Chapter 45: The Child with a Respiratory Alteration (Part 2- Lower Airway) Flashcards
four diagnostic methods that can be used to visualize the foreign body that has been aspirated
CT, MRI, chest X-ray, fluoroscopy
this treatment can help decrease asthma symptoms if a specific allergen is identified and it cannot be avoided
immunotherapy (allergy shots)
this percentage of male patients with cystic fibrosis are sterile
95%
four types of drug therapy used to reduce pulmonary edema and lessen airway resistance in bronchopulmonary dysplasia
diuretics
bronchodilators
theophylline
caffeine
characterized by abnormal secretions of thick, tenacious mucus and obstruction and dysfunction of the pancreas, lungs, salivary glands, sweat glands, and reproductive organs
cystic fibrosis
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)
bronchiolitis/RSV
inherited multisystem disorder characterized by widespread dysfunction of exocrine glands
cystic fibrosis
most common agent that causes acute bronchitis
rhinovirus
if a patient is using SABA _____________ times a week, the patient should be evaluated for need for __________________.
multiple, long-acting medications
onset of asthma is typically at this age
before age 6 years
severe diffuse lung injury involving breakdown in the alveolar-capillary barrier; precipitated by a variety of illnesses
acute respiratory distress syndrome (ARDS)
encourage patients with asthma to take a short-acting inhaler _____________ before exercise to reduce symptoms
30 minutes
in asthma patients, chest X-rays show this
normal
diet for cystic fibrosis should be high _________ and high ___________ with replacements of ________________.
calorie, protein, fat-soluble vitamins
when treating bronchitis, antibiotics are reserved for this type
bacterial confirmed with a culture
mild bronchiolitis can be treated by utilizing _______, _________, and a bedside ______________.
rest, fluids, cool-mist humidifier
diagnosis of bronchiolitis/RSV is based off of ___________ and __________ but may include _____ studies or ____________
history, physical, viral, chest X-ray
if the weather is hot or if the child with cystic fibrosis participates in vigorous exercise, this should be added to foods
extra salt
manifestations include a sudden, violent cough; gagging; wheezing; vomiting; brief apnea; possible cyanosis
foreign body aspiration
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
asthma
After the foreign body is removed, oral fluids should be restarted (fast, slowly) and increased as the child tolerates
slowly
diagnosis of apnea can be made for shorter periods of time when accompanied by these two conditions
bradycardia, cyanosis
these do not cause asthma episodes but can exacerbate symptoms of existing asthma attack
emotions
chronic obstructive pulmonary disease that occurs after lung injuries related to supplemental oxygen use and mechanical ventilation as an infant
bronchopulmonary dysplasia
worsening manifestations include choking, dysphagia, hoarseness, stridor, coughing, wheezing, decreased breath sounds, respiratory arrest
foreign body aspiration
Parents of children with bronchopulmonary dysplasia should be taught about _____________ and any supplemental _____________ and ________________ care needed
infection prevention, oxygen, tracheostomy
As cystic fibrosis progresses, patients have an increased risk of developing these two conditions
liver disease
diabetes mellitus
sudden onset of apnea, color change, heart rate change, alteration in muscle tone, or altered level of responsiveness in an otherwise healthy infant
brief resolved unexplained event (BRUE)
most foreign bodies become lodged in the (left, right) bronchi and can be removed mechanically
right
this is often the first sign of cystic fibrosis
lack of meconium ileus
should only be used for acute episodes and not to manage or prevent asthma
SABAs
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
bronchopulmonary dysplasia
50% cases of bronchiolitis are caused by this
RSV
if an object is _____________, it may not appear on a chest X-ray
nonmetallic
Emergency asthma treatment of an acute episode includes use of __________, inhaled _______________, humidified ___________, IV _________, and an oral or IV ______________.
SABA, anticholinergic, oxygen, fluids, corticosteroid
characterized by a dry cough, wheezing, shortness of breath, dyspnea on exertion, and varying degrees of respiratory distress
asthma exacerbation
after the initial aspiration, the child can return to normal for _________ or __________
hours, weeks
these three factors contribute to foreign body aspiration
children’s curiosity
oral needs
lack of supervision
significant number of deaths from foreign body aspiration are attributed to these objects
latex balloons
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
higher, rapid
manifestations include rhinitis, cough (nonproductive that may progress to productive), rhonchi, low-grade fever
bronchitis
this diagnostic method for foreign body aspiration can confirm diagnosis and remove the object
rigid bronchoscopy
leading cause of acute and chronic illness in pediatrics and leading cause for frequent hospital admissions
asthma
Treatment goals for bronchopulmonary dysplasia include maintaining proper _________ and preventing ________________ via giving ___________ and ______________ and supporting __________.
oxygenation, further lung damage, oxygen, drug therapy, nutrition
treatment of more severe bronchiolitis or respiratory distress includes _______________ for supportive treatment, which includes ___________, _____________, and __________.
