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peds 331 > acute respiratory > Flashcards

acute respiratory Flashcards

1
Q

general nursing interventions

A

ease respiratory efforts, promote rest, comfort, prevent spread of infection, promote hydration and nutrition, manage fever, fam support and teaching, support and plan for home care

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2
Q

ease resp effort

A

position, warm or cool mist, mist tent, saline nose drops with bulb suctioning, bed rest, quiet activites

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3
Q

tonsilitis

A

rapid test! strep test - heart and kidneys
treat S
usually viral - no abx

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3
Q

prevent spread of infection

A

HH, teach, judicious room assingments, immunizations, abx

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3
Q

improve oxygenation

A

cough and deep breathe, suction, neb meds, percussion and postural drainage, cpt, supplemental o2

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4
Q

hydration and nutrition

A

high cal fluids, avoid caffeine, allow to self regulate

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4
Q

nasopharyngitis tm

A

no OTC <3
antipyretics for high fever and discomfort
rest
older: decongestants, cough suppresants - OH
avoid: antihistamines, abx, expectorants

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5
Q

nasopharyngitis

A

common cold

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5
Q

strep pharyngitis tm

A

10 day abx - finish
sudden onset, school 24 hrs after being on abx, new tooth brush, dont share drinks, swabs, comfort care, teach

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6
Q

tonsillectomy nc

A

excessive bleeding, avoid suction - drool ok, position on side for drainage, no straws, cough, laugh, cry; inspect secretions and vomit (blood tinged is ok), swelling and airway compromise - stridor, iced collar, manage pain, cool mist vaporizer, no red or brown food, soft diet, no milk

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7
Q

tonsillectomy discharge

A

7-11 days
risk of bleeding, watch for excessive swallowing, s/s of hemorrhaging, lots of throat clearing
comfort measures

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8
Q

external otitis

A

abx/steroid drop - no oral
prevention is key - get water out (peroxide/vinegar, gravity, hair dryer, ear plugs)

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9
Q

otits media tm

A

teach prevention
abx therapy - amoxicillan
analgesia - heat compress, tylenol, ibuprofen

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10
Q

PE tube

A

chronic otitis media
sedation - still
no diving, jumping, prolonged submersion; no swimming in lakes/rivers, avoid post op pressure
drainage common after placement

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11
Q

croup - LTB

A

viral
sound worse than they look

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12
Q

croup - LTB tm

A

airway and breathing - priority
at home
cool moist env, humidified o2, fluids, comfort, avoid cough syrups and cold medicines, racemic epi, corticosteroids, stay calm
avoid: bronchodilators, abx

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13
Q

croup - LTB nc

A

resp assessment, conserve E, decrease anx (parents), assess and prevent dehydration, support fam

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14
Q

croup - LTB S of increasing severity

A

rr increase
agitation, restless, anxiety, decreased LOC, cyanosis

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15
Q

croup - epiglottitis

A

bacterial croup
serious, life threatening -airway

16
Q

croup - epiglottitis tm

A

vaccines
look bad, dont sound bad, no cough, drool
maintain airway, no tongue blades, avoid xray and transport, let parents be there, keep everyone calm, prepare for sedation and intubation
specimens, antipyretics for fever, abx, usually better at 48 hrs, discharge with abx at home

17
Q

bronchiolitis (RSV) tm/nc

A

maintain airway - suction
meds: antivirals (ribavirin), bronchodilators (albuterol), corticosteroids (controversial)
treat S (home): contact isolation, HH, parental participation, keep airway open, saline drops and bulb suction, humidity, fluids, rest, humidified O2, antipyretics, pulse ox, monitor hydration and encourage PO intake of clear fluids

18
Q

bronchiolitis (RSV) vaccine

A

synagis
at risk <2: <29 weeks, chronic lung disease, congenital defects, severe immune deficiencies
IM monthly - nov - april, expensive

19
Q

pneumonias tm and nc

A

humidified o2, abx, bronchodilators, chest tube, postural drainage, cpt, support and symptomatic, elevate HOB, position of comfort, close observation for S of increasing resp distress, continuous pulse ox

20
Q

pertussis tm/nc

A

tdap
erythromycin, <6 mo may need vent, oxygen, hydration, watch for and prevent pna

21
Q

tuberculosis tm/nc

A

will always test +
rarely need hospital, med adherence, isolation - school once on therapy and s/s reduced, nutrition!!!

