Chapter 45: The Child with a Respiratory Alteration (Part 2- Lower Airway) Flashcards

1
Q

four diagnostic methods that can be used to visualize the foreign body that has been aspirated

A

CT, MRI, chest X-ray, fluoroscopy

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2
Q

this treatment can help decrease asthma symptoms if a specific allergen is identified and it cannot be avoided

A

immunotherapy (allergy shots)

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3
Q

this percentage of male patients with cystic fibrosis are sterile

A

95%

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4
Q

four types of drug therapy used to reduce pulmonary edema and lessen airway resistance in bronchopulmonary dysplasia

A

diuretics
bronchodilators
theophylline
caffeine

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5
Q

characterized by abnormal secretions of thick, tenacious mucus and obstruction and dysfunction of the pancreas, lungs, salivary glands, sweat glands, and reproductive organs

A

cystic fibrosis

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6
Q

manifestations start with upper respiratory symptoms, such as nasal drainage, sneezing, low grade fever, and decreased PO intake followed by manifestations of respiratory distress (tachypnea, tachycardia, crackles or rhonchi, retractions, cyanosis)

A

bronchiolitis/RSV

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7
Q

inherited multisystem disorder characterized by widespread dysfunction of exocrine glands

A

cystic fibrosis

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8
Q

most common agent that causes acute bronchitis

A

rhinovirus

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9
Q

if a patient is using SABA _____________ times a week, the patient should be evaluated for need for __________________.

A

multiple, long-acting medications

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10
Q

onset of asthma is typically at this age

A

before age 6 years

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11
Q

severe diffuse lung injury involving breakdown in the alveolar-capillary barrier; precipitated by a variety of illnesses

A

acute respiratory distress syndrome (ARDS)

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12
Q

encourage patients with asthma to take a short-acting inhaler _____________ before exercise to reduce symptoms

A

30 minutes

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13
Q

in asthma patients, chest X-rays show this

A

normal

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14
Q

diet for cystic fibrosis should be high _________ and high ___________ with replacements of ________________.

A

calorie, protein, fat-soluble vitamins

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15
Q

when treating bronchitis, antibiotics are reserved for this type

A

bacterial confirmed with a culture

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16
Q

mild bronchiolitis can be treated by utilizing _______, _________, and a bedside ______________.

A

rest, fluids, cool-mist humidifier

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17
Q

diagnosis of bronchiolitis/RSV is based off of ___________ and __________ but may include _____ studies or ____________

A

history, physical, viral, chest X-ray

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18
Q

if the weather is hot or if the child with cystic fibrosis participates in vigorous exercise, this should be added to foods

A

extra salt

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19
Q

manifestations include a sudden, violent cough; gagging; wheezing; vomiting; brief apnea; possible cyanosis

A

foreign body aspiration

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20
Q

reversible obstructive airway disease characterized by increased airway responsiveness to a variety of stimuli, bronchospasm resulting from constriction of bronchial smooth muscle, and inflammation and edema of the mucous membranes that line the small airways and the subsequent accumulation of thick secretions in the airways

A

asthma

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21
Q

After the foreign body is removed, oral fluids should be restarted (fast, slowly) and increased as the child tolerates

A

slowly

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22
Q

diagnosis of apnea can be made for shorter periods of time when accompanied by these two conditions

A

bradycardia, cyanosis

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23
Q

these do not cause asthma episodes but can exacerbate symptoms of existing asthma attack

A

emotions

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24
Q

chronic obstructive pulmonary disease that occurs after lung injuries related to supplemental oxygen use and mechanical ventilation as an infant

A

bronchopulmonary dysplasia

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25
Q

worsening manifestations include choking, dysphagia, hoarseness, stridor, coughing, wheezing, decreased breath sounds, respiratory arrest

A

foreign body aspiration

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26
Q

Parents of children with bronchopulmonary dysplasia should be taught about _____________ and any supplemental _____________ and ________________ care needed

A

infection prevention, oxygen, tracheostomy

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27
Q

As cystic fibrosis progresses, patients have an increased risk of developing these two conditions

A

liver disease
diabetes mellitus

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28
Q

sudden onset of apnea, color change, heart rate change, alteration in muscle tone, or altered level of responsiveness in an otherwise healthy infant

