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331: Exam 2 (Respiratory, GI,, and Cardiac) > Acute Respiratory > Flashcards

Acute Respiratory Flashcards

1
Q

Viral Croup ages

A

<5Y

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2
Q

Viral Croup is inflammation of the?

A

Mucosal Lining of the:

  • Larynx
  • Trachea
  • Bonchi
  • causing narrowing
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3
Q

Croup Stage 1

A
  • Fever
  • Anxiety
  • Hoarseness
  • Brassy cough
  • Inspiratory stridor when disturbed
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4
Q

Croup Stage 2

A

Stage 2

  • Continuous stridor
  • Lower lip retraction
  • Retraction of soft neck tissue
  • Use of accessory muscles
  • Labored breathing
  • Maybe hospital?
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5
Q

Croup Stage 3

A

Stage 3

  • Signs of anoxia and CO2 retention
  • Restlessness
  • Anxiety
  • Pallor
  • Sweating
  • Rapid respirations
  • hospital
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6
Q

Croup Stage 4

A

Cyanosis + Stop breathing

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7
Q

What meds should be avoided with croup?

A

Cough syrups + cold meds

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8
Q

Medicines for Croup

A

Racemic Epi (less mucus)
Corticoid steroids
-Broncodilators NOT helpful

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9
Q

signs of worsening Croup

A
  1. Inc RR
  2. Increased agitation, restlessness, anxiety, and dec LOC
  3. Cyanosis
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10
Q

Epiglottitis is also called?

A

Bacterial Croup

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11
Q

Bacteria that cause Epiglottitis (Bacterial Croup)

A

H. Influenza B or Streptococcus pneumoniae
-Can be immunized

Don’t sound bad but look worse!
-Serous life threatening!

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12
Q

Age for bacterial Croup

A

2-5Y

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13
Q

Epiglottitis: Presentation

A

•Clinical presentation-

–Abrupt onset, starts with sore throat

–High fever, mouth open, tongue protruding, drooling, agitation.

–Looks very sick, insists on sitting upright (tripod position)

–Sore red inflamed throat, difficulty swallowing

–Muffled voice, inspiratory stridor, No spontaneous cough

  • Sitting forward and drooling! Get crash cart for intubation
  • Never put anything in mouth.

•Intervention-Maintain the airway

–NO tongue blades! Don’t look in the throat

–Avoid x-ray and transport

–Let parents be with child

–Prepare for sedation & intubation

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14
Q

Bronchiolitis: Def

A

Acute viral infection resulting in inflammation of the smaller bronchioles, characterized by thick mucus and can’t breath around it

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15
Q

Most common cause of Bronchiolitis

A

RSV

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16
Q

Common Age for Bronchiolitis

A

<2Y

17
Q

How is RSV spread?

A

Respiratory Secretion: Droplet Isolation

Skin: 0.5 hours
Surfaces: Hours

Fall + winter

18
Q

Bronchiolitis Symptoms

A
  • Apnea may be first sign
  • Rhinorrhea (runny nose)
  • Pharyngitis (sore throat)
  • Coughing/sneezing
  • Wheezing, crackles, decreased breath sounds
  • Possible ear and eye infection
  • Difficulty feeding
  • Irritability

May progress to:

  • Tachypnea
  • Air hunger
  • Retractions
  • Cyanosis
19
Q

Most common test for Bronchiolitis

A

SNOG (viral culture)

20
Q

Bronchiolitis: Treatment

A

LOTS OF SUCTION + o2

Symptomatic treatment

  • Antivirals: ribavirin (not usually given, fetal death)
  • Bronchodilators: Albuterol, Xopenex, Racemic epi

*Mist tent or vaporizer
fluids, rest, antipyretics, pulse ox

21
Q

RSV vaccine

A

Palivizumab (Synagis): monoclonal antibody vaccine for at risk infants and children <2

22
Q

Types of Pneumonia

A
  1. Viral
  2. mycoplasma,
  3. bacterial (S. pneumoniae most common),
  4. aspiration
  5. inhalation
  6. via blood stream
23
Q

Pneumonia: S/S

A

Pneumonias
Inflammation of the alveoli: May be primary or secondary

Etiology:

  1. Viral
  2. mycoplasma,
  3. bacterial (S. pneumoniae most common),
  4. aspiration
  5. inhalation
  6. via blood stream

Pneumonias: Manifestations
-Fever: mild to high

  • Chest pain (may be referred to abdomen)
  • Dullness to percussion
  • Cough-nonproductive early, slight to severe
  • Ronchi or fine rales, decreased breath sounds
  • Respiratory distress
24
Q

Complications of Pneumonia

A
  1. Empyema
  2. Pyopneumothorax
  3. Tension pneumothorax
  4. Pleural effusion
25
Q

Pneumonia: Treatment

A
  • Humidity oxygen therapy, antibiotics, maybe bronchodilators
  • May need chest tube for purulent discharge
  • May require postural drainage or CPT
  • Supportive & symptomatic-rest, hydration
  • Elevate HOB and allow child to assume a position of comfort
  • Close observation of increased signs of respiratory distress (Monitor O2)
26
Q

Pertussis: Manifestations

A

Unimmunized children <4Y & >10Y

Infants: <6M apnea
>6M: paroxysmal cough
Older kids: Persistent cough

27
Q

Pertussis: Treatment

A
  1. Erythromycin
  2. Infants <6M may need ventilator support
  3. Humidified O2
  4. Maintain Hydration
  5. Watch for and prevent pneumonia
28
Q

When do kids have decreased resistance to TB?

A
  • Decreased resistance in infancy
  • Decreased resistance during puberty & adolescence

Increased risk if in stress state:

  • Injury, illness, steroids
  • Nutritional deficiency
  • Concurrent infections (MMR, HIV)

**Adequate nutrition is as important as adherence to medications

29
Q

Apnea or ALTE looks like?

A

Some combination of:

  1. Apnea >20s
  2. Color change
  3. Marked change in muscle tone
  4. Choking or gagging
30
Q

Monitoring of ALTE

A

-Continuous cardiorespiratory monitoring until episode free for 6 months

31
Q

Etiology of ALTE

A

50% idiopathic
50% other disorders
Increased risk of SIDS

32
Q

SIDS

A

Sudden infant death <1Y that occurs during sleep

*leading cause of death in infants 1-12 months

33
Q

SIDS epidemiology

A

Highest in minorities

Increased in:

  • Males
  • Winter
  • Poor

Peak age 2-4 months, 95% within 6 months

34
Q

RF for SIDS

A
  • Race + gender
  • Preemie or low birth weight
  • Multiple births
  • Low apgar score
  • CNS disturbances + respiratory disorders
  • Later birth other
  • Overheating
  • Unsafe sleeping arrangment
  • Bottle-fed
  • old mom
  • Smoking
  • Drug users
  • Poor prenatal care
35
Q

Preventing SIDS

A

Place infant on back

331: Exam 2 (Respiratory, GI,, and Cardiac) (2 decks)

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