Exam 2- respiratory Flashcards
________ disorders are children’s most common infectious problem because their immunity to common infectious pathogens is not yet well established
Respiratory
Respiratory infections ___ as they age and have:
-decrease
-repeated exposure to organisms
Factors for decreased resistance to respiratory disorders (7)
-malnutrition
-anemia
-allergies
-fatigue
-daycare attendance
-exposure to second-hand or third-hand smoke
-history of respiratory/cardiac anomalies
Most respiratory infections are caused by
viruses
Children’s respiratory tract keeps growing till about ____ years of age
12
Children’s respiratory differences:
-Upper airway is _____ & _____
-_______ oral cavity with ______ tongue
-_______ nares and nasopharynx
-smaller and narrower
-smaller, larger
-smaller
Children’s respiratory differences:
-_________ amount of soft tissue & _________ anchored mucuous membranes leads to:
-larger
-loosely
-edema
Children’s respiratory differences:
_____ functional muscles in the airway means:
fewer
child may swallow more mucus because they cannot sneeze or cough
Children’s respiratory differences:
_________ Alveoli
At birth only _______, by age 8, increases to ______
Continues to increase until ______ when adult levels are present.
Less
25 million
300 million
puberty
Children’s respiratory differences:
Lower airway is _______, only ____mm in infants but ______mm in adults
narrower
4mm
10-20mm
Children’s respiratory differences:
Trachea is ____ & the angle of the right broncos at bifurcation is ____ acute than in an adult, making it more easily _____
shorter
more
obstructed
Children’s respiratory differences:
infants chest wall is ______; which makes it
leads to _____ with distress
_______ the work of breathing
-cartilaginous; twice as compliant as bony chest wall of adults
-retraction
-increases
Children’s respiratory differences:
Infants ribs are more _____ in orientation to vertebra, so intercostal muscles___________, which leads to _____ breathing
-horizontal
-struggle to lift the chest wall
-diaphragmatic
Children’s respiratory differences:
after 8 years of age, a _____ orientation of ribs enables intercostal muscles to lift ribs more easily
45 degree
Signs of respiratory distress (6)
-nasal flaring
-adventitious sounds
-tachypnea
-retraction
-color changes
-respiratory arrest
upper respiratory tract disorders (3)
-Epiglottis
-Strep/Scarlet fever
-Croup
inflammation and swelling of the epiglottis and upper trachea edema; treated as an emergency
epiglottitis
Epiglottitis vaccine
Hib
Epiglottitis is common in ages _____
2-5 years
IMPORTANT nursing consideration with epiglottitis
never use a tongue depressor to examine a child if epiglottis is suspected; airway will close
S/S of epiglottitis (7)
excessive drooling
fever
difficulty speaking
difficulty breathing
nasal flaring
stridor
tachycardia
Treatment of epiglottitis
antipyretics, steroids, IV fluids
Epiglottitis Interventions (7)
-Maintain patent airway
-O2 therapy
-Monitor respiratory status
-Maintain NPO
-do not place the child in a supine position
-Avoid throat culture
-prepare resuscitation equipment
Caused by Group A Beta Hemolytic Strep bacteria ONLY
Strep throat
Strep throat s/s
-fever
-red & sore throat
-exudative tonsils
-stomach ache
-palatal petechiae
-swollen submandibular lymph nodes
If red sandpaper rash develops with strep symptoms, its considered
Scarlet fever
Strep treatment
antibiotics: PCN & Cephalosporin
Most common age group that gets strep:_____; children less than ____ rarely get it
school-age; 18 months
How can children with strep return to school?
-24 hours on antibiotics
-24 hours without fever & fever reducing medication
Strep complications (2)
-Rheumatic fever
-Acute glomerulonephritis
inflammatory disease of heart, joints, CNS
Rheumatic fever
acute kidney infection
glomerulonephritis
Caused by virus in the larynx, mid trachea, and bronchi leading to inflammation edema
Laryngotracheobronchitis (croup)
virus that causes croup
adenovirus or parainfluenza
Croup s/s (5)
-hoarseness
-resonant cough described as “barking” or “brassy”
-inspiratory stridor
-respiratory distress
-high fever on onset
croup primarily occurs in children ___ to _____ and is rare after age _____
-6 months-3 years
-6 years
Croup treatment (5)
-cool humidified air
-steroids
-O2 if needed
-Rest
-Fluid
Lower respiratory tract disorders (4)
-Influenza
-Cystic Fibrosis
-Asthma
-Pneumonia
Viral infection that affects the respiratory system; highly contagious; prevention by vaccine; risk of development of sec infection
Influenza
S/S influenza (7)
-sore throat
-dry cough
-myalgia
-flushed face
-high fever
-fatigue
-photophobia
Influenza diagnosis
viral culture test of nasopharyngeal secretions
influenza supportive therapy
-treat symptoms
-hydration
-isolate for 7 days
Medications for influenza
antivirals (amantadine hydrochloride, oseltamivir, tamiflu)
inhaled zanamivir (Relenza)
IV peramivir (Rapivab) if diagnosed within 48 Horus of appearance of symptoms
inherited autosoma recessive trait that causes exocrine gland dysfunction, causing increased & abnormal mucus secretion int he lungs and gastrointestinal tract, leading to mechanical obstruction
Cystic Fibrosis