A

brief resolved unexplained event (BRUE)

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29
Q

most foreign bodies become lodged in the (left, right) bronchi and can be removed mechanically

A

right

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30
Q

this is often the first sign of cystic fibrosis

A

lack of meconium ileus

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31
Q

should only be used for acute episodes and not to manage or prevent asthma

A

SABAs

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32
Q

manifestations include tachypnea, tachycardia, increased work of breathing, retractions, prolonged exhales, use of accessory muscles, pallor, activity tolerance (feeding difficulties), poor weight gain or weight loss

A

bronchopulmonary dysplasia

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33
Q

50% cases of bronchiolitis are caused by this

A

RSV

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34
Q

if an object is _____________, it may not appear on a chest X-ray

A

nonmetallic

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35
Q

Emergency asthma treatment of an acute episode includes use of __________, inhaled _______________, humidified ___________, IV _________, and an oral or IV ______________.

A

SABA, anticholinergic, oxygen, fluids, corticosteroid

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36
Q

characterized by a dry cough, wheezing, shortness of breath, dyspnea on exertion, and varying degrees of respiratory distress

A

asthma exacerbation

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37
Q

after the initial aspiration, the child can return to normal for _________ or __________

A

hours, weeks

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38
Q

these three factors contribute to foreign body aspiration

A

children’s curiosity
oral needs
lack of supervision

39
Q

significant number of deaths from foreign body aspiration are attributed to these objects

A

latex balloons

40
Q

if they get sick, patients with cystic fibrosis will require a (lower, higher) than normal dose of antibiotics due to (slow, rapid) metabolism of these drugs

A

higher, rapid

41
Q

manifestations include rhinitis, cough (nonproductive that may progress to productive), rhonchi, low-grade fever

A

bronchitis

42
Q

this diagnostic method for foreign body aspiration can confirm diagnosis and remove the object

A

rigid bronchoscopy

43
Q

leading cause of acute and chronic illness in pediatrics and leading cause for frequent hospital admissions

A

asthma

44
Q

Treatment goals for bronchopulmonary dysplasia include maintaining proper _________ and preventing ________________ via giving ___________ and ______________ and supporting __________.

A

oxygenation, further lung damage, oxygen, drug therapy, nutrition

45
Q

treatment of more severe bronchiolitis or respiratory distress includes _______________ for supportive treatment, which includes ___________, _____________, and __________.

A

hospitalization, IV fluids, NPO status, cluster care (rest periods)

46
Q

After the foreign body is removed, the child should remain hospitalized to observe for _________________ caused by edema and soft tissue swelling

A

rebound obstruction

47
Q

the sweat in patients with cystic fibrosis contains abnormally high levels of __________ and ____________, putting them at risk for these three conditions

A

sodium, chloride
hyponatremia, hypochloremia, dehydration

48
Q

treatment for bronchitis is _____________ and includes ________, ________________, and increased ____________.

A

symptomatic, rest, cool-mist humidifier, fluid intake

49
Q

patients with bronchopulmonary dysplasia also often have this heart condition

A

patent ductus arteriosus

50
Q

most significant cause of inpatient admissions for children under age of one

A

bronchiolitis

51
Q

delay in removal of foreign bodies that have been aspirated can cause these three complications

A

aspiration pneumonia
atelectasis
death

52
Q

the sweat test used to diagnose cystic fibrosis is unreliable under this age

A

2 weeks

53
Q

hospitalized patients with bronchiolitis/RSV should be assessed for ___________

A

dehydration

54
Q

female patients with cystic fibrosis may have difficulty becoming pregnant for this reason

A

thickened cervical mucus

55
Q

premature infants at risk of RSV may be given this vaccine to reduce chance of contracting it or reduce the severity

A

Synagis

56
Q

cessation of breathing for 20 seconds or longer

A

apnea

57
Q

people with these three underlying chronic lung problems are more at risk for pneumonia and serious complications

A

AIDS
cystic fibrosis
congenital defects

58
Q

bronchopulmonary dysplasia occurs primarily in these two infant groups

A

low birth weight, premature

59
Q

children diagnosed with bronchopulmonary dysplasia need __________ formula to meet increased metabolic demand of damaged respiratory system

