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Pediatrics > Chapter 40 > Flashcards

Chapter 40 Flashcards

1
Q

factors that increase the risk for respiratory illness

A
  1. anatomy and genetics
  2. age
  3. prematurity
  4. prolonged oxygen use at birth
  5. environment
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2
Q
  1. are infants nose or mouth breathers?

2. other characteristics of newborn nose?

A
  1. nose breather
  2. -produce little mucus
    • small nasal passages
    • sinuses are not developed
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3
Q

describe the tongue and tonsils of infant and children

A
  1. tongue is large

2. tonsils and adenoids are enlarged

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4
Q

difference in location of trachea in children compared to adults

A

trachea is located third thoracic vertebra in children and sixth in adults

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5
Q
  1. infants under three months use which type of antibodies?
  2. toddler and preschool are at a high rate of which type of infection?
  3. older than 5 years, what infection is at higher risk?
  4. as age increases, what else increases in a child?
A
  1. maternal antibodies
  2. high rate of viral infections
  3. pneumonia and beta strep infections
  4. immunity increases due to maturity of immune system and increased exposure
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6
Q
  1. mycoplasmal infections are more common during?
  2. asthmatic bronchitis are more frequent during?
  3. RSV season is?
A
  1. Fall and winter
  2. cold season
  3. Winter and spring
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7
Q

when assessing the respiratory system, what do you assess for?

A
  1. colour
  2. breath sound, rate, depth (other noises like cough)
  3. nose and oral cavity
  4. anxiety and restlessness
  5. clubbing
  6. hydration
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8
Q

Chronic disorders:

A
  1. allergic rhinitis
  2. asthma
  3. Chronic lung disease
  4. Cystic fibrosis
  5. apnea
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9
Q

Acute infectious disorders:

A
  1. Cold, sinusitis
  2. influenza
  3. pharyngitis, tonsilitis, and laryngitis
  4. croup
  5. Respiratory syncytial Virus
  6. Pneumonia and bronchitis
  7. TB
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10
Q

Laboratory and diagnostic tests for respiratory

A
  1. Pulse oximetry
  2. X ray
  3. sputum culture
  4. CBC
  5. inflammatory markers
  6. ASO titer
  7. PFT (pulmonary function test)
  8. blood gasses
  9. sweat chloride test
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11
Q

common medical treatments for respiratory disorders.

A
  1. Oxygen therapy, humidification
  2. suction
  3. chest physiotherapy
  4. saline gargles and lavage
  5. chest tubes
  6. bronchoscopy
  7. Nebulizer, Inhalers
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12
Q

nursing interventions for respiratory illnesses:

A
  1. ease respiratory effort
  2. fever management
  3. promote rest and comfort
  4. infection control
  5. promote hydration and nutrition
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13
Q
  1. nasopharygitis aka
A
  1. common cold
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14
Q
  1. Inflammation of the throat mucosa (pharynx) is referred to as?
  2. Manifestations:
  3. this is a risk for what?
A
  1. Pharyngitis
  2. -fever, sore throat and difficulty swallowing, headache, and abdominal pain.
    • inflammation with exudate
    • strawberry tongue and sandpapaer rash on skin on trunk or abdomen.
  3. -Acute rheumatic fever
    • Acute glomerulonephritis
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15
Q
  1. Inflammation of the tonsils
  2. often occurs with?
  3. why would surgical removal of tonsils be warranted?
A
  1. tonsillitis
  2. pharyngitis
  3. recurrent tonsillitis
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16
Q
  1. clinical manifestation of tonsillitis
  2. therapeutic techniques for tonsillitis
  3. in the event of a surgery, how to promote airway clearance?
A
  1. hoarse voice sound, inflammation of pharynx and/or tonsils, difficulty breathing and swallowing, mouth breathing and snowing.
  2. -promote comfort by saline gargles, analgesics, lozenges or hard candy, humidifier, cool liquids, ice chips or popsicles.
  3. Until fully awake, place the child in a side-lying or prone position to facilitate safe drainage of secretions
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17
Q
  1. a self-limited illness caused by the Epstein–Barr virus.
  2. signs and symptoms of this disease?
  3. diagnosed through?
A
  1. Mono, commonly called kissing disease
  2. fever, malaise, sore throat, and lymphadenopathy, splenomegaly and hepatomegaly can occur
  3. Definitive diagnosis may be made by Monospot or Epstein–Barr virus titers.
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18
Q
  1. therapeutic management of MONO
A
  1. Symptomatic: analgesics and salt-water gargles are recommended, bed rest and res periods, corticosteroids may be given to decrease inflammation, avoid strenuous activity and contact sports. report signs of jaundice
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19
Q
  1. clinical manifestations of influenza
  2. therapeutic management
  3. prvention?
A
  1. fever, cough, irritability, pharyngitis, other respiratory symptoms
  2. symptomatic treatment of fever, cough, and comfort measures.
  3. vaccination
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20
Q
  1. infection of the external ear
  2. aka
  3. therapeutic techniques
A
  1. Otitis externa
  2. swimmer’s ear
  3. relief of pain
21
Q
  1. clinical manifestation of epiglottitis
  2. therapeutic technique
  3. prevention?
A
  1. -Sore throat, pain, tripod positioning,
    retractions
    -Inspiratory stridor, mild hypoxia,
    distress
  2. 100% oxygen, emergency equipment available, if airway becomes completely occluded tracheostomy can be done.
  3. Hib vaccine
22
Q
  1. things not to do in epiglottitis
A
  1. -do not attempt to visualize the throat
    • do not leave child unattended
    • no supine
23
Q

