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Pediatrics (SE) > Cardiopulmonary/NICU > Flashcards

Cardiopulmonary/NICU Flashcards

1
Q

Differences between adult and infant chests

A

LOOK AT SLIDES 3 AND 4 (nice table summarizes everything)

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2
Q

List 2 components of normal chest development.

A
  1. 6-12 months 2° to abdominal pull, ribs move from horiz. orientation to downward rotation
  2. Provides optimal pull for diaphragm and intercostals
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3
Q

List 3 components of abnormal chest development secondary to weak abdominals.

A
  1. Lower borders wing or flare (SB or SCI)
  2. Lateral flare of rib cage
  3. Intercostal retractions
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4
Q

Cystic fibrosis is a chromosome ___ autosomal recessive disease which causes _______ dysfunction due to a decrease in ________.

A

Chromosome 7

EXOCRINE gland dysfunction

CF transmembrane regulator

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5
Q

List 4 endocrine glands affected by CF.

A
  1. Respiratory
  2. Reproductive organs
  3. Pancreas
  4. Sweat glands
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6
Q

What occurs as a result of decreased CF transmembrane regulator?

A

Increase NaCl loss = hyper-viscous secretions

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7
Q

List 5 impairments associated with CF.

A
  1. Progressive airway obstruction
  2. Secondary infection, bronchiectasis, irreversible airway damage
  3. Impaired muscle dysfunction
  4. Hypoxemia
  5. Decreased vital capacity and tidal volume
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8
Q

Increase PACO2 levels lead to ________ which causes 95% of deaths in CF. What may this condition also cause?

A

Hypercapnic respiratory failure

May cause OSTEOARTHROPATHY (clubbing in fingers/toes)

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9
Q

_______ is a sign of decreased release of enzymes in the digestive system of children with CF. What does this condition lead to? (2)

A

Steatorrhea

  1. Malabsorption of fats and proteins
  2. Diabetes mellitus (7%)
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10
Q

Malnutrition leads to ______ and _______.

A

Muscle wasting

Failure to thrive

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11
Q

List 4 direct breathing techniques used to treat respiratory dysfunction in children with CF.

A
  1. Huffing
  2. Forced expiration
  3. Autogenic drainage
  4. Positive expiratory pressure
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12
Q

What are 2 problems with performing postural drainage and vibration in children?

A
  1. Postural drainage = GE reflux (no head down positions)

2. Vibration = difficult due to rapid breathing rates in infants

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13
Q

Describe the forced expiratory technique. (4)

A
  1. 1-2 huffs (forced expiration) from mid to low lung volume
  2. Upper chest relaxed
  3. Relaxed diaphragmatic breathing
  4. Repeated until secretions mobilize
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14
Q

Describe autogenic drainage.

A
  1. Sitting upright, relaxed position
  2. Several breaths at normal or relatively slow rhythm
  3. Secretion move upward due to breathing at different lung volumes
  4. Expel using gentle cough or forced expiration (huff) at end of sequence
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15
Q

Phase I of autogenic drainage is the ______ phase, which incorporates normal breathing and a ________ volume. The secretions are brought up to the _______.

A

Phase I = UNSTICK PHASE
SMALL tidal volume
Bronchial tree

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16
Q

Phase II of autogenic drainage is the ______ phase, which incorporates ________ lung volume. The secretions are brought up to the _______.

A

Phase II = COLLECT Phase
Low to mid volume
Central airways

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17
Q

Phase III of autogenic drainage is the ______ phase, which incorporates ________ volume.

A

Phase III = EVACUATE

Normal to high volume

18
Q

Active cycle breathing involves ______ expansion, _____ times with pausing after each expansion.

A

Thoracic expansion

3-4 times

19
Q

_______ can be done during chest expansion.

A

Percussion

20
Q

Describe the active cycle breathing technique (ACBT). (3)

A
  1. Breath control + 2-3 thoracic expansions + inspiratory hold
  2. Breath control + 1-2 huffs + breath control
  3. Repeat as needed (until dry huff or nonproductive cough)
21
Q

List 2 precautions to exercise in patients with CF.

A
  1. Bronchial hyperactivity (asthma)

2. Sweating (loss of electrolytes)

22
Q

Asthma is caused by a defect in chromosome ____.