A

high-calorie

60
Q

this treatment helps patients with cystic fibrosis mobilize excess secretions

A

chest physiotherapy (CPT)

61
Q

_____-term management of asthma includes identifying and avoiding triggers to prevent the onset of acute episodes.

A

Long

62
Q

pancreatic enzymes should be administered at this time frame in relation to meals

A

30 minutes before meals

63
Q

primary choice of treatment for patients with cystic fibrosis

A

IV antibiotics

64
Q

RSV is spread by these two methods

A

hand to hand
contact with contaminated surfaces

65
Q

children exposed to this have more frequent upper and lower respiratory complications

A

cigarette smoke

66
Q

For the hospitalized child with pneumonia, these two types of assessments are needed to monitor the patient’s status

A

respiratory, hydration

67
Q

the caloric requirement of a child with cystic fibrosis is ______% more than that of a normal child

A

150

68
Q

acute bronchitis is usually (viral, bacterial) in origin

A

viral

69
Q

these two methods may be necessary to remove mucus buildup in the nasal passages when treating bronchiolitis/RSV

A

saline drops
suctioning

70
Q

two complications of bronchiolitis/RSV that can be identified on a chest X-ray

A

atelectasis, pneumonia

71
Q

two causes of bacterial bronchitis

A

secondary to prolonged viral infection
foreign body aspiration

72
Q

infants with cystic fibrosis may need a special formula that is (less, more) concentrated and __________.

A

more, predigested

73
Q

foreign body aspiration is seen most frequently in this age group

A

6 months to 5 years

74
Q

chronic bronchitis may indicate this

A

underlying respiratory dysfunction

75
Q

50% of all fire-related deaths are due to this

A

smoke

76
Q

Teach the child with pneumonia about these two things

A

coughing, deep breathing

77
Q

aspiration can occur at any age but is most common under the age of _______

A

2 years

78
Q

children with cystic fibrosis have delayed ________

A

puberty

79
Q

with bronchitis, chest X-rays usually show this result

A

normal

80
Q

diagnosis of bronchopulmonary dysplasia is made if respiratory symptoms persist after ________ of life, need oxygen by _______ of life and is dependent by ________ of life, or those who need to be mechanically intubated in ____________ of life

A

28 days, 1-2 weeks, 28 days, first week

81
Q

Parents of children with bronchopulmonary dysplasia should be included in ___________ of the infants

A

basic care

82
Q

in asthma patients, pulmonary function tests show decreased _______________, increased _______________, and decreased _____________________.

A

vital capacity, residual volume, forced expiratory volume

83
Q

cystic fibrosis patients have an inability to absorb these vitamins

A

fat-soluble vitamins (A, D, E, K)

84
Q

preventive measures for bronchopulmonary dysplasia include _______ restriction, administration of supplemental ___________ and __________, and use of __________

A

fluid, vitamin A, surfactant, CPAP (continuous positive airway pressure)

85
Q

acute bronchitis resolves within _________

A

2 weeks

86
Q

most commonly used medications for long-term management of asthma

A

inhaled corticosteroids

87
Q

foreign bodies that become lodged in the _________ cause edema which can result in airway obstruction

A

larynx

88
Q

characterized by thickening of the alveolar walls and bronchiolar epithelium

A

bronchopulmonary dysplasia

89
Q

complication of acute asthma episode in which the patient is not responsive to emergency medication and symptoms are getting worse

A

status asthmaticus

90
Q

most often age range for children to get BRUEs

A

2 months to one year

91
Q

digestive system involvement in cystic fibrosis is marked by these two manifestations

A

steatorrhea
excess flatus

92
Q

dosage of pancreatic enzymes varies based on stool formation: (lower, higher) dose for constipation and (lower, higher) dose for loose, fatty stools

A

lower, higher

93
Q

As cystic fibrosis progresses, ____________ and _____________ occur, and scarring in the lungs can lead to _________________.

A

atelectasis, emphysema, congestive heart failure

94
Q

prevention of RSV involves these two things

A

meticulous hand hygiene
avoiding crowds