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nurs 345: children > ch 40: respiratory infections of LR tract > Flashcards

ch 40: respiratory infections of LR tract Flashcards

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1
Q

what are the lower airways considered? is cartilaginous support developed?

A

the reactive portion
- bronchi & bronchioles
- cartilaginous support NOT fully developed until adolescence
- constriction of airways

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2
Q

bronchitis, LR tract infection – what do we need to know?

A

aka tracheobronchitis
- mild & self limiting
- shorter bronchioles = faster infection
- manifestations: cough, fever, congestion & miserable

nursing care:
- cough suppressants for older kids
- fluids
- rest
- swab test for cause of infection
- antipyretics
- education about spread (closed spaces) of infection & hygiene

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3
Q

respiratory syncytial virus & bronchiolitis, LR tract infection – what do we need to know?

A

MOST COMMON
- acute & viral
- comes in winter & early spring
- prevent & prophylaxis

s/s
- runny nose & coughing
- fever
- wheezing
- cant breath –> suction
- cant eat

nursing care
- neonatal suction
- no antibx
- fluids for hydration
- educate parents –> saying no to ppl holding their baby & no kissing bby

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4
Q

pneumonias, LR tract infections – what do we need to know?

A

cause: inhaled organisms & bloodstream infections, bacterial, viral, mycoplasmal, pneumococcal
- lobar pneumonia = pneumonia in one or more lobes in lung
- pneumonitis = inflammation of lungs w/o infection
- support & symptomatic care, vaccines

s/s
- cough
- respiratory distress
- fever
- congestion

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5
Q

pertussis, LR tract infection – what do we need to know?

A

aka - WHOOPING COUGH
- cause: bordetella pertussis
- occurs in kids w/o immunization
- spring & summer
- highly contagious
- risk to infants –> VACCINES

s/s
- very intense coughing episodes
- continual cough
- cant breath
–> support & vaccines

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6
Q

tuberculosis, LR tract infection – what do we need to know?

A
  • cause: mycobacterium tuberculosis
  • transmitted: urban, low income nonwhite pop
  • diagnosis: PPD test
  • prognosis & prevention: same treatment as adults, monitor & track
  • support care & antibx + fluids
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7
Q

foreign body aspiration, LR tract – what do we need to know?

A

risk to 1-3 yo
- small objects: beads, paper clips, hotdogs, peanuts, popcorn, marbles, balloons, coins, & BUTTON BATTERIES –> be seen IMMEDIATELY
- diagnosis: imaging
- management: depends where it is & what is swallowed
- nursing care: education & monitor

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8
Q

aspiration pneumonia, LR tract infection – what do we need to know?

A
  • risk for kids with feeding difficulties
  • feeding techniques & positions
  • speech lang pathologist
  • avoid aspiration risks – think about SAFETY: hydrocarbons, lipids, solvents, & talcum powder
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9
Q

exposure to environmental tobacco smoke – what do we need to know?

A

passive second hand smoke
- car, house, clothes – stain environment
- effects growing fetus & children
- older kids when experiencing: vape, tobacco, marijuana

educate parents even IF they’re doing a lot of precautions

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10
Q

asthma, LR tract – what do we need to know?

A

chronic inflammations disorder of airways, hyper inflammation of alveoli
- recurring symptoms
- bronchial hyperresponsiveness
- airway obstruction
- limited airflow/obstruction that can REVERSE spontaneously or with treatment – back to BASELINE

risk factors
- allergies
- smoking
- RSV
- hospitilizations
- mold
- boys more likely to have

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11
Q

how do we classify of asthma?

A

INTERMITTENT
- symptoms < 2 days a week
- 0 night time awakenings
- using SABA < 2 days a week
- no interference with activities

MILD
- symptoms > 2 days a week but NOT daily
- 1-2 night time awakenings
- using SABA > 2 days a week but not daily
- minor interference with activities

MODERATE
- daily symptoms
- 3-4 night time awakenings
- using SABA daily
- some limitation in activities

SEVERE
- symptoms throughout the day, everyday
- > 1 week night time awakenings
- using SABA several times per day
- extremely limited in doing activities

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12
Q

how do we diagnose & manage asthma?

A
  • diagnosis: pulmonary function test (assessing how their air moves, real diagnosis) + skin testing for allergens

management
- goal: maintain norm activity levels
- prevent exacerbations

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13
Q

what are the drugs that we use for asthma?

A
  • long term control medications
  • quick relief medications = acute symptoms
  • metered dose inhalers
  • corticosteroids for increased inflammation
  • cromolyn sodium
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14
Q

what specific drugs do we use for asthma?

A
  • ALBUTEROL (most common), METAPROTERENOL, TERBUTALINE
  • long term bronchodilators: SALMETEROL
  • THEOPHYLLINE –> monitor serum lvls
  • LEUKOTRIENE MODIFIERS

classify first –> choose what to do

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15
Q

what are some interventions for asthma?

A
  • exercise
  • breathing exercises
  • CPT
  • hyposensitization: exposing them to allergen –> decrease reaction
  • prognosis: make it as close to intermittent as possible
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16
Q

what is a peak flow rate? what does green, yellow & red mean?

