APACIBLE 03 Flashcards
An immediate hypersensitivity (type I) response, is the most common chronic illness in
children, accounting for a large number of days of absenteeism from school and many hospital
admissions each year.
Asthma
It tends to occur initially before 5 years of age, although in these early years it may
be diagnosed as frequent occurrences of bronchiolitis rather than asthma.
Asthma
Asthma Assessment
P D D D W C
Panting
Dry cough at night
Difficulty exhaling
Dyspnea and Wheezing
Wheezing is primarily heard on expiration
If a child coughs up mucus, it is generally copious and may contain white casts
Asthma Management
A S R A E L L I S
Avoidance of allergens by environmental control
Skin testing and hypo-sensitization to identify allergens
Relief of symptoms by pharmacologic agents
Avoid milk or milk products
Encourage children to continue to drink fluids
Long acting bronchodilators at bedtime in addition to inhaled antiinflammatory corticosteroids daily
Leukotriene receptor antagonists such as Montelukast
Inhaled antiinflammatory corticosteroids for mild but persistent asthma
Short acting beta-2-agonist bronchodilator if attack should begin
When children fail to respond readily to the aerosol administration of a bronchodilator such as
albuterol, terbutaline, levalbuterol (Xopenex), or salmeterol (Serevent) and an attack continues, they are in…
Status Asthmaticus
This is an extreme emergency because, if the attack cannot be relieved, a child may
die of _ caused by the combination of _ _ _.
heart attack
exhaustion, atelectasis, and respiratory acidosis from
bronchial plugging.
Status Asthmaticus Assessment
S H B L H L
shows acute respiratory distress
heart rate and respiratory rate are elevated
both oxygen saturation and PO2 are low
Loud wheezing initially heard in an asthma attack
Have so little air to pass in and out of the lungs
Low oxygen saturation level
Status Asthmaticus Management
C O G I I M E
Continuous nebulization with an inhaled beta-2-agonist and intravenous corticosteroids may be necessary
Oxygen is given by face mask or nasal prongs to maintain the PO2 at more than 90 mmHg
Give oxygen with humidification to prevent drying of pulmonary secretions
Increase fluid to combat dehydration
Intravenous infusion such as 5% glucose in 0.45 saline
Monitor intake and output, measure the specific gravity of urine
Endotracheal intubation and mechanical ventilation, in severe attacks
the single most common cause of death in children, estimated at 1.2
million every year.This represents 18% of all deaths below 5 years of age worldwide.
Pneumonia
can lead to 2 million
child deaths annually, and these two diseases have been the major focus of attention to reduce childhood
morbidity and deaths. (Santos, 2021)
Pneumonia and diarrhea
Pneumonia can be prevented by:
- immunization
- adequate nutrition
- addressing environmental factors
Infection and inflammation of the alveoli
Pneumonia
Two types of pneumonia
Hospital acquired
Community acquired
Pneumonia Occurs most often
Late winter and early spring
Pneumococcal pneumonia etiology
The onset is generally abrupt and follows an upper respiratory tract infection
Pneumococcal pneumonia assessment
C H N C A R T T
Chest Pain
High fever to febrile seizure
Nasal flaring
Chills
Appears acutely ill
Retractions
Tachycardia
Tachypnea
Treatment of Pneumococcal Pneumonia
P P O H C R
Pneumococcal vaccine for children with chronic illness
Pharmacologic management may include IV therapy and antipyretics
Oxygen saturation levels should be assessed frequently
Humidified oxygen
CPT
Reposition the child to prevent pooling of secretions
is most often seen in newborns up to 12 weeks of age because the
organism is contracted from the mother’s vagina during birth.
Chlamydial Pneumonia etiology
Chlamydial Pneumonia Assessment
N M E
Nasal congestion and sharp cough
May progress to tachypnea with wheezing and rales audible on auscultation
Elevated level of immunoglobulin IgG and IgM antibodies, peripheral eosinophilia, and a special antibody to C. trachomatis
Treatment for Chlamydial Pneumonia
Macrolide antibiotics (for C. trachomatis) such as Erythromycin
Viral pneumonia
generally caused by the viruses of upper respiratory tract infection: the RSVs, myxoviruses,
or adenoviruses.
Viral pneumonia assessment
B M F
begins as an upper respiratory tract infection
may progress to diminished breath sounds and fine rales on auscultation
fatigue often occurs following an acute phase of illness
Viral pneumonia treatment
R A
Rest and Antipyretics are used
Occurs more frequently in children over 5 years of age during winter months
Mycoplasmal Pneumonia