Cystic fibrosis
-__ in ___ Americans are carriers
-only inherited if ____ parents have gene
1 in 20
both parents have to have gene
Cystic fibrosis affects:
-GI
-Respiratory system
-reproductive system
Cystic fibrosis: effects on the gastrointestinal system (4)
-fat soluble vitamins (ADEK)
-nutrient malabsorption
-growth failure
-cystic fibrosis-related diabetes (CFRD)
Diagnosis of cystic fibrosis
sweat chloride test and stool analysis for stool fat/enzymes
Cystic fibrosis S/S: respiratory (7)
-repeated episodes of brochioltiis/pneumonia
-wheezy respirations
-dry, nonproductive cough
-patchy areas of atelectasis
-development of emphysema
-unable to expectorate the mucus bc its too thick
-dyspnea
Cystic fibrosis S/S: GI (4)
-pancreas: thick secretions block the ducts, leading to pancreatic fibrosis
-child will have bulky, difficult to pass, frothy, fatty, and foul smelling stools & rectal prolapse
-weight loss from poor absorption
-bile-stained vomit
Cystic fibrosis S/S: integumentary (3)
-High Na and Cl in sweat
-electrolyte imbalance
-dehydration
Cystic fibrosis S/S: reproductive (3)
-98% of males are sterile
-vagina secretion is too thick for sperm to move
-irregular menstrual cycle due to less frequent ovulation
Cystic fibrosis treatment: respiratory (7)
-chest physiotherapy (several times a day)
-postural drainage
-antibiotics
-bronchodilators
-O2 therapy
-mucolytics
-anticholinergics
Cystic fibrosis treatment: GI (3)
-high protein, fatty, high-calorie diet
-Vitamins ADEK
-monitor weight and stool pattern, administer pancreatic enzymes
Cystic fibrosis treatment: other (5)
-monitor vitals
-up-to-date vaccines
-wear mask
-monitor electrolytes
-provide emotional support for pt and family
Hypersensitivity Type I immune response that causes inflammation; increased mucus production, mucus thickening, bronchospasm, airway edema/observation, muscle tightening
asthma
chronic cause of chronic illness in children; misdiagnosis is common
asthma
Asthma triggers (4)
-Resp. infections
-allergies (cockroach poop)
-some meds (NSAIDs)
-Strong emotions
Asthma symptoms (8)
-cough
-wheeing
-SOB
-dyspnea
-mucus production
-sweating
-low SpO2
-use of accessory muscles
4 classifications of Asthma
-intermittent
-mild
-moderate
-severe
asthma with no interference with activity
intermittent asthma
asthma with minor interference w/ activity
mild persistent
asthma with some interference with activity
moderate persistent
asthma with extreme limitation with activity
severe persistent
asthma with symptoms <2 times a week
intermittent asthma
asthma with symptoms more than 2x a week but not daily
mild persistent
asthma with symptoms daily
moderate persistent
asthma with symptoms throughout the day
severe persistent
Asthma treatment (5)
-allergen control
-drug therapy
-symptom management
-chest physiotherapy
-hyposensitization
Bronchodilators that provide quick relief of symptoms
SABA (rescue meds)
asthma medications taken daily to achieve & sustain control of the inflammatory process
Leukotriene modifiers (singular) adjunct therapy or if you cannot gain control with inhaled anti-inflammatory alone (control meds)
______ asthma meds are always taken first
inhaled anti-inflammatory
asthma medication mixed with saline & delivered over time using compressed air
nebulizer
used for control & rescue; now in powder form; even 2-year olds can use with spacer device
Metered dose inhalers (MDI’s)
Bronchodilators:
-Short acting
-Long acting
-Mehtylxanthines
-Albuterol
-Salmeterol
-Theophylline
Corticosteroids have suffix (2)
-asone
-ide
Types of asthma medications (4)
Bronchodilators
Corticosteroids
Leukotriene Modifiers
Anticholinergics
Inflammation of the pulmonary tissue caused by bacteria, fungi, and viruses
pneumonia
_____ pneumonia occurs more frequently; ____________ the most common cause between 5-12 years
Viral
Mycoplasma
________ pneumonia is more serious because it affects ________; treated aggressively; often caused by ________
-Bacterial
-Affects lobes
-Streptococcus pneumonia
Pneumonia symptoms (4)
-fever
-abdominal pain
-V/D
-cough
pneumonia breath sounds w/ auscultation (2)
-course
-crackles
Bacterial pneumonia treatment: (6)
-O2 therapy
-IV fluids
-antibiotics
-suction mucus
-promote rest
-increase fluids
Viral pneumonia treatment (6)
-O2 therapy
-antipyretics
-chest physiotherpay
-increased fluid intake
-IV fluids
-responds to macrolide (Zithromax) but cough persists for weeks
essential in many cases of hypoxemia, may be delivered by mask, nasal cannula, face tent, hood, face mask, or ventilator
oxygen
oxygen is not effective with
cardiac diseases
Nursing considerations for oxygen
_______ L oxygenation is sufficient
_____ instead of prongs for kids
oxygen can be _____ for kids
use _______ for O2 monitoring
-2-3 L
-Mask
-flavored
-pulse ox
Breaks up med into small particles to be dispersed into airway
inhalation therapy
Nursing considerations for inhalation therapy
-use a _______ or mask
-pour med into _____ and attach device to ______
-takes ______ minutes
-mouthpiece
-small container; air/oxygen source
-10-15 minutes
inhalation therapy is used for ________, including:(4)
acute & infectious respiratory illnesses
-croup
-epiglottitis
-bacterial pneumonia
-flu
