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nurs 345: children > ch 40: respiratory dysfunction of UR tract > Flashcards

ch 40: respiratory dysfunction of UR tract Flashcards

EXAM 2 content -- all the most important things to know (imo)

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1
Q

what is considered part of the upper & lower respiratory track?

A
  • UPPER = oronasopharynx, pharynx, larynx, & upper trachea
  • LOWER = lower trachea, bronchi, bronchioles & alveoli
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2
Q

what influences the risk of getting respiratory infections?

A
  • infectious agents
  • age, size
  • resistance & seasonal variations
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3
Q

how does each age range play a role is getting respiratory infections? what increases with age?

A
  • < 3 mo: maternal antibodies
  • 3-6 mo: infection rate increases
  • toddler + preschool: high rate of viral infections
  • > 5 yo incr of mycoplasma pneumoniae & beta hemolytic strep infections

immunity increases with age!!

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4
Q

how does size play a role of getting respiratory infections?

A

small size = smaller structures = infections spread faster
- diameter small
- distance between structures are shorter –> move fast
- Eustachian tubes (to the ear) are short & open

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5
Q

what influences resistance to infection?

A
  • immune system
  • malnutrition & asthma
  • preterm
  • cardiac anomalies
  • cystic fibrosis
  • DAY CARE
  • 2nd hand smoke
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6
Q

what seasons increase risk of respiratory infection?

A

mostly winter & spring
- mycoplasmal infections – fall & winter
- infection related asthma – cold weather
- RSV – winter & spring

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7
Q

what are the general s/s for respiratory infections?

A
  • fever & meningismus –> neurological symptoms
  • GI symptoms are big indicators – anorexia, vomit, diarrhea, abdominal pain
  • cough, sore throat, nasal block or discharge
  • respiratory sounds
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8
Q

what causes meningeal inflammation?

A

movement of spinal cord or nerves against meninges

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9
Q

how do we assess for respiratory infection?

A
  • resp effect: rate, rhythm, depth, using accessory muscles, retraction, & nasal flaring
  • oxygenation: pulse oximetry & skin color
  • temperature
  • activity level: lethargic –> show concern
  • level of comfort
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10
Q

how do we care for the child w respiratory infection/dysfunction

A
  • ease resp rate
  • promote rest & comfort
  • prevent spread of infection
  • reduce temp
  • hydration & nutrition
  • support & reassurance
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11
Q

nasopharyngitis, UR tract infection – what do we need to know?

A

nasopharyngitis = common cold
- cause: different viruses
- fever (varies w age)
- can be managed at home
- no specific treatment

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12
Q

acute strep pharyngitis, UR tract infection – what do we need to know?

A
  • cause: group A – beta hemolytic strep infection
  • risk for: rheumatic fever
  • inflamed tonsils
  • nursing care: medication & hydration
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13
Q

what are the s/s of strep pharyngitis?

A
  • sudden onset
  • fever of 103-104
  • sore throat
  • erythema
  • exudate
  • tonsilitis
  • abd pain
  • HA
  • pos. RST & high WBC
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14
Q

what are the s/s of viral pharyngitis?

A
  • gradual onset
  • low grade fever
  • slight sore throat
  • less erythema
  • hoarseness
  • cough & rhinitis (MOST COMMON SIGN)
  • neg. RST, slight elevation of WBC
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15
Q

tonsillitis, UR tract infection – what do we need to know?

A
  • occurs usually with pharyngitis
  • frequent infection
  • treatment: tonsillectomy & adenoidectomy

nursing care: education
- avoid dairy & red colored food
- avoid berries –> incr mucous
- avoid coughing
- ice cream day 2 post op
- GIVE cold drinks

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16
Q

if a kid has a tonsillectomy & post op he is constantly swallowing, what does that mean

A

early sign of bleeding
- day 2-14 = bleeding risks

17
Q

influenza, UR tract infection – what do we need to know?

A

influenza = flu
- cause by: orthomyxovirus type A B & C
- manifestations: fever, chills, headache, sore throat, dry cough, rhinitis
- prevent: flu shot at 6 mo old

nursing care:
- hand hygiene + flu shot
- sneeze in elbow
- hydration
- meds at right age
- support
- educate

18
Q

otitis media – UR tract infection, what do we need to know?

A
  • diagnostic eval: tugging ear + doesnt want to drink bc of incr pressure
  • medications & surgery
  • nursing care: watchful waiting
  • prevent reoccurance
19
Q

what are the general s/s of otitis media?

A
  • crying & irritable
  • pulling ears
  • decr PO
  • acute hearing loss
  • fever
20
Q

what are the physical s/s of otitis media?

A

AOM: acute otitis media
- bright red bulging TM with thick fluid, worm looking
- fever 101 , tugging ear, not drink

OME: otitis media w effusion
- dull gray TM with clear fluid or fluid level

21
Q

how do we treat otitis media?

A
  • AOM: antibx for 10-14 dyas
  • analgesics –> incr PO, decr pain
  • decongestants –> taper off, no strong evidence
  • if frequent ear infections > 3 episodes in < 6 mo –> consider adenoidectomy
  • comfort
22
Q

infectious mononucleosis – UR tract infection, what do we need to know?

A
  • cause: herpes like epstein barr virus
  • manifestations: low grade s/s, fatigue, puffy eyes, nose bleeds, fever, sore throat
  • nursing care: no contact sports for 4-6 weeks – prevents obstruction
23
Q

what are croup syndromes? what is it characterized by? what are the types of croup syndromes?

A
  • BARKING COUGH, hoarse, inspiratory stridor & carrying degrees of respiratory distress (bc of constricting of airways)
  • < 5 yo (3mo - 3yo)
  • cause: H influenzae type B
    effects the larynx, trachea & bronchi –> types of croup syndromes: epiglottitis, laryngitis, laryngotracheobronchitis (LBT), tracheitis
24
Q

what are the manifestations of LBT, UR tract infection, type of croup?

A
  • preceded by UR tract infection
  • INSPIRATORY STRIDOR
  • BARKING SEAL LIKE COUGH
  • suprasternal retractions
  • incr respiratory distress & hypoxia
  • progress to respiratory acidosis & respiratory failure
25
Q

how do we manage LTB croup syndrome?

A
  • maintain airway
  • hydration
  • nebulizer: epinephrine & steroids
  • hot shower with the mist
26
Q

acute spasmodic laryngitis, UR tract infection, type of croup infection – what do we need to know?

A

aka SPASMODIC CROUP
- paroxysmal attacks of laryngeal obstruction
- happens at night
- inflammation is mild or absent
- 1-3 yo
- management: similar to LTB croup – taking a hot shower is the best benefit

27
Q

what are the manifestations of bacterial tracheitis, UR tract infection, type of croup infection? what is the biggest difference between this one and the other croup infections?

A
  • infection of mucosa of upper trachea
  • features of croup & epiglottitis
  • manifestations similar to LTB
  • can be a complication OF LTB

biggest difference:
- thick, purulent secretions –> respiratory distress

28
Q

how do we manage bacterial tracheitis?

A

vigorous management
- humidified o2
- antipyretics
- antibx
- maybe intubate
- mechanical vent – due to inflammation & secretions –> hard to get air in

29
Q

acute epiglottitis, UR tract infection – what do we need to know?

A

A MEDICAL EMERGENCY – dont try to examine, get a provider and airway cart ASAP
- sore throat, pain, tripod
- drooling, cant swallow
- inspiratory stridor, mild hypoxia, distress
- increase pulse
- retractions & restless
- anxiety

management
- prevent progression of obstruction
- intubation or tracheostomy

nurs 345: children (23 decks)

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