hospitalization, IV fluids, NPO status, cluster care (rest periods)
After the foreign body is removed, the child should remain hospitalized to observe for _________________ caused by edema and soft tissue swelling
rebound obstruction
the sweat in patients with cystic fibrosis contains abnormally high levels of __________ and ____________, putting them at risk for these three conditions
sodium, chloride
hyponatremia, hypochloremia, dehydration
treatment for bronchitis is _____________ and includes ________, ________________, and increased ____________.
symptomatic, rest, cool-mist humidifier, fluid intake
patients with bronchopulmonary dysplasia also often have this heart condition
patent ductus arteriosus
most significant cause of inpatient admissions for children under age of one
bronchiolitis
delay in removal of foreign bodies that have been aspirated can cause these three complications
aspiration pneumonia
atelectasis
death
the sweat test used to diagnose cystic fibrosis is unreliable under this age
2 weeks
hospitalized patients with bronchiolitis/RSV should be assessed for ___________
dehydration
female patients with cystic fibrosis may have difficulty becoming pregnant for this reason
thickened cervical mucus
premature infants at risk of RSV may be given this vaccine to reduce chance of contracting it or reduce the severity
Synagis
cessation of breathing for 20 seconds or longer
apnea
people with these three underlying chronic lung problems are more at risk for pneumonia and serious complications
AIDS
cystic fibrosis
congenital defects
bronchopulmonary dysplasia occurs primarily in these two infant groups
low birth weight, premature
children diagnosed with bronchopulmonary dysplasia need __________ formula to meet increased metabolic demand of damaged respiratory system
high-calorie
this treatment helps patients with cystic fibrosis mobilize excess secretions
chest physiotherapy (CPT)
_____-term management of asthma includes identifying and avoiding triggers to prevent the onset of acute episodes.
Long
pancreatic enzymes should be administered at this time frame in relation to meals
30 minutes before meals
primary choice of treatment for patients with cystic fibrosis
IV antibiotics
RSV is spread by these two methods
hand to hand
contact with contaminated surfaces
children exposed to this have more frequent upper and lower respiratory complications
cigarette smoke
For the hospitalized child with pneumonia, these two types of assessments are needed to monitor the patient’s status
respiratory, hydration
the caloric requirement of a child with cystic fibrosis is ______% more than that of a normal child
150
acute bronchitis is usually (viral, bacterial) in origin
viral
these two methods may be necessary to remove mucus buildup in the nasal passages when treating bronchiolitis/RSV
saline drops
suctioning
two complications of bronchiolitis/RSV that can be identified on a chest X-ray
atelectasis, pneumonia
two causes of bacterial bronchitis
secondary to prolonged viral infection
foreign body aspiration
infants with cystic fibrosis may need a special formula that is (less, more) concentrated and __________.
more, predigested
foreign body aspiration is seen most frequently in this age group
6 months to 5 years
chronic bronchitis may indicate this
underlying respiratory dysfunction
50% of all fire-related deaths are due to this
smoke
Teach the child with pneumonia about these two things
coughing, deep breathing
aspiration can occur at any age but is most common under the age of _______
2 years
children with cystic fibrosis have delayed ________
puberty
with bronchitis, chest X-rays usually show this result
normal
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
28 days, 1-2 weeks, 28 days, first week
Parents of children with bronchopulmonary dysplasia should be included in ___________ of the infants
basic care
in asthma patients, pulmonary function tests show decreased _______________, increased _______________, and decreased _____________________.
vital capacity, residual volume, forced expiratory volume
cystic fibrosis patients have an inability to absorb these vitamins
fat-soluble vitamins (A, D, E, K)
preventive measures for bronchopulmonary dysplasia include _______ restriction, administration of supplemental ___________ and __________, and use of __________
fluid, vitamin A, surfactant, CPAP (continuous positive airway pressure)
acute bronchitis resolves within _________
2 weeks
most commonly used medications for long-term management of asthma
inhaled corticosteroids
foreign bodies that become lodged in the _________ cause edema which can result in airway obstruction
larynx
characterized by thickening of the alveolar walls and bronchiolar epithelium
bronchopulmonary dysplasia
complication of acute asthma episode in which the patient is not responsive to emergency medication and symptoms are getting worse
status asthmaticus
most often age range for children to get BRUEs
2 months to one year
digestive system involvement in cystic fibrosis is marked by these two manifestations
steatorrhea
excess flatus
dosage of pancreatic enzymes varies based on stool formation: (lower, higher) dose for constipation and (lower, higher) dose for loose, fatty stools
lower, higher
As cystic fibrosis progresses, ____________ and _____________ occur, and scarring in the lungs can lead to _________________.
atelectasis, emphysema, congestive heart failure
prevention of RSV involves these two things
meticulous hand hygiene
avoiding crowds
