Child with Respiratory Disorder

Question 1

NINE major differences between adult and child respiratory systems

Answer 1

1. child chest wall is round, trachea bifurcates higher
2. child diaphragm is more immature and fatigues easily
3. internal organs reduce expansion
4. children are obligate nose breathers
5. children have narrower airways, therefore higher airway resistance; respiratory edema leads to higher reduction of airway lumen
6. bronchial walls are more immature
7. poorer developed cilia in lungs
8. insufficient surfactant (preemies or mom w GDM)
9. fewer alveoli until 2 yo

Question 2

signs of respiratory difficulty in children

Answer 2

mouth breathing, exhaustion, nasal flaring

Question 3

signs of increased airway resistance in children

Answer 3

increased RR, retractions, flaring, accessory muscle use

Question 4

signs of bronchial wall difficulties in children

Answer 4

dry night cough, chest tightness

Question 5

upper airway infection types

Answer 5

rhinitis, pharyngitis, tonsillitis, laryngitis, otitis media

Question 6

lower airway infection types

Answer 6

pneumonia, bronchiolitis, bronchitis

Question 7

respiratory assessment for children

Answer 7

respiratory rate, depth, and rhythm; retractions; flaring; oxygenation, HR, temp; LOC; hydration, level activity comfort.

Question 8

respiratory interventions for children

Answer 8

ease effort, promote comfort and hydration, decrease fever, sufficient nutrition; early intervention is VITAL

Question 9

causes of URI

Answer 9

rhinovirus, RSV, influenza

Question 10

S/S of URI

Answer 10

rhinitis, congestion, sore throat, cough, sneeze

Question 11

URI tx

Answer 11

primarily supportive – hydration, analgesic. NO ABX if caused by virus!

Question 12

Whooping Cough: cause, preventive tx

Answer 12

Bordetella pertussis

very contagious – get immunized!

Question 13

acute otitis media; tx

Answer 13

inflammation of middle ear

tx: ABX; may need surgical incision or tube implanted in tympanic membranes to ease psi.

if not tx, may lead to deafness

Question 14

Group A streptococcus may lead to WHAT

Answer 14

rheumatic fever

Question 15

influenza is what

Answer 15

highly contagious and viral; seasonal

Question 16

Croup

Answer 16

viral infection of larynx

Question 17

croup s/s

Answer 17

barking cough, inspiratory stridor, hoarseness, fever, other URI s/s

Question 18

croup tx

Answer 18

at home: hydration, humid air, 3-5 days

if severe: supplementary oxygen, IV fluids; corticosteroids to open airways

Question 19

asthma

Answer 19

chronic inflammation/hypersensitivity of air passages to the lungs.

maintain airway patency, rest, o2 sats

VERY common in children

Question 20

bronchitis

Answer 20

inflammation of larger lower airways, very common after viral infection

Question 21

bronchitis s/s

Answer 21

dry, hacking cough; may be febrile

Question 22

bronchitis tx

Answer 22

supportive; bronchodilators, steroids, pain meds; humidify air; ABX if bacterial cause suspected

Question 23

bronchiolitis

Answer 23

acute viral infection cause (usually RSV 80% of cases)

Question 24

bronchiolitis s/s

Answer 24

coughing, rhinorrhea, increased RR, increased WOB, hypoxia, vomiting, wheezing, crackles, fever

Question 25

bronchiolitis tx

Answer 25

supportive. nebulized saline may help, o2 may be used

Question 26

RSV/respiratory syncytial virus S/s

Answer 26

initial: rhinorrhea, decreased appetite, cough, sneeze, fever, wheeze

later: increase RR, grunting, chest caving, blue skin

Question 27

pneumonia

Answer 27

inflamed air sacs, may fill with purulent material

Question 28

viral pneumonia

Answer 28

bacterial infection following viral infection

Question 29

bacterial pneumonia most commonly caused by

Answer 29

staph

Question 30

pneumonia dx

Answer 30

chest X ray, crackles and decreased breath sounds

Question 31

bacterial pneumonia tx

Answer 31

abx - amoxicillin

Question 32

tonsilitis tx and post-care

Answer 32

tonsillectomy/adenoidectomy

watch for hemorrhage; position to promote drainage

Question 33

foreign body in LRT s/s dx

Answer 33

sudden onset, asymmetrically decreased breath sounds.

X=ray to ID