Exam 2 Respiratory Flashcards

1
Q

Describe Moderate dehydration in pediatric clients:

Weight loss % infants:
Weight loss % child:
Pulse: 
RR:
BP:
Anterior fontanel:
Cap refill:
Turgor:
Urine:
Behavior:
Mucous membranes:
A
Weight loss % infants:  6-9%
Weight loss % child: 6-8%
Pulse:  mildly increased
RR: slight tachypnea
BP: normal to orthostatic ( > 10mmHg change)
Anterior fontanel:  Normal to sunken
Cap refill: 2-4 seconds
Turgor: decreased
Urine: Oliguria
Behavior: irritable and thirsty
Mucous membranes:  dry
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2
Q

Acute Laryngealtracheobronchitis Treatment

A
  • Decadron (corticosteroid) *reduces inflammation

- racemic epinephrine *relaxes smooth muscles

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3
Q

Acute Laryngealtracheobronchitis Causes

A

Virus

Upper respiratory Tract Infection

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4
Q

Acute Laryngealtracheobronchitis Age Group

A

Infant or Child <5 yrs

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5
Q

Acute Laryngealtracheobronchitis S/S

A
  • barky/seal-like cough
  • nighttime exacerbation
  • lung sounds: inspiratory stridor
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6
Q

Epiglottis Causes

A

Bacteria

-H. influenza

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7
Q

Epiglottis Ages

A

Ages 2-5 yrs

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8
Q

Epiglottis Treatment

A
  • IV corticosteroids

- Antibiotics

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9
Q

Epiglottis Prevention

A

HIB vaccine

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10
Q

Epiglottis S/S

A
  • muffled voice
  • froggy cough
  • tripod sitting
  • drooling
  • Stridor when supine
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11
Q

Epiglottis

A

MEDICAL EMERGENCY

-rapid/acute onset

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12
Q

Respiratory Syncytial Virus (RSV) Causes

A

Virus

  • At bronchiolar level
  • Lower respiratory infection
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13
Q

Respiratory Syncytial Virus (RSV) Assessment

A
  • Premature infants
  • Multiples (Twins)
  • Ages older than 3 have at it at least once
  • Less than 1 month presents as apnea
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14
Q

Respiratory Syncytial Virus (RSV) S/S

A
  • Congestive Cough
  • Clear and Cloudy drainage
  • Thick layer of mucus in the airway
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15
Q

Respiratory Syncytial Virus (RSV) Treatment

A
  • Suction
  • supportive care: antipyretics, fluids, ant

DO NOT GIVE: Corticosteroids, antibiotics, antihistamines, antivirals

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16
Q

Respiratory Syncytial Virus (RSV) Prevention

A
  • Synagis Vaccine
  • Kissing babies on lips
  • Spit sharing
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17
Q

Pertussis AKA Whooping cough Causes

A
  • Bacterial infection
  • Bordatella pertussis

Highly contagious

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18
Q

Pertussis Mechanism

A

-Bacteria releases toxins which inhibits cilia than increases inflammation, can’t clear lung secretions which leads to congestive coughing

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19
Q

Pertussis S/S

A

-Frequent congestive cough

-

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20
Q

Pertussis Prevention

A
  • DTap vaccine

- Family vaccination important

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21
Q

Pertussis Treatment

A
  • antibiotics (-mycin)
  • antipyretics (ibuprofen, acetaminophen)
  • sideline position for aspiration
  • fluids
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22
Q

Type 1 Diabetes S/S

A
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23
Q

Hypoglycemia <60

A
  • Rapid onset
  • Skin pallor
  • Respiration: low/shallow
  • Seizure, shock, coma
  • Negative ketones
  • Ph normal
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24
Q

Toddler/pre-schoolers <6 yrs

-Blood glucose and A1c Values

A

Blood glucose before meals: 100-180
Blood glucose at bedtime: 110-200
A1c: 7.5-8.5

