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Peds > Exam 2- respiratory > Flashcards

Exam 2- respiratory Flashcards

1
Q

________ disorders are children’s most common infectious problem because their immunity to common infectious pathogens is not yet well established

A

Respiratory

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2
Q

Respiratory infections ___ as they age and have:

A

-decrease
-repeated exposure to organisms

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3
Q

Factors for decreased resistance to respiratory disorders (7)

A

-malnutrition
-anemia
-allergies
-fatigue
-daycare attendance
-exposure to second-hand or third-hand smoke
-history of respiratory/cardiac anomalies

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4
Q

Most respiratory infections are caused by

A

viruses

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5
Q

Children’s respiratory tract keeps growing till about ____ years of age

A

12

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6
Q

Children’s respiratory differences:
-Upper airway is _____ & _____
-_______ oral cavity with ______ tongue
-_______ nares and nasopharynx

A

-smaller and narrower
-smaller, larger
-smaller

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7
Q

Children’s respiratory differences:
-_________ amount of soft tissue & _________ anchored mucuous membranes leads to:

A

-larger
-loosely
-edema

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8
Q

Children’s respiratory differences:
_____ functional muscles in the airway means:

A

fewer
child may swallow more mucus because they cannot sneeze or cough

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9
Q

Children’s respiratory differences:
_________ Alveoli
At birth only _______, by age 8, increases to ______
Continues to increase until ______ when adult levels are present.

A

Less
25 million
300 million
puberty

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10
Q

Children’s respiratory differences:
Lower airway is _______, only ____mm in infants but ______mm in adults

A

narrower
4mm
10-20mm

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11
Q

Children’s respiratory differences:
Trachea is ____ & the angle of the right broncos at bifurcation is ____ acute than in an adult, making it more easily _____

A

shorter
more
obstructed

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12
Q

Children’s respiratory differences:
infants chest wall is ______; which makes it
leads to _____ with distress
_______ the work of breathing

A

-cartilaginous; twice as compliant as bony chest wall of adults
-retraction
-increases

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13
Q

Children’s respiratory differences:
Infants ribs are more _____ in orientation to vertebra, so intercostal muscles___________, which leads to _____ breathing

A

-horizontal
-struggle to lift the chest wall
-diaphragmatic

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14
Q

Children’s respiratory differences:
after 8 years of age, a _____ orientation of ribs enables intercostal muscles to lift ribs more easily

A

45 degree

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15
Q

Signs of respiratory distress (6)

A

-nasal flaring
-adventitious sounds
-tachypnea
-retraction
-color changes
-respiratory arrest

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16
Q

upper respiratory tract disorders (3)

A

-Epiglottis
-Strep/Scarlet fever
-Croup

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17
Q

inflammation and swelling of the epiglottis and upper trachea edema; treated as an emergency

A

epiglottitis

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18
Q

Epiglottitis vaccine

A

Hib

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19
Q

Epiglottitis is common in ages _____

A

2-5 years

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20
Q

IMPORTANT nursing consideration with epiglottitis

A

never use a tongue depressor to examine a child if epiglottis is suspected; airway will close

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21
Q

S/S of epiglottitis (7)

A

excessive drooling
fever
difficulty speaking
difficulty breathing
nasal flaring
stridor
tachycardia

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22
Q

Treatment of epiglottitis

A

antipyretics, steroids, IV fluids

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23
Q

Epiglottitis Interventions (7)

A

-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

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24
Q

Caused by Group A Beta Hemolytic Strep bacteria ONLY

A

Strep throat

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25
Q

Strep throat s/s

A

-fever
-red & sore throat
-exudative tonsils
-stomach ache
-palatal petechiae
-swollen submandibular lymph nodes

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26
Q

If red sandpaper rash develops with strep symptoms, its considered

A

Scarlet fever

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27
Q

Strep treatment

A

antibiotics: PCN & Cephalosporin

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28
Q

Most common age group that gets strep:_____; children less than ____ rarely get it

A

school-age; 18 months

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29
Q

How can children with strep return to school?