nursing management of asthma

A
  1. increase medications as child’s condition worsens and reducing when it improves.
24
Q

nursing management for tonsillectomy

A
  1. promote airway clearance (sidelying and prone position)
  2. maintain hydration (avoid citrus)
  3. avoid coughing
  4. realieving pain (ice collar, analgesics)
25
Q
  1. most common of the croup syndrome?
  2. this generally affects who?
  3. what causes this?
A
  1. acute laryngotracheobronchitis
  2. younger than 5
  3. RSV, Paraninfluenza, mycoplasma pneumoniae, influenza
26
Q
  1. Manifestations of Laryngeotracheobronchitis

2. therapeutic technique

A
  1. air-hungry, exhibiting various degrees of cyanosis and respiratory distress, including tachypnea, retractions, accessory muscle use, grunting, and periods of apnea. Cough and audible wheeze. uninterested in feeding and surroundings.
  2. focuses on supportive treatment. Supplemental oxygen, nasal and/or nasopharyngeal suctioning, oral or intravenous hydration, and inhaled bronchodilator therapy
27
Q
  1. croup is characterized by?
  2. aka
  3. therapeutic managemnet.
A 
1.  hoarseness, “barking”
cough, inspiratory stridor and varying
degrees of respiratory distress
2.  laryngotracheobronchitis
3. humidified air, dexamethasone
28
Q
  1. laryngitis is characterized by
  2. it is more common in
  3. therapeutic technique
A
  1. hoarse voice or loss of the voice, self limiting. Goes away on its own
  2. older children and adolescents
  3. oral fluids and resting voice.
29
Q
  1. infection of mucosa of upper trachea
  2. signs and symptoms?
  3. can be a complication of?
  4. what does thick purulent secretions suggest
A
  1. Bacterial Tracheitis
  2. features of croup, epiglottitis, and LTB
  3. LTB
  4. respiratory distress.
30
Q
  1. lower airway includes:

2. when does cartilaginous support develop?

A
  1. bronchi and bronchioles

2. adolescence

31
Q
  1. Bronchitis clinical manifestations:
  2. Pathophysiology
  3. how is it diagnosed
A
    • begin with URI.
    • fever, dry hacking cough that may wake the child at night and may become productive in older children.
    • coarse rales lung sounds
    • alveolar hyperinflation.
  2. Bronchitis is an inflammation of the trachea and major bronchi. It is often associated with a URI. Caused by M. Pneumonia.
    3.
32
Q
  1. therapeutic technique for bronchitis.
A
  1. supportive care: administer expectorant and adequate hydration. antibiotics can be given if bacterial. discourage cough suppressants.
33
Q
  1. acute inflammatory process of the bronchioles and small bronchi
  2. what causes this?
  3. Manifestations:
A
  1. Bronchiolitis.
  2. RSV
  3. -appear air hungry, cyanosis and respiratory distress (tachypnea, retractions and use of accessory muscles, grunting, and periods of apnea), cough and audible wheezes.
    • uninterested in eating or surroundings.
34
Q

Therapeutic technique for Brochiolitis and RSV:

A
  • supportive care. (antipyretics, hydration, close observation
  • home care can be done, notify provider if condition worsen.
  • hospitalization is required for more severe conditions.
  • maintain patent airway (position, suction)
  • oxygen
35
Q

Preventing RSV

A
  • hand washing
  • Palivizumab (Synagis) for those who are most susceptible (prematurity, Chronic lung disease, congenital heart disease, and neuromuscular disease).
36
Q

Most common cause of pneumonia in younger children and least common cause in older children