A

11

23
Q

What is asthma? (2)

A
  1. Intermittent reversible episodes of dyspnea, wheezing, coughing
  2. Airways hypersensitive to stimuli or triggers
24
Q

Those with acute asthma are all sensitive to developing a _______, and 60% are sensitive to ______.

A

Upper respiratory infection

Exercise (60%)

25
Q

List 5 signs of acute asthma.

A
  1. Expiratory grunting
  2. Retractions
  3. Nasal flaring
  4. Alterations in inspiratory expiratory ratio
  5. Coughing
26
Q

What is the exercise challenge test? What result indicated a diagnosis of exercise induced asthma?

A
  1. PFT at 5 min intervals, 20-30 min after treadmill run

2. Drop of 15% from prelevels OR development of a cough/wheeze = exercise induced asthma

27
Q

List 4 impairments that arise from using accessory muscles for respiration.

A
  1. Decreased thoracic mobility/thoracic kyphosis
  2. Hypoextensibility of pecs, hip and knee flexors
  3. Elevated adducted shoulders/winging scap.
  4. Hypertrophied neck muscles/forward head
28
Q

What are 2 main differences between acyanotic and cyanotic heart defects?

A

Acyanotic

  1. Blood shunted from left to right side of heart
  2. Oxygenated blood goes to lungs
  3. Decreased weight

Cyanotic

  1. Blood is shunted from right to left side
  2. Unoxygenated blood returns to the body
  3. Decreased weight and height
29
Q

Children with cardiac defects will have a poor ______ experience, and never properly _____ due to energy requirements.

A

Poor FEEDING

Never CRAWL due to energy requirements

30
Q

Describe the HR, respiratory effort, muscle tone, reflex irritability, and color of a baby with an Apgar score of 0.

A 
HR = absent
Respiratory effort = absent 
Muscle tone = extreme hypotonicity/limp
Reflex irritability = none 
Color = blue/pale throughout
31
Q

Describe the HR, respiratory effort, muscle tone, reflex irritability, and color of a baby with an Apgar score of 1.

A 
HR = <100bpm 
Respiratory effort = irregular or slow 
Muscle tone = some flexion 
Reflex irritability = grimace 
Color = extremities blue/pale
32
Q

Describe the HR, respiratory effort, muscle tone, reflex irritability, and color of a baby with an Apgar score of 2.

A 
HR = >100bpm
Respiratory effort = good strong cry 
Muscle tone = normal physiological flexion
Reflex irritability = cry or sneeze 
Color = pink color throughout
33
Q

List 3 progressions a premature baby will undergo.

A
  1. Generalized hypotonia to flexor tone (caudocephalic)
  2. Random total movements to purposeful controlled movements
  3. Inconsistent (absent) primitive reflexes to consistent presences (cephalocaudal)
34
Q

Premature babies in the NICU typically have _____ syndrome, which can progress to _______ if on O@ for greater than 28 days.

A

Respiratory distress syndrome

Bronchopulmonary dysplasia

35
Q

_______ and _______ are 2 conditions that can result from an ischemic lesion.

A

Periventricular leukomalacia

Periventricular/intraventricular hemorrhage

36
Q

List 3 risk profiles for premature infants.

A
  1. Irritable/Hypotonic (poor midline with disorganized movement)
  2. Lethargic hypotonic (poor feeding)
  3. Disorganized (fluctuating tone and irritable when stimulated)
37
Q

List 3 impairments associated with fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE).

A
  1. Growth deficiency
  2. Cardiac defects
  3. CNS dysfunction (development delays, poor judgement/comprehension)
38
Q

________ is an impairment associated with FAS but not present with FAE.

A

Dysmorphology (facial anomalies)

39
Q

List 5 direct effects of cocaine on infants.

A
  1. Vasoconstriction
  2. Growth retardation
  3. Anomalies
  4. Abnormal neurotransmitter levels
  5. Decreased auditory and visual responsiveness
40
Q

List 2 indirect effects of cocaine on infants.

A
  1. Placental insufficiency

2. Fetal hypoxia

41
Q

List 5 signs of cocaine withdrawal in new borns.

A
  1. Irritability
  2. Tremors
  3. Apnea
  4. Seizure
  5. Sleep disturbances
42
Q

List 3 impairments caused by cocaine exposure in the 1st year of life.

A
  1. Increased muscle tone
  2. Poorly developed primitive reflexes
  3. Delayed automatic reactions and volitional movements

Pediatrics (SE) (18 decks)

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