*High risk for hypoglycemia

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25
School age 6-12 yrs | -Blood glucose and A1c Values
Blood glucose before meals: 90-180 Blood glucose at bedtime: 100-180 A1c: <8 *High risk for hypoglycemia low risk for complications before puberty
26
Adolescents >12 yrs | -Blood glucose and A1c Values
Blood glucose before meals: 90-130 Blood glucose at bedtime: 90-150 A1c: <7.5
27
epiglottis
Prepare for emergency intubation, assess vital signs, and listen to breath sounds
28
Best way to way monitor weight in a child with dehydration?
Daily weights, same scale, same time
29
Components of RAPID+
``` R: Rapid heart rate A: Altered color P: Pee nonexistent I: Inability to interact w/ environment D: Decreased blood pressure ``` Rapid bolus 20/kg over 5-10 minutes
30
What patients would you alter how fast to give fluids?
Pt with Cardiac and Renal disease
31
Oral rehydration
- Formula/breastmilk | - Pedialyte
32
Determine the severity of asthma
Peak flow meter
33
The order in which drugs are given via svn to a patient w/ cystic fibrosis
Albuterol 1st and than Dornase Alpha (pulmonary enzyme)
34
Severe dehydration
Tachycardia, sunken fontanel, and decreased blood pressure, >10% weight loss
35
What is prodromal(early) symptom for asthma?
Itching on the back of the neck
36
Infants and children are more prone to respiratory distress
- Large tongue - long floppy apiglottis - short neck - horizontal face - funnel shaped airway - less alveoli
37
Minimun urine output in 10kg infant over 8 hrs
10x1.5=15 15x8=120ml 120ml!
38
Acute Laryngealtracheobronchitis
Provide cool mist and observe for signs of respiratory distress
39
S/S Respiratiry sitress
- Stridor - head bobbing - retraxtions - nasal flaring - tachycardia
40
What defect in the cystic fibrosis transmembrane regulating gene cause
Na and H2O are unable to cross the chloride channel causing secretions to become thick
41
First S/S of cystic fibrosis in an infant
Meconium ileus | -Older children can get rectal prolapse
42
Nephrotic syndrome
Frothy urine
43
RSV
Encourage hydration, cluster care, provide oxygen as needed
44
Breathe sounds that are signs of emergencies
-Inspiratory stridor at rest
45
Acute Glomerulonephritis
- Tea colored urine - +RBCs in urine - +ASO titer (strep infection)
46
Correct number ml/kg given as oral rehydration in a mildly dehydration
50ml/kg
47
Mainitance Drugs for Asthma
Bronchodilator: - morning or at night - 2 hr before exercise
48
Who get Synagis
- Prematures - immunocompromised - Lung and congenital heart defects - once a month IM during RSV season
49
Respiratory Differences from adults and children
- long floppy epiglottis - large tongue - short neck - nose breather - funnel airway - diaphragmatic breathers - Low alveoli - Alveoli walls thick - smaller nasopharynx - immature muscles - prominent occiput - premature cilia
50
Cystic Fibrosis
-Defective/mutated gene on chromosome 7
51
Cystic Fibrosis Pathophysiology
No CFTR = no Cl pump = no water in secretions = think secretions
52
Cystic Fibrosis S/S
- Thick mucus - Clogged airways - Bacterial growth in airways when mucus in thick leads to infection - Salty skin
53
Cystic Fibrosis how it affects Lungs
- thick mucus - clogged airways - bacteria loves mucus - pneumothorax - pneumonia - emphysema
54
Cystic Fibrosis how it affects Pancreas
- insufficiency in enzymes due to ducts blocked with mucus - treated with pancrelipase (creon) - CF related DM (insulin resistance and deficiency)
55
Cystic Fibrosis how it affects GI
Small intestine: - inspissated meconium - obstruction of small intestine - rectal prolaps Malabsorption issues - Steatorrhea: bulky stools frothy from undigested fats - Azortorrhea: foul smell from putrefied stool
56
Cystic Fibrosis Treatment
-Give fat soluble vitamins (ADEK) -Give creon within 30 min of eating meals (helps absorb fats) Airway clearance therapies: -huffing -continuous postural -high frequency chest compressions -exercise
57
Cystic Fibrosis Treatment Meds
``` CFRD: oral glucose tolerance test Maintenance: -bronchodilators -hypertonic saline -Dornase alfa: cough medicine Antibiotics ``` *Use oxygen cautiously C02 retention
58
Asthma S/S
- wheezing - breathlessness - chest tightness Early signs of asthma: -Prodromal itching: front of neck/upper back Chronic signs: -coughing w/out infection or expiratory breathing
59
How to judge Asthma Severity
Peak flow meter *kids older than 5yrs - Green: good - Yellow: not well controlled, possible exacerbation - Red: severe narrowing of airways (give short acting bronchodilator)
60
Asthma Triggers
control allergens: - dust mites - cockroaches - cat and dog danger - mouse dropping - tobacco smoke - ozone - cleaning products Remove allergens: - carpet - dehumidifiers - air conditioners
61
RDS S/S
Cardinal signs: - Restlessness - Tachycardia - Diaphoresis - Tachypnea - retractions - nasal flaring - retractions
62
RDS Intervention
Mild: -Oxygen via nasal prongs Moderate: - oxygen mask - nonrebreather - repositioning - suctioning (mushroom tip/NP) Severe *EMERGENCY* -AMBU bag