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Alteration in Gas Exhange/Respiratory Dx Flashcards

1
Q

What is the most common cause of illness and hospitalization in children?

A

Respiratory Disorders

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2
Q

How long are newborns typically obligatory nose breathers?

A

4 weeks of age

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3
Q

If the newborns nose is obstructed are they able to open their mouths to breath?

A

No

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4
Q

The Infants Nose

A
  • produce very little mucus which makes them more susceptible to infections
  • small nasal passages more prone to obstruction
  • sinuses are not developed
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5
Q

The Infants Throat

A
  • tongue relative to oropharynx are larger; placement can lead to obstruction
  • enlarged tonsillar and adenoid tissue which can lead to obstruction
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6
Q

Why is the capacity for air passage greatly diminished when edema, mucus, or bronchospasm is present?

A

Airway lumen is smaller

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7
Q

What results in an exponential increase in resistance to airflow causing increased work or breathing?

A

small reduction in diameter of the child airway

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8
Q

What increases the chance of aspiration of foreign material into the lower airway?

A

Congenital laryngomalacia due to funnel shape and location of the larynx

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9
Q

A child’s airway us highly compliant making it more susceptible for what?

A

dynamic collapse during airway obstruction

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10
Q

Where is the trachea located in children?

A

third thoracic vertebra

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11
Q

Where is trachea located in adults?

A

sixth thoracic vertebrae

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12
Q

Children exposed to environmental smoke have an increased risk of what?

A

Respiratory illnesses such as asthma, bronchitis, and pneumonia

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13
Q

Prolonged expiration is a sign of what?

A

bronchial or bronchiolar obstruction

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14
Q

Wheezing

A

high pitched sound on expiration

-may occur w/ obstruction in lower trachea or bronchioles

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15
Q

Rales

A

crackling sound heard when alveoli become fluid filled

-may occur w/ pneumonia

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16
Q

Lab/Diagnostic Tests ordered for Bronchiolitis

A
  • pulse oximetry
  • chest radiography
  • blood gases
  • nasal pharyngeal washings
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17
Q

A chest radiography may reveal what for bronchiolitis?

A

hyperinflation and patchy areas of atelectasis or infiltration

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18
Q

Blood Gases test may show what for bronchiolitis?

A

carbon dioxide retention and hypoxemia

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19
Q

Lab/Diagnostic Tests for Pneumonia

A
  • pulse ox
  • chest x-ray
  • sputum culture
  • white blood cell count
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20
Q

Lab/Diagnostic Tests for Cystic Fibrosis

A
  • sweat chloride test
  • pulse ox
  • chest radiograph
  • pulmonary function test
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21
Q

Common medical treatments for respiratory disorders are?

A
  • oxygen
  • high humidity
  • suctioning
  • chest physiotherapy/postural drainage
  • saline gargles/lavage
  • chest tubes
  • bronchoscopy
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22
Q

