ENPC 6th Ed Chap 8 Child with Cough

Question 1

Red flags during respiratory assessment? (8)

Answer 1

1. AMS
2. anxiety
3. central cyanosis
4. decreased or absent air movement w/ auscultation
5. POX <92%
6. prolonged capillary refill
7. Rate >60
8. Suprasternal retraction (tracheal tugging) (119)

Question 1

Seven signs of increased work of breathing?

Answer 1

1. abnormal posture
2. grunting
3. head bobbing
4. nasal flaring
5. retractions
6. accessory muscle use
7. tachypnea (119)

Question 2

What does a silent chest imply?

Answer 2

Air is not moving and immediate action is required (119)

Question 3

Predominant cause of pneumonia in a neonate < 7 days old?

Answer 3

1. amniotic fluid aspiration
2. transplacental transmission (120 T)

Question 4

Predominant cause of pneumonia in a > 7 days old?

Answer 4

1. parental transmission
2. prolonged hospital stay
3. anomaly of the airway
   (120)

Question 5

Predominant cause of pneumonia in an infant/child < 5 years old?

Answer 5

Viral (120)

Question 6

Predominant cause of pneumonia in a child > 5 years old?

Answer 6

Bacterial

Question 7

What causes Bronchiolitis?

Answer 7

RSV (119)

Question 8

What age range does RSV/bronchiolitis affect?

Answer 8

< 2 (119)

Question 9

What are the “Three Ds of Epiglottitis”?

Answer 9

1. drooling
2. dysphagia
3. distress (123)

Question 10

What are some signs of epiglottitis?

Answer 10

1. high fever
2. symptoms evolve suddenly, over the course of hours
   3, muffled voice (hot potato voice)

Question 11

What type of airway is preferred in epiglottitis patients?

Answer 11

ETT as an LMA may not as effective (123)

Question 12

What is the usual causative agent of croup?

Answer 12

viral (124)

Question 13

At what age can children use a peak flow meter?

Answer 13

Age 6 (123)

Question 14

What is the most common causative agent for epiglottitis?

Answer 14

Hemophilus influenza type B (123)

Question 15

What causes Croup?

Answer 15

A virus, usually resolves in 3 days

Question 16

What causes Pertussis and what age group does it usually affect?

Answer 16

Bordetella pertussis bacteria
< 4 years old who are not immunized
also known as whooping cough

Question 17

What are the three stages of whooping cough?

Answer 17

1. Catarrhal - 2 weeks of mild cold
2. Paroxysmal – coughing spells start and may last 8 weeks, post-tussive vomiting can occur
3. Convalescent stage –cough subsides over weeks to months (126)

Question 18

What is a “Steeple Sign”?

Answer 18

Upper airway narrowing that can be seen in Croup (125)