ch 40: respiratory dysfunction of UR tract Flashcards
EXAM 2 content -- all the most important things to know (imo)
what is considered part of the upper & lower respiratory track?
- UPPER = oronasopharynx, pharynx, larynx, & upper trachea
- LOWER = lower trachea, bronchi, bronchioles & alveoli
what influences the risk of getting respiratory infections?
- infectious agents
- age, size
- resistance & seasonal variations
how does each age range play a role is getting respiratory infections? what increases with age?
- < 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!!
how does size play a role of getting respiratory infections?
small size = smaller structures = infections spread faster
- diameter small
- distance between structures are shorter –> move fast
- Eustachian tubes (to the ear) are short & open
what influences resistance to infection?
- immune system
- malnutrition & asthma
- preterm
- cardiac anomalies
- cystic fibrosis
- DAY CARE
- 2nd hand smoke
what seasons increase risk of respiratory infection?
mostly winter & spring
- mycoplasmal infections – fall & winter
- infection related asthma – cold weather
- RSV – winter & spring
what are the general s/s for respiratory infections?
- fever & meningismus –> neurological symptoms
- GI symptoms are big indicators – anorexia, vomit, diarrhea, abdominal pain
- cough, sore throat, nasal block or discharge
- respiratory sounds
what causes meningeal inflammation?
movement of spinal cord or nerves against meninges
how do we assess for respiratory infection?
- 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
how do we care for the child w respiratory infection/dysfunction
- ease resp rate
- promote rest & comfort
- prevent spread of infection
- reduce temp
- hydration & nutrition
- support & reassurance
nasopharyngitis, UR tract infection – what do we need to know?
nasopharyngitis = common cold
- cause: different viruses
- fever (varies w age)
- can be managed at home
- no specific treatment
acute strep pharyngitis, UR tract infection – what do we need to know?
- cause: group A – beta hemolytic strep infection
- risk for: rheumatic fever
- inflamed tonsils
- nursing care: medication & hydration
what are the s/s of strep pharyngitis?
- sudden onset
- fever of 103-104
- sore throat
- erythema
- exudate
- tonsilitis
- abd pain
- HA
- pos. RST & high WBC
what are the s/s of viral pharyngitis?
- gradual onset
- low grade fever
- slight sore throat
- less erythema
- hoarseness
- cough & rhinitis (MOST COMMON SIGN)
- neg. RST, slight elevation of WBC
tonsillitis, UR tract infection – what do we need to know?
- 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
if a kid has a tonsillectomy & post op he is constantly swallowing, what does that mean
early sign of bleeding
- day 2-14 = bleeding risks
influenza, UR tract infection – what do we need to know?
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
otitis media – UR tract infection, what do we need to know?
- diagnostic eval: tugging ear + doesnt want to drink bc of incr pressure
- medications & surgery
- nursing care: watchful waiting
- prevent reoccurance
what are the general s/s of otitis media?
- crying & irritable
- pulling ears
- decr PO
- acute hearing loss
- fever
what are the physical s/s of otitis media?
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
how do we treat otitis media?
- 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
infectious mononucleosis – UR tract infection, what do we need to know?
- 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
what are croup syndromes? what is it characterized by? what are the types of croup syndromes?
- 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
what are the manifestations of LBT, UR tract infection, type of croup?
- preceded by UR tract infection
- INSPIRATORY STRIDOR
- BARKING SEAL LIKE COUGH
- suprasternal retractions
- incr respiratory distress & hypoxia
- progress to respiratory acidosis & respiratory failure