22
Q

ALTE tm/nc

A

not if in nicu
lots of testing and assessment - continuous monitoring for 6 months episode free
discharge teach: CPR, no extension cords, interference (TV, radio, cell phones, police scanners), emergency # on phones
methylxanthine - caffeine

23
Q

SIDS tm/nc

A

back to sleep
compassionate, sensitive, initial approach, ask factual Qs only, allow goodbye, provide lock of hair, foot and hand prints, arrange home visit ASAP

24
Q

s of resp distress

A

tachypnea, tachycardia, diaphoresis, change in LOC, restless, irritable, anx, cyanosis, increased WOB (grunt, nasal flare, retractions)
adventitious sounds
cough

25
Q

general cm of rti in kids

A

fever, meningismus, anorexia, v/d, abd pain, nasal blockage/discharge, resp sounds, sore throat

26
Q

nasopharyngitis etiology

A

common cold - virus

27
Q

nasopharyngitis cm - younger

A

fever, irritable, restless, sneeze, v/d

28
Q

nasopharyngitis cm - older

A

dryness and irritation of nose and throat, sneeze, chill, muscle aches, cough, edema and vasodilation of mucosa

29
Q

strep pharyngitis (GABHS) cm

A

sudden onset, sore throat, HA, fever, v, lymphadenopathy, abd pain, beefy red throat
can lead to RF
impetigo and pyoderma, scarlet dever
exudate on tonsils, petechiae of pharynx

30
Q

external otitis

A

water trapped by earwax = growth medium
inflam/infection of outer ear

31
Q

external otitis cm

A

pain (disproportionate, increase w movement), drainage (serousanguineous or purulent)

32
Q

otitis media

A

middle ear, collection of fluid or pus
non breast fed, cig smoke, bottles in bed, unimmunized, pacifier beyond infancy, allergies, winter

33
Q

otitis media cm

A

ear pain, irritable, hold/pull at ear, roll head from side to side, fever up to 104, ruptured tympanic membrane
chronic = hearing loss

34
Q

LTB cm

A

slowly progressive
edema of epiglottis, trachea swells, mucosal inflam, harsh mechanic cough, insp stridor, resp distress, agitations, retractions

35
Q

croup increasing severity

A

increasing rr, agitation, restless, anx, decreased LOC, cyanosis

36
Q

epiglottitis cm

A

abrupt onset - sore throat
hight fever, mouth open, tongue protruding, drool, agitation, looks sick, sit upright (tripod), sore red inflamed throat, difficulty swallowing, muffled voice, insp stridor, no cough

37
Q

bronchiolitis

A

viral (RSV) - inflam of broncioles, thick mucus
cm: apnea, rhinorrhea, pharyngitis, cough/sneeze, adventitious or decreased breath sounds, eye/ear infection, low grade fever, difficulty feeding, irritable
progress: tachypnea, air hunger, retractions, cyanosis

38
Q

pneumonias cm

A

viral or bacterial
fever, chest pain (abd), dullness to percussion, cough non productive early, ronchi or fine rales, decreased breath sounds, resp distress

39
Q

whooping cough

A

persistant cough
too busy coughing, dont want to eat

40
Q

TB cm

A

may be asymp with normal CXR
malaise, fever, night sweats, slight cough, weight loss, anorexia, lymphadenopathy

41
Q

ALTE cm

A

apnea >20 sec, color change (cyanosis or pallor), marked change in muscle tone, choke or gag

42
Q

SIDS rf

A

race and gender, premie or low birth weight, multiple births, low apgar, cns disturbance or resp disorder, later birth order, overheating, unsafe sleeping, bottle fed, maternal age, smoking, substance abusers, poor prenatal care

peds 331 (28 decks)

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