A

-24 hours on antibiotics
-24 hours without fever & fever reducing medication

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30
Q

Strep complications (2)

A

-Rheumatic fever
-Acute glomerulonephritis

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31
Q

inflammatory disease of heart, joints, CNS

A

Rheumatic fever

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32
Q

acute kidney infection

A

glomerulonephritis

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33
Q

Caused by virus in the larynx, mid trachea, and bronchi leading to inflammation edema

A

Laryngotracheobronchitis (croup)

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34
Q

virus that causes croup

A

adenovirus or parainfluenza

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35
Q

Croup s/s (5)

A

-hoarseness
-resonant cough described as “barking” or “brassy”
-inspiratory stridor
-respiratory distress
-high fever on onset

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36
Q

croup primarily occurs in children ___ to _____ and is rare after age _____

A

-6 months-3 years
-6 years

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37
Q

Croup treatment (5)

A

-cool humidified air
-steroids
-O2 if needed
-Rest
-Fluid

38
Q

Lower respiratory tract disorders (4)

A

-Influenza
-Cystic Fibrosis
-Asthma
-Pneumonia

39
Q

Viral infection that affects the respiratory system; highly contagious; prevention by vaccine; risk of development of sec infection

A

Influenza

40
Q

S/S influenza (7)

A

-sore throat
-dry cough
-myalgia
-flushed face
-high fever
-fatigue
-photophobia

41
Q

Influenza diagnosis

A

viral culture test of nasopharyngeal secretions

42
Q

influenza supportive therapy

A

-treat symptoms
-hydration
-isolate for 7 days

43
Q

Medications for influenza

A

antivirals (amantadine hydrochloride, oseltamivir, tamiflu)
inhaled zanamivir (Relenza)
IV peramivir (Rapivab) if diagnosed within 48 Horus of appearance of symptoms

44
Q

inherited autosoma recessive trait that causes exocrine gland dysfunction, causing increased & abnormal mucus secretion int he lungs and gastrointestinal tract, leading to mechanical obstruction

A

Cystic Fibrosis

45
Q

Cystic fibrosis
-__ in ___ Americans are carriers
-only inherited if ____ parents have gene

A

1 in 20
both parents have to have gene

46
Q

Cystic fibrosis affects:

A

-GI
-Respiratory system
-reproductive system

47
Q

Cystic fibrosis: effects on the gastrointestinal system (4)

A

-fat soluble vitamins (ADEK)
-nutrient malabsorption
-growth failure
-cystic fibrosis-related diabetes (CFRD)

48
Q

Diagnosis of cystic fibrosis

A

sweat chloride test and stool analysis for stool fat/enzymes

49
Q

Cystic fibrosis S/S: respiratory (7)

A

-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

50
Q

Cystic fibrosis S/S: GI (4)

A

-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

51
Q

Cystic fibrosis S/S: integumentary (3)

A

-High Na and Cl in sweat
-electrolyte imbalance
-dehydration

52
Q

Cystic fibrosis S/S: reproductive (3)

A

-98% of males are sterile
-vagina secretion is too thick for sperm to move
-irregular menstrual cycle due to less frequent ovulation

53
Q

Cystic fibrosis treatment: respiratory (7)

A

-chest physiotherapy (several times a day)
-postural drainage
-antibiotics
-bronchodilators
-O2 therapy
-mucolytics
-anticholinergics

54
Q

Cystic fibrosis treatment: GI (3)

A

-high protein, fatty, high-calorie diet
-Vitamins ADEK
-monitor weight and stool pattern, administer pancreatic enzymes

55
Q

Cystic fibrosis treatment: other (5)

A

-monitor vitals
-up-to-date vaccines
-wear mask
-monitor electrolytes
-provide emotional support for pt and family

56
Q

Hypersensitivity Type I immune response that causes inflammation; increased mucus production, mucus thickening, bronchospasm, airway edema/observation, muscle tightening

A

asthma

57
Q

chronic cause of chronic illness in children; misdiagnosis is common

A

asthma

58
Q

Asthma triggers (4)

