5. Respiratory Distress

Question 1

Cardiopulmonary arrest in children (d/t absence of effective ventilation, circulation or both) has three components, including respiratory (O2), circulatory volume, and?

Answer 1

cardiac (pump, perfusion, BP)

Question 2

In contrast to adults, cardiac arrest in infants and children does not usually result from a primary cardiac cause. Instead it is more often a terminal result of a progressive?

Answer 2

respiratory failure/shock - termed asphyxial arrest

Question 3

Most pediatric arrests are respiratory, which without intervention lead to cardiac arrest. Sudden, unanticipated non traumatic cardiac arrests are?

Answer 3

uncommon in children

Question 4

The pediatric assesment triangle (PAT) is used for the first at the door, general assesment and it includes what 3 componenets?

Answer 4

Appearance
Breathing
Circulation

Question 5

Along with PAT, overall demeanor is checked such as restlessness, anxiety and combativeness-suggesting hypoxia- somnolence/lethargy BAD. What else is focused on in a child with resp. distress?

Answer 5

Tone (poor/lethargic movements=bad)
Interaction (reasuring/not reasuring)
Consolability (can the child be comforted)

Question 6

Look/Gaze is looked at in child presenting in respiratory distress- bad is eyes rolling around with unfocused gaze. Speech/cry : loud cry/strong voice is good. weak cry or no cry is?

Answer 6

bad

Question 7

Initial response to respiratory compromise is tachypnea, as resp. compromise progresses, RR often will?

Answer 7

decrease and become irregular **bad

Question 8

Stridor is high pitched crowing sounds with inspiration, secondary to narrowing of the larynx (croup/laryngomalacia) or trachea as see in tracheomalacia or?

Answer 8

vascular ring (croup d/t parainfluenza w no response to tx)

Question 9

Wheezing is a squaking noise made by air passing through narrowed airways, usually due to obstruction due to inflammation or?

Answer 9

bronchoconstriction

Question 10

Rales can sound like ceran wrap being crushed usually moist sounds heard resulting from narrowed bronchi due to airway inflammation and?

Answer 10

thick mucus

Question 11

All of the following are done to assess which component of the pediatric assessment triangle?
Decreased perfusion, cooling of the skin peripheral to proximal, and pale mottled cool or ashen skin (hypoxemia/shock)

Answer 11

Circulatory Assesment

Question 12

Cap refill is usually 2 seconds, if cap refill is more than 3 s, then what two things can be expected?

Answer 12

Volume depletion and Hypotension

Question 13

HR also changes in resp arrest, initially see tachycardia to compensate but when the body lacks to ability to compensate, what can occur?

Answer 13

bradycardia ** dec HR == BAD

Question 14

Respiratory distress occurs in children when breathing does not match the body’s metabolic demand for oxygen, resulting in hypercarbia and?

Answer 14

hypoexemia

Question 15

The following are what type of conditions? foreign body aspiration, angioedema from anaphylaxis, epiglottitis

Answer 15

Severe upper airway obstruction = life threatening condition

Question 16

Cardiac tamponade can cause hypoxemia and respiratory acidosis and presents with “beck’s traid” which is jugular venous distention, muffled cardiac sounds and?

Answer 16

hypotension (triad seen in 1/3 of patients with cardiac tamponade)

Question 17

respiratory tract conditions like infections (FEVER) also can cause respiratory distress in kids. what type of abscesses present with sore throat/difficulty swallowing and local pain and swelling, hoarse voice (hot potato voice **) and ENT emergency?

Answer 17

retroperitoneal /peritonsillar abscesses (another cause)

Question 18

What is the MC cause of infectious airway obstruction in kids ages 6-36 months, caused by parainfluenza virus often times with chracteristic STRIDOR*?

Answer 18

Croup

*Steeple sign on XR

Question 19

What is a common cause of respiratory distress due to H. flu type B, which has basically been elimnated by the vaccine, kids are SICK, - go to OR for exam/ possible intubation?

Answer 19

Epiglottitis

Question 20

What is the MCC of bronchiolitis, in children less than 2y/o, characterized by URI symtpoms, progressive cough, wheezing/atelectasis and COPIOUS amounts of secretions?

Answer 20

Respiratory syncytial virus RSV

Question 21

Anaphylaxis can cause respiratory distress due to food or medications. If an allergy is reported always ask what?

Answer 21

what happens when exposed to the allergen

tx with epi, oxygen, steroids

Question 22

What is an important and dangerous thing that a kid can swallow, that may erode through the walls?

Answer 22

Button batteries**

Question 23

What disease can cause acute on chronic conditions, known as acute chest syndrome- presents with sudden onset of respiratory distress and chest pain, new infiltrate on CXR and fever?

Answer 23

Sickle Cell Dz