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Peds Exam 2 > Acute respiratory conditions > Flashcards

Acute respiratory conditions Flashcards

1
Q

physical difference between adult and child airways

A 
small size
rely on diaphragmatic/abdominal breathing
larynx and glottis higher in neck
eustachian tubes are horizontal
ribs are horizontal r/t downward slope
fewer numbers of alveoli
higher metabolic rate
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2
Q

when do we hold bottle feeding in an infant

A

RR 60 or higher

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3
Q

respiratory assessment of child

A 
LOC
RR
Respiratory effort
skin and mucous membranes
breath sounds
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4
Q

RR of infant

A

30-40

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5
Q

RR of child

A

20-24

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6
Q

RR of adolescent

A

16-18

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7
Q

what respiratory symptoms are concerning when assessing the respiratory system

A 
nasal flaring 
grunting
retractions
restlessness
irritability
anxiousness
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8
Q

cardinal signs of respiratory distress

A

tachypnea
tachycardia
diaphoresis
change in LOC (restless, irritability, anxiousness)
cyanosis
increased work of breathing ( grunting, nasal flaring, retractions)

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9
Q

what about retractions is associated with the severity of the distress?

A

depth and location

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10
Q

other worrisome signs of respiratory diestress

A

adventitious breath sounds
absent breath sounds
cough (quality: is it dry, wet, productive, brassy, croupy)
expiratory grunting, inspiratory stridor, expiratory wheezing

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11
Q

which of the following patients has severe respiratory distress?

a) Jason, 3m old with RR 18
b) Jackson, 3 yr old, RR 22
c) Megan, 13 yr old, RR 24
d) Michelle, 19m old, RR 26

A

a) Jason, 3m

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12
Q

Goals for nursing care of child

A

normal respiratory effort
adequate rest
not spread infections to others
maintain normal hydration and nutrition

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13
Q

how do you ease respiratory efforts and promote rest and comfort

A 
positioning (sit up to help breathe)
no steam vapor- warm or cool mist
mist tents
saline nose drops and bulb suctioning
bed rest and quiet activites
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14
Q

how do you prevent the spread of infection?

A 
handwashing
teaching
judicious patient room assignments (cohort similar patients)
immunizations
antibiotics
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15
Q

how do you promote hydration and nutrition

A

high calorie fluids
avoid caffeine
allow children to self regulate their diet

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16
Q

specific therapies to improve oxygenation

A 
coughing and deep breathing (make it a game)
suctioning
neb treatments
percussion and postural drainage
chest physiotherapy
supplemental oxygen
ALWAYS humidify air
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17
Q

causes of respiratory infections

A 
viruses
b-hemolytic strep a
staphylococci
hemophilic influenzas b
mycoplasma
pneumococci
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18
Q

what makes up the upper air way

A 
nose
pharynx
tonsils
paranasal sinuses
larynx
epiglottis
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19
Q

what makes up the lower airway

A

bronchi
bronchioles
alveoli

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20
Q

why do infections in children tend to spread faster?

A

because structures are so close together infections spread more rapidly from structure to structure.

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21
Q

clinical manifestations of respiratory infections in infants and children

A 
fever
meningism's ( HA, stiff-necked, photophobia)
anorexia
Vomiting and Diarrhea
Abdominal pain
nasal blockage and or discharge
respiratory sounds
sore throat
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22
Q

nasopharyngitis

A

common cold

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23
Q

causes of common cold

A

rhinovirus, adenovirus, influenza, para-influenza virus

24
Q

clinical manifestations of nasopharyngitis in younger child

A 
fever
irritability
restlessness
sneezing
vomiting/ and or diarrhea
25
Q

clinical manifestations of nasopharyngitis in older child

A 
dryness and irritation of nose and throat
sneezing
chilling
muscular aches
cough
edema
vasodilators of mucosa
26
Q

at 3 months and less infants are protected by mothers

A

antibodies

27
Q

infection rates soar at what age

A

3-6m when moms antibodies are decreasing

28
Q

what is a true temperature in a child?

