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Pediatric Nursing Care > Chapter 45: The Child with a Respiratory Alteration (Part 1- Upper Airway) > Flashcards

Chapter 45: The Child with a Respiratory Alteration (Part 1- Upper Airway) Flashcards

1
Q

Croup patients with these four symptoms should be taken to the emergency room immediately

A

stridor at rest
cyanosis
retractions
inability to take PO fluids

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2
Q

pink, sandpaper rash on trunk indicates this

A

scarlet fever

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3
Q

peritonsillar abscess has a higher risk for ____________________ and _________________

A

airway obstruction, dehydration

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4
Q

most common cause of neonatal stridor

A

laryngomalacia

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5
Q

two drugs of choice to treat sinusitis

A

amoxicillin
amoxicillin-potassium clavulanate

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6
Q

viral or bacterial pharyngitis: abrupt onset (may be gradual in children younger than 2 years)

A

bacterial

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7
Q

four cardinal signs of epiglottitis

A

drooling, dysphagia, dysphonia, distressed respiratory efforts

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8
Q

When treating sinusitis, _____________ can be used to treat allergic rhinitis but tend to _____________ secretions and impair ______________.

A

antihistamines, thicken, sinus drainage

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9
Q

viral or bacterial pharyngitis: fever usually high (39.4 to 40 degrees C)

A

bacterial

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10
Q

Care for pharyngitis/tonsillitis includes ____________, gargling _______________, ________ and ________ foods and liquids, and _______________ applied to the neck.

A

antipyretics, warm salt water, cool, bland, warm compress

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11
Q

treatment for bacterial pharyngitis includes these antibiotics of ______ doses orally daily over a course of ______ days

A

penicillins, 2-3, 10

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12
Q

The tonsillectomy patient is most at risk for postoperative hemorrhage in these two time periods after surgery

A

first 24 hours
days 7-10

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13
Q

these two openings in the fetal heart must close shortly after birth to establish effective pulmonary and circulatory systems

A

foramen ovale, ductus arteriosus

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14
Q

After a tonsillectomy, avoid the use of ___________________ unless absolutely necessary, when they should be __________.

A

tongue depressors, sterile

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15
Q

pharyngitis/tonsillitis peaks between the ages of _________

A

4-7 years

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16
Q

to help relieve mucus buildup in nares, teach parents how to use these

A

saline drops and bulb syringe for suction

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17
Q

ideal treatment for allergic rhinitis

A

remove the allergen

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18
Q

In the postoperative period after a tonsillectomy, the child should be placed in a _________ or _____________ position to facilitate drainage

A

prone, side-lying

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19
Q

infants <6 months are obligatory ________ breathers

A

nose

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20
Q

these children will always test positive for strep throat even if there is not an active infection

A

carriers/colonized

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21
Q

viral or bacterial pharyngitis: usually low grade fever but may be high

A

viral

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22
Q

a child with croup should be monitored in the emergency room for about ________ in case of ______________.

A

3 hours, rebound stridor

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23
Q

surfactant starts to be produced at this point in pregnancy

A

mid pregnancy

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24
Q

viral or bacterial pharyngitis: manifestations include abdominal pain, headache, vomiting

A

bacterial

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25
Q

In a child with croup, __________ can aggravate symptoms and make respiratory distress worse

A

crying

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26
Q

rapid strep antigen tests have a false negative rate of this

A

20%

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27
Q

viral or bacterial pharyngitis: sometimes accompanied with a pink, sandpaper rash on trunk

A

bacterial

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28
Q

For treating croup, a single dose of this drug is also indicated to reduce airway inflammation and reduce necessity for hospitalization

A

dexamethasone

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29
Q

_____________ occur more likely in pediatrics with respiratory distress

A

retractions

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30
Q

crease across the bridge of the nose from wiping the nose upward with the palm of the hand

A

allergic salute

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31
Q

viral or bacterial pharyngitis: usually lasts 3-5 days

A

bacterial

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32
Q

untreated strep throat increases the risk of developing this inflammatory heart condition

A

rheumatic fever

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33
Q

sudden onset of harsh, metallic, barky cough; sore throat; inspiratory stridor; hoarseness

A

croup

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34
Q

Parents of children with laryngomalacia should be educated about signs of ________________ and ___________________, which can make symptoms worse.

