APACIBLE 04 Flashcards
the presence of atmospheric air in the pleural space; its presence causes the alveoli to
collapse (atelectasis)
pneumothorax
pneumothorax assessment
A P C S
absent or decreased breath sounds
percussion may not be revealing
chest may be hyper-resonant
shift of the apical pulse away from the site of pneumothorax
Pneumothorax treatment
CO T W
Chest radiography will show a darkened area of the air-filled pleural space
Oxygen therapy to relieve respiratory distress
Thoracotomy catheter or needle may be placed through the chest wall into the pleural space to
remove accumulated air.
Water-seal drainage with children
A chronic pulmonary involvement that occurs in 10% to 40% of infants who are treated for
acute respiratory distress in the first days of life.
The condition most often occurs in infants who received
mechanical ventilation for respiratory distress syndrome at birth.
Bronchopulmonary Dysplasia
The condition is thought to occur from a combination of surfactant deficiency (decreased from lung trauma), barotrauma (lung damage from ventilator pressure), oxygen toxicity (from high levels needed to counteract the original respiratory
distress), and continuing inflammation.
Bronchopulmonary Dysplasia
Causes of Bronchopulmonary Dysplasia (occurs from a combination of)
Surfactant deficiency
Barotrauma
Oxygen toxicity
Continuing inflammation
Bronchopulmonary Dysplasia Assessment
T A T O R N
Tachycardia
Auscultation reveals decreased air movement
Tachypnea
Oxygen dependence
Retractions
Nasal flaring
Bronchopulmonary Dysplasia treatment
A I
Administration of a corticosteroid to reduce inflammation and a bronchodilator by nebulizer
greatly improves respiratory function
Infants need to be monitored carefully for nutrition and fluid intake
Caused by bacterium Mycobacterium tuberculosis, is a highly contagious pulmonary disease
that affects children worldwide
Tuberculosis
The mode of transmission is inhalation of infected droplets. The
incubation period is 2 to 10 weeks.
Tuberculosis
Tuberculosis assessment
P S - L A W N
Pulmonary inflammation occurs
Slight cough develops
As the disease progresses,
- low grade fever
- anorexia
- weight loss
- night sweats
TB Treatment
T N M S A
tuberculin test as part of basic preventive health care at 9 to 12 months of age
negative tuberculin result before administering this vaccine.
Mantoux test, also called a purified protein derivative (PPD) test, 5 units of protein derivative vaccine is injected intradermally, usually on the left lower arm.
sputum may be analyzed, to confirm a diagnosis of active disease. Done for 3 consecutive days
Anti-tuberculosis drugs include Isoniazid, Rifampin, Pyrazinamide, and ethambutol.
Children should have periodic chest radiographs for the rest of their life to make certain their
disease does not become active again later in life.
The Bacille Calmette-Guérin (BCG) vaccine is available against tuberculosis, but it is not used
routinely in the United States.
A skin test will be strongly positive after effective BCG vaccination.
may produce peripheral neurologic symptoms if pyridoxine (vitamin B6) is not
administered concurrently. Rifampin is a secondary drug often used in combination with this drug
INH
used with older children. It must be used with caution with infants because one
side effect is optic neuritis
Ethambutol
An inherited disease of the secretory glands.
This is characterized by thick mucus secretions, particularly in the pancreas and the lungs, as well as electrolyte abnormalities in sweat gland secretions.
Cystic Fibrosis
It occurs most commonly in Caucasian children and rarely in black or Asian children.
Cystic Fibrosis
The disorder is inherited as an autosomal recessive trait. It occurs in approximately 1 in 2500
live births.
Cystic Fibrosis
This means that to have this, a person must have a nutation in both copies of the CFTR gene on
each cell. People with CF inherit one mutated copy of the gene from each parent, who is referred to as a carrier.
Cystic Fibrosis
Pancreas involvement in CF
Without pancreatic enzymes in the duodenum, children cannot digest fat, protein, and some sugars. The
child’s stools become large, bulky, and greasy (steatorrhea).
child’s stools become large, bulky, and greasy
steatorrhea
Cystic Fibrosis assessment
Pancreatic Involvement
P S S L
Protuberant abdomen due to bulk of feces in the intestine
Stool is extremely foul in odor
Shows sign of malnutrition: emanciated extremities and loose, flabby folds of skin on their buttocks
Low levels of fat-soluble vitamins particularly A D E
The anteroposterior diameter of the chest becomes enlarged in CF. Thickened mucus pools in
bronchioles. Pockets of infection then begin in these secretions.
The organisms most frequently cultured are Staphylococcus aureus, Pseudomonas aeruginosa, and H. influenzae.
Atelectasis occurs as a result
of absorption of air from alveoli behind blocked bronchioles.
Cystic Fibrosis
Lung involvement
Lung Involvement
CF assessment
C
The child’s fingers become clubbed because of the inadequate peripheral tissue perfusion
Sweat gland involvement
CF
Although sweat glands are not changed in structure, the level of chloride to sodium in perspiration is increased 2 to 5 times above normal, resulting in “saltry” perspiration.
