109 LECTURE Flashcards
is a chronic, inflammatory lung disease involving recurrent breathing problems.
Asthma
Asthma is caused by complex, multicellular reaction in the airway characterized by:
Airway inflammation
Airway hyper-responsiveness to a variety of triggers
most common chronic health problem among children
Symptoms of Asthma
Wheezing Cough Tightness of Chest Prolonged expiratory phase Hypoxemia X-ray- hyper-expansion of the lungs
Medical Management of Asthma
High fowler's position/ bed rest Pulse Oximetry Nebulized Albuterol CPT (chest physical therapy) Methylprednisolone/ Solu-medrol IV IV FLUIDS OXYGEN TO KEEP OXYGEN > 95%
Home Management of Asthma
Peak flow spirometer Identify Triggers Maximize lung expansion Optimal physical growth Optimal psycho-social state Maximum participation
measures how much and how fast air is forcefully expelled from fully inflated lungs
Spirometry
Rescue Drugs for Asthma
short acting albuterol beta 2 agonist- used as a quick relief agent for acute bronchospasm and for prevention of exercise- induced bronchospasm
Anti-inflammatory or preventive for Asthma
low-dose inhaled corticosteroid: inhaled or oral prednisone
Allergy for asthma
Singulair
rapidly relax the airway smooth muscle cells, thus reversing the bronchospasm until anti-inflammatory effects of steroids is attained
Bronchodilators
Aerosols
Mouth piece- 3 years and older
Facial Mask - less than 3 years
reduce the inflammatory component of bronchial obstruction, decrease mucus production, and mediator release as well as the late phase inflammatory process.
Corticosteroids
Corticosteroid for severe cases
Methylprednisolone Iv
Corticosteroids for experiencing GI upset
Reglan
always give with food to decrease GI upset
Oral Prednisone
recommended for short course in moderate or severe exacerbation
Oral Prednisone
Family Teaching for Asthma
Teach how to use medication When to use and how often No to OTC drugs Increase fluid intake Sign and symptoms of respiratory distress
has decrease dramatically since introduction of the Haemophilus influenzae type b or HIB vaccine in 1985
Epiglottitis
Epiglottitis Symptoms
Acute inflammation of supra-glottic structures Medical emergency Sudden onset High fever Dysphasia and drooling Epiglottis is cherry red and swollen
Management of Epiglottitis
Diagnosis made on presenting symptoms Ceftriaxone- 3rd gen cephalosporin no tongue blade in mouth emergency tracheostomy set no procedure until in the operating room keep in quiet room
inflammation of the tonsils
Tonsilitis
occurs when the tonsils are so enlarged they touch each other
“Kissing Tonsils”
Signs and Symptoms of Tonsilitis
Children may refuse to drink
Night snoring = enlarged tonsils or adenoids
size of the tonsils are obstructing the airway
high grade fever
Treatment for Tonsilitis
Antibiotic X ten days if positive for beta strep
Acetaminophen for pain
Cold fluids
saline gargles
Antiseptic sprays
Viral throat infections will not get better faster with antibiotics
Acute obstruction and inflammation of the bronchioles `
Bronchiolitis
Causative agent of Bronchiolitis
RSV (Respiratory syncytial virus)
Symptoms of Bronchiolitis
Harsh dry cough Low grade fever feeding difficulties Respiratory Distress with apnea t
Symptoms of Bronchiolitis
Harsh dry cough Low grade fever feeding difficulties Respiratory Distress with apnea Thick mucus Wheezing
Management of Bronchiolitis
Oxygen saturation of > than 95%
Pulse oximetry
Normal saline nose drop before suctioning
deep suction especially before feeding
CPT (chest pulmonary physiotherapy) to mobilize secretion
Inhalation therapy
Mechanical ventilation
inflammatory condition of the lungs in which alveoli fill with fluid or blood resulting in poor oxygenation and air exchange
Pneumonia
Symptoms of pneumonia
High fever
Thick green, yellow or blood tinged secretion
Grunting respiration
Rales, crackles diminished breath sounds
Cough and cyanosis
Infiltrates seen on x-ray
Symptoms of pneumonia
High fever
Thick green, yellow or blood tinged secretion
Grunting respiration
Rales, crackles diminished breath sounds
Cough and cyanosis
Infiltrates seen on x-ray
Management for pneumonia
Assess respiratory distress NPO (RR > 60 - high risk for aspiration) IV fluids Oxygen saturation above 95% CPT (chest pulmonary physiotherapy) Deep suctioning Acetaminophen fo fever Antibiotics
Pneumonia Isolation
Respiratory Isolation
inherited autosomal recessive disorder of the exocrine glands
Cystic Fibrosis
a chronic, progressive, genetic illness involving the digestive system and lungs
Cystic Fibrosis
Mucous secretion are thick and tenacious
> Dysfunction of mucous producing glands leads to multiple gastrointestinal absorption problems
> blocked pancreatic ducts
no secretion of digestive enzymes
Exocrine gland dysfunction
Symptoms of cyctic Fibrosis
meconium ileus at birth failure to thrive steatorrhea stools/ constipation voracious appetite with poor weight gain recurrent respiratory infections chronic cough malabsorption of intestines
Diagnosis of Cystic Fibrosis
Positive Sweat test genetic marker lifelong management includes: - enzyme replacement with eating - daily CPT postural drainage