A

respiratory distress, respiratory infections

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35
Q

epiglottitis is typically caused by this pathogen

A

H. influenza

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36
Q

allergic rhinitis onset is _________________ but rarely occurs before the age of _____

A

during childhood, 2 years

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37
Q

eustachian tubes are relatively _______________ and ____________ in pediatric patients

A

horizontal, shorter

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38
Q

the average age of occurrence of epiglottitis

A

3-7 years

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39
Q

incidences of epiglottitis decreased substantially since the introduction of this vaccine

A

Hib

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40
Q

pulmonary function tests can sometimes be difficult on young children for this reason

A

inability to follow commands

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41
Q

Parents of children with laryngomalacia should use a (smaller, larger) nipple if bottle feeding and may tolerate (small, large) and (less, more) frequent feedings better.

A

smaller, small, more

42
Q

___________________ emesis is common, but emesis that contains ____________________ is a sign of postoperative hemorrhage (tonsillectomy)

A

Coffee-ground, bright red blood

43
Q

pediatric patients have __________________ intercostal muscles, which can cause ____________ breathing and (increased, decreased) respiratory rate

A

underdeveloped, abdominal, increased

44
Q

croup typically occurs in this age group

A

6 months to 6 years

45
Q

In a patient with laryngomalacia, the nurse should assess for __________________, __________ difficulties, and pattern of _____________ and ________.

A

respiratory distress, feeding, weight gain, growth

46
Q

viral or bacterial pharyngitis: vesicles or ulcers on tonsils

A

viral

47
Q

viral or bacterial pharyngitis: early manifestations include hoarseness, cough, rhinitis, conjunctivitis, malaise, anorexia

A

viral

48
Q

viral or bacterial pharyngitis: cervical lymph nodes may be enlarged, tender

A

viral and bacterial

49
Q

this test measures vital capacity and expiratory flow rate

A

pulmonary function test (via spirometry)

50
Q

In the postoperative period after a tonsillectomy, the nurse should assess the child for excess __________ and the ability to __________________.

A

bleeding, swallow secretions

51
Q

caused by immature neuromuscular development of the airway

A

laryngomalacia

52
Q

manifestations include cold-like symptoms that do not improve after 10-14 days, low grade fever, nasal congestion with purulent drainage, halitosis, and cough that worsens when lying flat, headache

A

sinusitis

53
Q

only reliable and accurate diagnostic for bacterial pharyngitis

A

throat culture

54
Q

children have (more, less) flexible larynx, (decreasing, increasing) susceptibility to spasms and their complications

A

more, increasing

55
Q

pediatric patients have __________ airways and ____________ cartilage, increasing the risk for these three things

A

smaller, undeveloped
foreign body aspiration, edema, mucus obstruction

56
Q

these drugs are not recommended for treatment of respiratory disorders due to adverse side effects

A

decongestants

57
Q

tonsillectomies should not be performed under ________ of age and are contraindicated in _________________ and those with a ____________.

A

3 years, active infection, cleft palate

58
Q

manifestations include refusal to talk, swallow, or eat due to severe pain, which may radiate up to the ear

A

peritonsillar abscess

59
Q

pediatric patients have a(n) _________ respiratory rate due to ______________ metabolic needs

A

faster, increased

60
Q

end tidal carbon dioxide, used with the pulse oximeter, is useful in the patient in these three conditions

A

intubated
under procedural sedation
evaluating asthma severity

61
Q

newborns can have brief periods of _________ which can last up to 15 seconds; this is normal until ___________

A

apnea, 1 month

62
Q

croup occurs most often during the _______ (time of day) in the __________ (season)

A

night, winter

63
Q

symptoms of laryngomalacia usually resolve spontaneously between _____________________ of age.

A

18-24 months

64
Q

_________________ studies and a thorough history should be done prior to a tonsillectomy because the tonsils are a highly ___________ area.