Chest Physiotherapy

A

promotes mucus clearance through percussion and vibration

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23
Q

Suctioning

A

removes secretions via bulb syringe or suction catheter

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24
Q

Chest Tubes

A

remove air or fluid through a drain inserted into the pleural cavity

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25
Bronchoscopy
intro of a bronchoscope into the bronchial tree for diagnostic purposes
26
Acute Infectious Disorders
- common cold, sinusitis - influenza - pharyngitis, tonsillitis, laryngitis - croup syndromes - RSV (respiratory syncytial virus) - pneumonia and bronchitis
27
Nursing Management for the Common Cold
- symptom relief - promote comfort - provide family education - prevent spread of cold
28
Sinusitis Symptoms
- cough - fever - halitosis - facial pain - eyelid edema - irritability - poor appetite
29
Severe Influenza Infection
- chronic heart or lung disease - diabetes - chronic renal disease - immune deficiency - children w/ cancer receiving chemo
30
Pharyngitis History of Symptoms
- fever - sore throat - difficulty swallowing - headache - abdominal pain
31
Nursing Care Post-Tonsillectomy
- promote airway clearance by placing child on side or prone - encourage fluids - avoid citrus, brown, or red fluids - discourage coughing - pain relief w/ ice collar and analgesics w/ or w/o narcotics
32
Nursing Management for Mono
- analgesics - salt water gargles - bed rest - rest periods - avoid contact sports
33
Croup
- upper airway infection - barky-seal like cough - significant stridor at rest - severe retractions after several hour period of observation
34
Epiglottitis
- inflammation and swelling of epiglottis - most often seen b/t ages of 2-7 - life threatening - maintain patent airway - IV antibiotics - ICU
35
What is Epiglottitis often caused by?
Haemophilus influenzae B
36
Nursing Management for Epiglottitis
- do NOT attempt to visualize the throat - do NOT leave unattended - do NOT place in supine position - provide 100% oxygen in least invasive manner - ensure emergency equipment is available
37
If complete airway occlusion occurs with Epiglottitis what intervention may be necessary?
Tracheostomy
38
S/S of Bronchiolitis (RSV)
- onset of illness w/ a clear runny nose - pharyngitis - low grade fever - development of cough 1-3 days into the illness, followed by a wheeze shortly after - poor feeding
39
Pneumonia
inflammation of the lung parenchyma caused by a virus, bacteria, Mycoplasma, or fungus
40
What is the most common cause of pneumonia in younger children?
Respiratory virus
41
What is the most common type of bacterial pneumonia in all ages?
Streptococcus pneumoniae
42
What is the most common type of bacterial pneumonia specifically for school-age and adolescents?
M. pneumoniae
43
Risk factors for Tuberculosis
- HIV infection - incarceration or institutionalization - positive recent history of latent TB infection - immigration or travel to endemic countries - exposure at home to HIV-infected or homeless persons, illicit drug users, persons recently incarcerated, migrant farm workers, nursing home residents
44
Acute Non-infectious Disorders
- epistaxis - foreign body aspiration - RDS - ARDS - Pneumothorax
45
What is the most important nursing intervention for foreign body aspiration?
Prevention
46
Respiratory Distress Syndrome (RDS)
- respiratory disease specific to neonates - immature lungs/deficiency in surfactant - intensive respiratory care - mechanical ventilation - new techniques for ventilator support
47
Acute Respiratory Distress Syndrome (ARDS)
- sepsis - viral pneumonia - smoke inhalation - drowning - ICU
48
What occurs acutely w/in 72 hours of the insult of ARDS in infants/children w/ previously healthy lungs?
Respiratory distress and hypoxemia
49
Pneumothorax
- collection of air in the pleural space - chest trauma or surgery - intubation and mechanical ventilation - history of chronic lung disease such as cystic fibrosis
50
S/S for a Pneumothorax
- chest pain - respiratory distress - tachypnea - retractions - nasal flaring - grunting
51
Risk Factors for a Pneumothorax
- chest trauma or surgery - intubation and mechanical ventilation - hx of chronic lung disease such as cystic fibrosis
52
Chronic Respiratory Disorders
- allergic rhinitis - asthma - chronic lung disease - cystic fibrosis - apnea
53
Medications
- anti-inflammatory inhaled meds - short-acting bronchodilators - supplemental long-term oxygen therapy may be required
54
Asthma
chronic inflammatory airway disorder characterized by hyperresponsiveness, airway edema, and mucus production
55
Teaching for Asthma
- nebulizers - metered-dose inhalers - spacers - dry-powder inhalers - diskus
56
Cystic Fibrosis
- autosomal recessive disorder | - thickened, tenacious secretions in the seat glands, GI tract, pancreas, resp tract, etc
57
What is the most common debilitating disease of childhood among those of European descent?
Cystic Fibrosis
58
S/S of Cystic Fibrosis
- salty taste to the skin - meconium ileus - abdominal pain - bulky, greasy stools - poor weight gain - chronic cough
59
Apnea
absence of breathing for longer than 20 seconds
60
How often do you perform tracheostomy care?
8 hours
61
What is the life expectancy for someone with cystic fibrosis?
30
62
Epiglottitis S/S
- high fever - toxic appearance - may refuse to speak or speak softly - refuses to lie down - sits forward w/ neck extended
63
Allergic Rhinitis
common chronic condition in childhood, associated w/ atopic dermatitis and asthma -intermittent or persistent inflammatory state
64
What is treatment for Allergic Rhinitis aimed at?
decreasing response to allergic mediators as well as treating inflammation
65
S/S of Allergic Rhinitis
- red-rimmed eyes or tearing - mild eyelid edema - "allergic shiners" (blue/grayish cast below eyes) - "allergic salute" (nasal crease from rubbing)
66
What is therapeutic management of cystic fibrosis aimed at?
minimizing pulmonary complications maximizing lung function preventing infection facilitating growth
67
All children with cystic fibrosis who have pulmonary involvement require what?
chest physiotherapy and postural drainage several times daily to mobilize secretions from the lungs
68
Nursing Management for Cystic Fibrosis
- maintain patent airway - prevent infection through vigorous pulmonary hygiene - maintain growth - promote family coping

Pediatrics (24 decks)

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