A

-Resp. infections
-allergies (cockroach poop)
-some meds (NSAIDs)
-Strong emotions

59
Q

Asthma symptoms (8)

A

-cough
-wheeing
-SOB
-dyspnea
-mucus production
-sweating
-low SpO2
-use of accessory muscles

60
Q

4 classifications of Asthma

A

-intermittent
-mild
-moderate
-severe

61
Q

asthma with no interference with activity

A

intermittent asthma

62
Q

asthma with minor interference w/ activity

A

mild persistent

63
Q

asthma with some interference with activity

A

moderate persistent

64
Q

asthma with extreme limitation with activity

A

severe persistent

65
Q

asthma with symptoms <2 times a week

A

intermittent asthma

66
Q

asthma with symptoms more than 2x a week but not daily

A

mild persistent

67
Q

asthma with symptoms daily

A

moderate persistent

68
Q

asthma with symptoms throughout the day

A

severe persistent

69
Q

Asthma treatment (5)

A

-allergen control
-drug therapy
-symptom management
-chest physiotherapy
-hyposensitization

70
Q

Bronchodilators that provide quick relief of symptoms

A

SABA (rescue meds)

71
Q

asthma medications taken daily to achieve & sustain control of the inflammatory process

A

Leukotriene modifiers (singular) adjunct therapy or if you cannot gain control with inhaled anti-inflammatory alone (control meds)

72
Q

______ asthma meds are always taken first

A

inhaled anti-inflammatory

73
Q

asthma medication mixed with saline & delivered over time using compressed air

A

nebulizer

74
Q

used for control & rescue; now in powder form; even 2-year olds can use with spacer device

A

Metered dose inhalers (MDI’s)

75
Q

Bronchodilators:
-Short acting
-Long acting
-Mehtylxanthines

A

-Albuterol
-Salmeterol
-Theophylline

76
Q

Corticosteroids have suffix (2)

A

-asone
-ide

77
Q

Types of asthma medications (4)

A

Bronchodilators
Corticosteroids
Leukotriene Modifiers
Anticholinergics

78
Q

Inflammation of the pulmonary tissue caused by bacteria, fungi, and viruses

A

pneumonia

79
Q

_____ pneumonia occurs more frequently; ____________ the most common cause between 5-12 years

A

Viral
Mycoplasma

80
Q

________ pneumonia is more serious because it affects ________; treated aggressively; often caused by ________

A

-Bacterial
-Affects lobes
-Streptococcus pneumonia

81
Q

Pneumonia symptoms (4)

A

-fever
-abdominal pain
-V/D
-cough

82
Q

pneumonia breath sounds w/ auscultation (2)

A

-course
-crackles

83
Q

Bacterial pneumonia treatment: (6)

A

-O2 therapy
-IV fluids
-antibiotics
-suction mucus
-promote rest
-increase fluids

84
Q

Viral pneumonia treatment (6)

A

-O2 therapy
-antipyretics
-chest physiotherpay
-increased fluid intake
-IV fluids
-responds to macrolide (Zithromax) but cough persists for weeks

85
Q

essential in many cases of hypoxemia, may be delivered by mask, nasal cannula, face tent, hood, face mask, or ventilator

A

oxygen

86
Q

oxygen is not effective with

A

cardiac diseases

87
Q

Nursing considerations for oxygen
_______ L oxygenation is sufficient
_____ instead of prongs for kids
oxygen can be _____ for kids
use _______ for O2 monitoring

A

-2-3 L
-Mask
-flavored
-pulse ox

88
Q

Breaks up med into small particles to be dispersed into airway

A

inhalation therapy

89
Q

Nursing considerations for inhalation therapy
-use a _______ or mask
-pour med into _____ and attach device to ______
-takes ______ minutes

A

-mouthpiece
-small container; air/oxygen source
-10-15 minutes

90
Q

inhalation therapy is used for ________, including:(4)

A

acute & infectious respiratory illnesses
-croup
-epiglottitis
-bacterial pneumonia
-flu

Peds (3 decks)

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