Common Respiratory Disorders in Pediatrics Flashcards
Why do kids have so many respiratory infections?
- not good at hand hygiene
- germy little people
Primary Preventions to Decrease Likelihood of Respiratory Illnesses
- proper use of tissues (throw away after)
- washing hands
- not sharing utensils
- use of paper cups
- washing toys
- outdoor activity
- limit exposure to those who are ill
- change toothbrushes w/ each URI and every 3 months
Differences between infants/children and adult respiratory systems
- funnel shaped larynx
- increased RR
- fatigue easily
- bronchiole measures 4mm vs. 8mm in adults
- larger tongue (can obstruct airway)
- 80% of pediatric arrests are d/t respiratory arrest
- obligate nasal breathers until 4-6wks
- shorter neck
- smaller, shorter, narrower airways > more susceptible to airway obstruction and resp distress
- smaller lung capacity
- rely on diaphragm breathing > high risk for resp failure if diaphragm unable to contract
S/Sx of Respiratory Distress
- head bobbing
- snoring
- nasal flaring
- retractions: slight solitary intercostal retractions may be normal in infants d/t pliability of rib cage
- poor feeding
*if RR over 60, should be NPO b/c at risk for aspiration
Upper Airway Obstruction: S/Sx
retractions w/ stridor or snoring (inspiratory)
Lower Airway Obstruction: S/Sx
retractions w/ expiratory wheeze
Children under 6 not advised to use which meds:
- cough medicine
- expectorants
- decongestants
- antihistamines
- zinc
- vitamin C
Cold: S/Sx
- secretions of varying colors
- mild erythema of throat (no exudate)
- freely moveable nodes
- lungs are clear
Cold: Management
- acetaminophen or ibuprofen
- small frequent amounts of fluids to stay hydrated
- cool mist humidifier (change water daily and clean w/ vinegar to prevent mold)
- call if symptoms persist for more than 10 days or get worse
Sinusitis: Sx
- runny nose w/ yellow/greenish discharge
- fever
- headache
- anorexia
Sinusitis: Tx
- antibiotics (amoxicillin)
- Neti Pot
Tonsillitis/Pharyngitis: Viral Sx
90% are viral
- gradual onset
- low grade fever
- mild headache
- loss of appetite
- sore throat
- horse voice
- productive cough
Tonsillitis/Pharyngitis: Viral Management
Throat cx to r/o GABHS
comfort measures (salt water gargles, throat lozenges), fluids
Tonsillitis/Pharyngitis: Bacterial Sx
much more dramatic
- fever
- headache
- n/v
- sore throat
- increased cervical nodes and tender
- muscle aches
- petechiae on palate
- swollen/red uvula
- red enlarged tonsils w/ exudate
- bad breath
- strawberry tongue
*bacteria is usually strep
Tonsillitis/Pharyngitis: Bacterial Management
- throat cx
- antibiotics (penicillin)
- comfort measures (salt water gargles)
*can return to class when afrebrile and after 24 hours of starting antibiotics
Tonsillitis/Pharyngitis: Bacterial Complications
tonsillar abscess
AOM
mastoiditis
Complications of Strep Infections
- rheumatic fever (inflammatory disease of heart, joints, and CNS)
- acute glomerulonephritis (PSGN): acute kidney infection > renal failure
- surgery - tonsillectomy indicated for: recurrent symptomatic hypertrophy, s/sx of obstruction, chronic infection
Post Tonsillectomy Care
- comfort measures
- meds ATC
- ice collar
- HOB at 30 degrees
- cool fluids
- tonsil soft diet (no hard foods)
- no straws
- monitor for bleeding
Acute Otitis Media (AOM)
- inflammation of the middle ear
- may be caused by microorganisms (bacterial or viral)
- primarily result of dysfunctional eustachian tubes (short, wide and may be blocked by adenoids)
AOM: Clinical Manifestations
- pain and discomfort
- irritable
- pull at ears
- up at night
- decreased appetite
- fever
- may have draining ears (ruptured TM)
- visual exam = red, bulging ear drum, no clear landmark, opaque
AOM: Tx/Nursing Interventions
- high dose amoxicillin
- ceftriaxone if sick
- pain control
- monitor for complications
Serous Otitis/Otitis Media w/ Effusion
fluid in the middle ear
-prevention = prevnar
Serous Otitis: Clinical Manifestations
- decreased hearing
- visual exam = a little red, dull TM, fluid w/ air bubbles
Serous Otitis: Tx
time
tx if more than 3 months unless or interferes w/ speech or not resolving over time
-place PET tubes
Serous Otitis: Nursing Interventions
- pain control
- ear wicks if draining
- education regarding antibiotic use
- swimming w/ PETs
- second hand smoke exposure
Otitis Externa
swimmer’s ear
may also be caused by formula dribbling in the ear or if child puts head in bath water
Otitis Externa: Clinical Manifestations
- begins often w/ itching
- pain w/ touching outer ear or around ear
- pain w/ movement
Otitis Externa: Tx
antibiotic ear drops (Corticosporin or Floxin)
Otitis Externa: Prevention
alcohol
white vinegar
in each ear at the end of swimming
Foreign Body in Nose
remove object
antibiotics if needed for secondary infection
Rhinitis
inflammation of mucous membranes
may be caused by:
-allergies
Rhinitis d/t Allergies: Sx
- clear nasal discharge
- boggy/pale turbinate
- sneeze in bouts
- no fever
- allergic salute
- allergic shiners
Rhinitis: Tx
- remove allergen
- antihistamines
- immunotherapy (subQ allergy shots)