A

Bleeding, vascular

65
Q

sinusitis often follows a(n) ____________________________ but may also occur after ______________ or _________________

A

upper respiratory infection, allergic rhinitis, otitis media

66
Q

viral or bacterial pharyngitis: usually lasts 3-4 days

A

viral

67
Q

if the child is not responsive to treatments for allergic rhinitis, this therapy may be used

A

immunotherapy

68
Q

noisy, crowing, respiratory sounds with or without retractions in the neonatal period

A

laryngomalacia

69
Q

assessment findings include stridor with or without retractions, acyanotic, and worsening symptoms with laying down or crying

A

laryngomalacia

70
Q

unilateral abscess that displaces the uvula to the opposite side

A

peritonsillar abscess

71
Q

ABGs are more reliable for patients with these two problems

A

chronic pulmonary alteration
decreased peripheral perfusion

72
Q

diagnosis of pharyngitis

A

rapid antigen test and throat culture

73
Q

In a patient with laryngomalacia, stridor can be reduced by placing the child’s neck in this position

A

hyperextended

74
Q

characterized by flaccidity of epiglottis and weakness along airway walls

A

laryngomalacia

75
Q

most effective drug treatment for allergic rhinitis

A

antihistamines, intranasal corticosteroids

76
Q

alveoli are expanded within the first ________ after birth

A

hour

77
Q

manifestations include clear rhinorrhea; itching of nose, eyes, and ears; and paroxysmal sneezing

A

allergic rhinitis

78
Q

inflammation and infection of the sinuses

A

sinusitis

79
Q

After a tonsillectomy, after the child is fully awake, provide _____________ liquids and avoid ___________, ____________, and extreme ______ or ______ liquids.

A

clear cool, carbonated, citrus, hot, cold

80
Q

this medication is given to decrease laryngeal swelling and bronchospasms in croup

A

nebulized racemic epinephrine

81
Q

tonsils in children are naturally (smaller, larger) than in adults

A

larger

82
Q

dark circles under the eyes caused by edema

A

allergic shiners

83
Q

pediatric patients have __________ surfactant

A

decreased

84
Q

Interventions and teaching for sinusitis include increasing _____________ intake, using a bedside ___________, placing a ______________ on the face for pain relief, and _________________ for pain and fever control.

A

clear fluid, humidifier, warm compress, acetaminophen

85
Q

viral or bacterial pharyngitis: erythema, inflammation of pharynx and tonsils

A

viral and bacterial

86
Q

After a tonsillectomy, have ____________ equipment available, but do not use unless there is a(n) __________________.

A

suction, airway obstruction

87
Q

diagnostic test that checks oxygen and carbon dioxide levels through electrodes on the patient’s skin

A

transcutaneous monitoring

88
Q

children with strep throat are infectious until this

A

24 hours after antibiotics are started

89
Q

Before a tonsillectomy, teach the child and parents of the presence of a ______________ after the procedure and the importance of _____________________.

A

sore throat, drinking fluids

90
Q

most cases of sinusitis are ___________________, but some cases may require _____________

A

self-limiting, antibiotics

91
Q

Treat epiglottitis with ______________, the drugs _______________ and ______________, and place child on _______ status.

A

intubation, antipyretics, IV antibiotics, NPO

92
Q

diagnostic test that assesses acid base balances

A

arterial blood gas (ABG)

93
Q

four common viruses that cause pharyngitis

A

adenovirus
coronavirus
enterovirus
respiratory syncytial virus (RSV)

94
Q

tonsillectomies should be reserved in cases of upper airway ____________, ____________________, ____________ sleep apneas, or other serious problems.

A

obstruction, peritonsillar abscesses, obstructive

95
Q

pulmonary function tests are used to assess the _________ of disease, response to _____________, or presence of ______________________ pulmonary disease

A

degree, therapy, restrictive or obstructive

96
Q

If epiglottitis is suspected, do not do these two things

A

leave child unattended
examine or attempt to obtain culture

97
Q

viral or bacterial pharyngitis: gradual onset with sore throat

A

viral

98
Q

may be preceded by several days of symptoms of upper respiratory tract infection

A

croup

99
Q

electrodes in transcutaneous monitoring must be changed every ___________, and the machine must be ____________ each time they are changed

A

3-4 hours, recalibrated

100
Q

seasonal, recurrent inflammatory disorder of the nasal mucosa

A

allergic rhinitis

101
Q

total inflation of a normal lung is complete within the first _____________________

A

few breaths of life

102
Q

viral or bacterial pharyngitis: usually severe sore throat

A

bacterial

Pediatric Nursing Care (17 decks)

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