stools per day, or as having more stools than is normal for that person.
#%B#@ $iarrhea
Pontifcal and Royal
The Catholic University of the Philippines
Espa!a "o#levard$ Sa%paloc$ &anila$ Philippines '(')
Nursing Care Management 101
S.Y. 2014-2015
First Semester
A partial fulfillment of needed reuirements in NCM 101!
"iffi#ult$ of %reat&ing and "iarr&ea
'ritten (eport
Su%mitted %$)
(e#io* (a#&elle Ann
(egino* +eter Mat&e,
(eposar* -erardeanne
(e$es* .dgardo
(e$es* /arlo 0gna#io
(e$es* Mi#&aela 1ouise
(e$es* (ose Anne
(e$estan* 1a,ren#e
(e$noso* 1ermal$n
2N2(3 (1. 3.1
Su%mitted to)
Ms. (olisa Almario* (N* MAN