A

max flow rate that can be generated during a forced expiration (L/min), their personal best
- green = 80-100
- yellow = 50-80, take medication
- red = < 50, call MD & seek care immediately –> anxious, scared, nothing is working, cant breath, education

17
Q

what is status asthmaticus? what do we need to know?

A

the RED ZONE of peak flow rate, going into hospital
- MEDICAL EMERGENCY
- respiratory distress even w therapeutic measures
- concurrent infection
- uncomfortable, tripod, cant breath, using accessory muscles
- respiratory failure if no intervention

intervention
- improved ventilation
- medications
- intubation if nebulizer not working

18
Q

what are the goals of asthma management?

A
  • prevent exacerbation, avoid allergens
  • provide acute asthma care
  • relieve bronchospasm
  • monitor with peak flow meter –> make sure they have an action plan
  • master self management of inhalers, devices & activity regulation – EDUCATION
19
Q

cystic fibrosis, LR tract infection – what do we need to know?

A

EFFECTS THE WHOLE BODY
- increased viscosity of mucous gland secretions
- increase sweat electrolytes
- increase enzyme in saliva
- ANS abnormalities

a defective gene inherited from both parents, rate of 1:4 ppl –> genetic counseling

20
Q

how does increased viscosity of mucous gland secretion worsen cystic fibrosis?

A

–> mechanical obstruction
- mucoprotein accumulates, dilates, precipitates & coagulates –> concentrates in glands & ducts
- resp tract & pancreas are affected

21
Q

how do we diagnose cystic fibrosis?

A

newborn screening: will come up for risk of cystic fibrosis, uses SWEAT CHLORIDE TEST to confirm

  • DNA identification of mutant genes
  • abnormal measurement of nasal potential difference
  • expensive tests
22
Q

how will cystic fibrosis show in respiratory system?

A
  • wheezing, dry nonprod cough
  • generalized obstructive emphysema
  • patchy atelectasis
  • cyanosis
  • clubbing
  • repeated bronchitis & pneumonia – esp in the hospital
23
Q

how will cystic fibrosis show in GI system?

A
  • delayed meconium if newborn
  • meconium ileus
  • distal intestinal obstruction syndrome
  • excretion of undigested food in stool –> incr bulk, frothiness, & foul odor
  • wasting of tissues
  • prolapse of rectum
24
Q

how does cystic fibrosis AFFECT GI tract?

A
  • thick secretions –> blocks ducts –> cystic dilation, degeneration, & diffuse fibrosis
  • prevents pancreatic enzymes from reaching duodenum
  • impaired digestion/absorption of fat –> steatorrhea
  • impaired digestion/absorption of protein –> azotorrhea

pancreas
- endocrine function INITIALLY stays same
- EVENTUALLY pancreatic fibrosis –> diabetes
- focal biliary obstruction –> multilocular biliary cirrhosis
- pancreatic enzyme deficiency
- sweat gland dysfunction
- failure to thrive
- increase WEIGHT LOSS w increased APPETITE

25
Q

what is the general presentation of cystic fibrosis?

A
  • girls: delayed puberty
  • boys: sterility
  • skin tastes SALTY
  • dehydration
  • hyponatremic/hypochloremic alkalosis
  • hypoalbuminemia
26
Q

how will cystic fibrosis affect the body as it progresses? what is the initial progression?

A
  • frequent infections
  • chronic infection
  • bronchial epithelium destroyed
  • infection spreads to peribronchial tissues –> weakening bronchial walls
  • increase peribronchial (tissues around bronchioles) increases
  • o2 & co2 exchange decreases
27
Q

how will cystic fibrosis affect the body as it progresses? what is the further progression?

A
  • chronic hypoxemia –> contraction//hypertrophy of muscle fibers in pulmonary arteries & arterioles
  • pulmonary htn
  • cor pulmonale
  • pneumothorax
  • hemoptysis
28
Q

how do we manage cystic fibrosis for respiratory effects?

A
  • chest PT
  • strict schedule
  • airway clearance therapies
  • bronchodilator meds
  • physical exercise
  • aggressive treatment of pulmonary infections
  • aerosolized antibx
  • home IV antibx
29
Q

how do we manage cystic fibrosis for GI effects?

A
  • replacement of pancreatic enzymes –> helps process foos
  • high protein & high calorie diet, 150%
  • relief of ileus
  • reduction of rectal prolapse
  • treat chronic GI reflux
30
Q

what is the prognosis of cystic fibrosis?

A

expected life up to 44-46 yo, in the 40s
- increase life expectancy
- availability of organs
- portable stuff
- better management

31
Q

how do we give family support if their child has cystic fibrosis?

A
  • coping with emo needs of child & fam
  • treatments multiple times a day
  • frequent hospitalization
  • home care
  • implications of genetic transmission of disease
  • genetic counseling
  • education
  • Claire’s Place = foundation for cystic fibrosis support

nurs 345: children (23 decks)

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