  1. a child who presents with recurrent pneumonia should be evaluated for?
  2. complicaitons
  3. Manifestations
A
  1. respiratory pneumonia.
  2. Chronic lung disease like asthma or cystic fibrosis
  3. pneumothorax
  4. respiratory distress symptoms, wheezes and rales with deminished breath sounds
37
Q
  1. manifestations of pneumonia
  2. treatment of pneumonia
  3. what is pneumonia
A
  1. Fever, chills, flushing, malaise, cough and coryza, photophobia.
  2. supportive care. symptomatic treaments
  3. Pneumonia is an inflammation of the lung parenchyma. It can be caused by a virus, bacteria, Mycoplasma, or a fungus.
38
Q
  1. Pertusis is aka

2. caused by and highest incidence in?

A
  1. whooping cough

2. bordetella pertusis, spring in non immunized children.

39
Q
  1. TB is caused by
  2. clinical manifestations
  3. treatment and prevention
  4. diagnosed through
  5. prevention of infection
A
  1. Mycobacterium Tuberculosis
    • can be asymptomatic
    • fever, malaise,
    • weight loss, anorexia
    • chest tightness and some times hemoptysis
    • cough may or may not be present.
    • asymmetric lung expansion, dullness and crackles
  3. provide supportive care (managing nutrition, comfort, and fever) and adherence to treatment
  4. mantoux test, interferon (IGRA) or X-ray.
  5. Tuberculosis infection is prevented by avoiding contact with the tubercle bacillus
40
Q

Acute respiratory distress syndrome

  1. Pathophysiology
  2. treatment
  3. nursing actions
A
  1. a condition that occurs after an insult such as sepsis, viral pneumonia, smoke inhalation, or near drowning. Pulmonary edema occurs, ultimately gas diffusion is impaired.
  2. aimed at improving oxygenation and ventilation (PEEP)
  3. -supportive care with close monitoring of respiratory and cardiovascular.
    • manage pain, anxiety, nutrition, and prevention of infection.
41
Q

Allergic rhinitis

  1. Pathophisiology
  2. Manifestations
  3. diagnosis and treatment
  4. nursing teachings
A
  1. an immune response to allergen
  2. rhinorrhea, nasal congestion, sneezing, itchy nose, moth breathing and snoring. allergic salute)
  3. -nasal smear
    • maintain patent airway with nasal washes
    • anti-inflammatory corticosteroids, antihistamine,
  4. teach to avoid known allergens
42
Q

Asthma

  1. Patho
  2. therapeutic management
  3. Manifestations
A
  1. airway hyperresponsiveness with edema and mucus.
  2. avoid triggers and medications (bronchodilators)
  3. Cough, particularly at night: hacking cough that is initially nonproductive, becoming productive of frothy sputum
    Difficulty breathing: shortness of breath, chest tightness or pain, dyspnea with exercise Wheezing
43
Q

Describe the classification of asthma

A
  1. Intermittent - 1 - 2 times a week with nighttime symptoms 1 - 2 times a month
  2. Mild persistent -more than twice a week but less than once a day. nighttime symptoms 3 or 4 times a month
  3. Moderate persistent - daily symptoms, nighttime symptoms greater than 1 times a week but not nightly.
  4. severe persistent - throughout the day with nighttime symptoms almost daily.
44
Q

what are the goals of asthma management?

A

1.Avoid exacerbation
2.Avoid allergens
3.Relieve asthmatic episodes promptly
4.Relieve bronchospasm
5.Monitor function with peak flowmeter
6.Self-management of inhalers, devices,
and activity regulation

45
Q

Emergency treatment for status asthmaticus

A
  1. Epinephrine
46
Q

Talk about cystic fibrosis

A

1 Exocrine gland dysfunction that produces multisystem involvement
2. most common lethal genetic disease among white children.

47
Q
  1. How is CF diagnosed?

2. management goals

A 
1. • Quantitative sweat chloride test
• Chest x-ray
• PFT
• Stool fat and/or enzyme analysis
• Barium enema

2.Prevent/minimize pulmonary
complications
• Adequate nutrition for growth
• Assist in adapting to chronic illness

48
Q

how is CF managed?

  1. respiratory
  2. GI
A 
1. CPT
Bronchodilators
forced expiration
aggressive treatment of pulmonary infection
Antibiotics
2.
• Replacement of pancreatic enzymes
• High-protein, high-calorie diet as
much as 150% RDA
• Repair/Prevent Intestinal
obstruction
• Reduction of rectal prolapse
• Salt supplementation

Pediatrics (15 decks)

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