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

Question 1

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

Answer 1

CT, MRI, chest X-ray, fluoroscopy

Question 2

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

Answer 2

immunotherapy (allergy shots)

Question 3

this percentage of male patients with cystic fibrosis are sterile

Answer 3

95%

Question 4

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

Answer 4

diuretics
bronchodilators
theophylline
caffeine

Question 5

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

Answer 5

cystic fibrosis

Question 6

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)

Answer 6

bronchiolitis/RSV

Question 7

inherited multisystem disorder characterized by widespread dysfunction of exocrine glands

Answer 7

cystic fibrosis

Question 8

most common agent that causes acute bronchitis

Answer 8

rhinovirus

Question 9

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

Answer 9

multiple, long-acting medications

Question 10

onset of asthma is typically at this age

Answer 10

before age 6 years

Question 11

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

Answer 11

acute respiratory distress syndrome (ARDS)

Question 12

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

Answer 12

30 minutes

Question 13

in asthma patients, chest X-rays show this

Answer 13

normal

Question 14

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

Answer 14

calorie, protein, fat-soluble vitamins

Question 15

when treating bronchitis, antibiotics are reserved for this type

Answer 15

bacterial confirmed with a culture

Question 16

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

Answer 16

rest, fluids, cool-mist humidifier

Question 17

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

Answer 17

history, physical, viral, chest X-ray

Question 18

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

Answer 18

extra salt

Question 19

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

Answer 19

foreign body aspiration

Question 20

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

Answer 20

asthma

Question 21

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

Answer 21

slowly

Question 22

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

Answer 22

bradycardia, cyanosis

Question 23

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

Answer 23

emotions

Question 24

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

Answer 24

bronchopulmonary dysplasia

Question 25

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

Answer 25

foreign body aspiration

Question 26

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

Answer 26

infection prevention, oxygen, tracheostomy

Question 27

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

Answer 27

liver disease diabetes mellitus

Question 28

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

Answer 28

brief resolved unexplained event (BRUE)

Question 29

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

Answer 29

right

Question 30

this is often the first sign of cystic fibrosis

Answer 30

lack of meconium ileus

Question 31

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

Answer 31

SABAs

Question 32

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

Answer 32

bronchopulmonary dysplasia

Question 33

50% cases of bronchiolitis are caused by this

Answer 33

RSV

Question 34

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

Answer 34

nonmetallic

Question 35

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

Answer 35

SABA, anticholinergic, oxygen, fluids, corticosteroid

Question 36

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

Answer 36

asthma exacerbation

Question 37

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

Answer 37

hours, weeks

Question 38

these three factors contribute to foreign body aspiration

Answer 38

children's curiosity oral needs lack of supervision

Question 39

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

Answer 39

latex balloons

Question 40

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

Answer 40

higher, rapid

Question 41

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

Answer 41

bronchitis

Question 42

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

Answer 42

rigid bronchoscopy

Question 43

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

Answer 43

asthma

Question 44

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

Answer 44

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

Question 45

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

Answer 45

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

Question 46

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

Answer 46

rebound obstruction

Question 47

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

Answer 47

sodium, chloride hyponatremia, hypochloremia, dehydration

Question 48

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

Answer 48

symptomatic, rest, cool-mist humidifier, fluid intake

Question 49

patients with bronchopulmonary dysplasia also often have this heart condition

Answer 49

patent ductus arteriosus

Question 50

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

Answer 50

bronchiolitis

Question 51

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

Answer 51

aspiration pneumonia atelectasis death

Question 52

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

Answer 52

2 weeks

Question 53

hospitalized patients with bronchiolitis/RSV should be assessed for ___________

Answer 53

dehydration

Question 54

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

Answer 54

thickened cervical mucus

Question 55

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

Answer 55

Synagis

Question 56

cessation of breathing for 20 seconds or longer

Answer 56

apnea

Question 57

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

Answer 57

AIDS cystic fibrosis congenital defects

Question 58

bronchopulmonary dysplasia occurs primarily in these two infant groups

Answer 58

low birth weight, premature

Question 59

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

Answer 59

high-calorie

Question 60

this treatment helps patients with cystic fibrosis mobilize excess secretions

Answer 60

chest physiotherapy (CPT)

Question 61

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

Answer 61

Long

Question 62

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

Answer 62

30 minutes before meals

Question 63

primary choice of treatment for patients with cystic fibrosis

Answer 63

IV antibiotics

Question 64

RSV is spread by these two methods

Answer 64

hand to hand contact with contaminated surfaces

Question 65

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

Answer 65

cigarette smoke

Question 66

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

Answer 66

respiratory, hydration

Question 67

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

Answer 67

150

Question 68

acute bronchitis is usually (viral, bacterial) in origin

Answer 68

viral

Question 69

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

Answer 69

saline drops suctioning

Question 70

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

Answer 70

atelectasis, pneumonia

Question 71

two causes of bacterial bronchitis

Answer 71

secondary to prolonged viral infection foreign body aspiration

Question 72

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

Answer 72

more, predigested

Question 73

foreign body aspiration is seen most frequently in this age group

Answer 73

6 months to 5 years

Question 74

chronic bronchitis may indicate this

Answer 74

underlying respiratory dysfunction

Question 75

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

Answer 75

smoke

Question 76

Teach the child with pneumonia about these two things

Answer 76

coughing, deep breathing

Question 77

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

Answer 77

2 years

Question 78

children with cystic fibrosis have delayed ________

Answer 78

puberty

Question 79

with bronchitis, chest X-rays usually show this result

Answer 79

normal

Question 80

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

Answer 80

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

Question 81

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

Answer 81

basic care

Question 82

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

Answer 82

vital capacity, residual volume, forced expiratory volume

Question 83

cystic fibrosis patients have an inability to absorb these vitamins

Answer 83

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

Question 84

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

Answer 84

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

Question 85

acute bronchitis resolves within _________

Answer 85

2 weeks

Question 86

most commonly used medications for long-term management of asthma

Answer 86

inhaled corticosteroids

Question 87

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

Answer 87

larynx

Question 88

characterized by thickening of the alveolar walls and bronchiolar epithelium

Answer 88

bronchopulmonary dysplasia

Question 89

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

Answer 89

status asthmaticus

Question 90

most often age range for children to get BRUEs

Answer 90

2 months to one year

Question 91

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

Answer 91

steatorrhea excess flatus

Question 92

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

Answer 92

lower, higher

Question 93

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

Answer 93

atelectasis, emphysema, congestive heart failure

Question 94

prevention of RSV involves these two things

Answer 94

meticulous hand hygiene avoiding crowds