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NUR 417: Peds Lecture > Exam 2 Respiratory > Flashcards

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
Q

School age 6-12 yrs

-Blood glucose and A1c Values

A

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
Q

Adolescents >12 yrs

-Blood glucose and A1c Values

A

Blood glucose before meals: 90-130
Blood glucose at bedtime: 90-150
A1c: <7.5

27
Q

epiglottis

A

Prepare for emergency intubation, assess vital signs, and listen to breath sounds

28
Q

Best way to way monitor weight in a child with dehydration?

A

Daily weights, same scale, same time

29
Q

Components of RAPID+

A 
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
Q

What patients would you alter how fast to give fluids?

A

Pt with Cardiac and Renal disease

31
Q

Oral rehydration

A
  • Formula/breastmilk

- Pedialyte

32
Q

Determine the severity of asthma

A

Peak flow meter

33
Q

The order in which drugs are given via svn to a patient w/ cystic fibrosis

A

Albuterol 1st and than Dornase Alpha (pulmonary enzyme)

34
Q

Severe dehydration

A

Tachycardia, sunken fontanel, and decreased blood pressure, >10% weight loss

35
Q

What is prodromal(early) symptom for asthma?

A

Itching on the back of the neck

36
Q

Infants and children are more prone to respiratory distress

A
  • Large tongue
  • long floppy apiglottis
  • short neck
  • horizontal face
  • funnel shaped airway
  • less alveoli
37
Q

Minimun urine output in 10kg infant over 8 hrs

A

10x1.5=15
15x8=120ml

120ml!

38
Q

Acute Laryngealtracheobronchitis

A

Provide cool mist and observe for signs of respiratory distress

39
Q

S/S Respiratiry sitress

A
  • Stridor
  • head bobbing
  • retraxtions
  • nasal flaring
  • tachycardia
40
Q

What defect in the cystic fibrosis transmembrane regulating gene cause

A

Na and H2O are unable to cross the chloride channel causing secretions to become thick

41
Q

First S/S of cystic fibrosis in an infant

A

Meconium ileus

-Older children can get rectal prolapse

42
Q

Nephrotic syndrome

A

Frothy urine

43
Q

RSV

A

Encourage hydration, cluster care, provide oxygen as needed

44
Q

Breathe sounds that are signs of emergencies

A

-Inspiratory stridor at rest

45
Q

Acute Glomerulonephritis

A
  • Tea colored urine
  • +RBCs in urine
  • +ASO titer (strep infection)
46
Q

Correct number ml/kg given as oral rehydration in a mildly dehydration

A

50ml/kg

47
Q

Mainitance Drugs for Asthma

A

Bronchodilator:

  • morning or at night
  • 2 hr before exercise
48
Q

Who get Synagis

A
  • Prematures
  • immunocompromised
  • Lung and congenital heart defects
  • once a month IM during RSV season
49
Q

Respiratory Differences from adults and children

A
  • 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
Q

Cystic Fibrosis

A

-Defective/mutated gene on chromosome 7

51
Q

Cystic Fibrosis Pathophysiology

A

No CFTR = no Cl pump = no water in secretions = think secretions

52
Q

Cystic Fibrosis S/S

A
  • Thick mucus
  • Clogged airways
  • Bacterial growth in airways when mucus in thick leads to infection
  • Salty skin
53
Q

Cystic Fibrosis how it affects Lungs

A
  • thick mucus
  • clogged airways
  • bacteria loves mucus
  • pneumothorax
  • pneumonia
  • emphysema
54
Q

Cystic Fibrosis how it affects Pancreas

A
  • insufficiency in enzymes due to ducts blocked with mucus
  • treated with pancrelipase (creon)
  • CF related DM (insulin resistance and deficiency)
55
Q

Cystic Fibrosis how it affects GI

A

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
Q

Cystic Fibrosis Treatment

A

-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
Q

Cystic Fibrosis Treatment Meds

A 
CFRD: oral glucose tolerance test 
Maintenance:
-bronchodilators
-hypertonic saline
-Dornase alfa: cough medicine 
Antibiotics

*Use oxygen cautiously C02 retention

58
Q

Asthma S/S

A
  • 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
Q

How to judge Asthma Severity

A

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
Q

Asthma Triggers

A

control allergens:

  • dust mites
  • cockroaches
  • cat and dog danger
  • mouse dropping
  • tobacco smoke
  • ozone
  • cleaning products

Remove allergens:

  • carpet
  • dehumidifiers
  • air conditioners
61
Q

RDS S/S

A

Cardinal signs:

  • Restlessness
  • Tachycardia
  • Diaphoresis
  • Tachypnea
  • retractions
  • nasal flaring
  • retractions
62
Q

RDS Intervention

A

Mild:
-Oxygen via nasal prongs

Moderate:

  • oxygen mask
  • nonrebreather
  • repositioning
  • suctioning (mushroom tip/NP)

Severe EMERGENCY
-AMBU bag

NUR 417: Peds Lecture (12 decks)

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