A

100.4

29
Q

at what age can you start giving ibuprofen to a child?

A

6m

30
Q

fever can reduce a viral load by how much?

A

50%

fever kills virus

31
Q

the nurse in an outpatient center is caring for a 4 month old infant with a URI. The parent asks “what should I do about this fever?” The Childs temperature is 100. How should the nurse respond?

A

a low grade fever can actually be beneficial

32
Q

The nurse caring for 6-month-old Alexa obtains an axillary temperature of 100.4. What action should the nurse take at this time?

a) Administer prn acetaminophen
b) assess respiratory and fluid status
c) Question the parent about the child’s usual temperature status.
d) Record the temperature and retake in one hour.

A

b) assess respiratory and fluid status

33
Q

if you are taking a temperature under the arm do you add or subtract a degree?

A

add a degree and subtract rectally

34
Q

Therapeutic management of nasopharyngitis

A

no OTC cough meds less than 3 months
antipyretics for high fever and discomfort
rest
older children- decongestants, cough suppressants

35
Q

what types of meds do you avoid in nasopharyngitis

A

antihistamines
antibiotics
expectorants

36
Q

COLD

A

c- comfort symptoms
o- offer fluids
l- look for complications
d- decrease disease spread

37
Q

common cause of tonsillitis

A

viral

38
Q

how do you treat tonsilitis

A

treat symptomatically

no antibiotic necessary

39
Q

what causes step pharyngitis

A

Group A ( GABHS)

40
Q

clinical manifestations of strep pharyngitis

A 
sudden onset sore throat
headache
fever
vomiting
lymphadenopathy
abdominal pain
BEEFY red throat
41
Q

what is there a risk of if strep pharyngitis is left untreated?

A 
Acute Rheumatic Fever (18 days)
Acute Glomerulonephritis (10 days)
42
Q

what is the management of strep pharyngitis?

A

antibiotics for 10 days

43
Q

nursing considerations for strep pharyngitis

A

severe sore throat seek medical attention
obtain swabs
teaching

44
Q

When does a child need to get a new toothbrush after strep?

A

24-48 hours after starting abx

45
Q

when can a child return to school after strep?

A

24 hours after starting antibiotics

46
Q

when is a tonsillectomy indicated?

A

only if documented recurrent, frequent strep peritonsillar abscess, or sleep apnea

47
Q

contraindications for tonsillectomy

A

cleft palate
acute infections
uncontrolled systemic disease or blood dyscrasias
less than 4 years of age

48
Q

1 sign of hemorrhage after tonsillectomy

A

excessive swallowing

49
Q

what types of foods do you teach to avoid after tonsillectomy?

A

red, brown and dairy ( dairy coats the throat)

50
Q

is drooling ok after a tonsillectomy?

A

Yes

51
Q

what should providers avoid doing after tonsillectomy if possible?

A

suctioning

52
Q

what should be discouraged after tonsillectomy?

A

straws
coughing
laughing
crying

53
Q

what should you monitor for when doing a respiratory assessment after tonsillectomy?

A

stridor, can mean swelling and airway compromise

54
Q

what can be used for comfort after tonsillectomy?

A

ice collars

cool mist vaporizer

55
Q

when is the second time there is an immediate risk of hemorrhage after a tonsillectomy?

A

8-10 days after when the scabs fall off

56
Q

the nurse is caring for a 3-year-old child who is 3 hours post tonsillectomy. The child appears restless and is swallowing frequently. The child is quiet. The most appropriate action of the nurse is which of the following?

a) allow the child to sleep
b) use a tongue blade to assess the surgical site
c) perform a focused assessment of the child
d) administer analgesia to promote comfort

A

c) perform a focused assessment of the child

Peds Exam 2 (13 decks)

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