L6/7 Cardiopulmonary & Pain

Question 1

Asthma

Answer 1

• obstructive pulmonary disease, episodic periods of reversible narrowing by way of airway inflammation
• most common chronic childhood disease
• 20% of those with asthma at 7 will have asthma at 42
• presents as prolonged exhalation time

Question 2

Etiology of Asthma

Answer 2

genetics
infection
environment (air quality, air pollution, allergens, cold/dry air)

Question 3

Exacerbations of Asthma

Answer 3

irritant
virus
cigarette smoke

Question 4

Asthmatic Airway vs normal airway

Answer 4

wall is inflammed and thickened

during an asthma attack, the smooth muscles become tight, and air becomes trapped in the alveoli

Question 5

PT’s role with asthma

Answer 5

• encourage aerobic conditioning
• monitor impact of inhaled corticosteroids
• help with medication use and timing
• longer warm up period

Question 6

Outcome measure for asthma

Answer 6

pediatric asthma QOL questionnaire

Question 7

Exercise induced bronchospasm

Answer 7

• defined by s/s within 5-10 min of exercise with intensity of 70-85%
• may include airway narrowing that occurs anytime during or immediately after exercise
• resolves spontaneosusly within 20-30 min

Question 8

S/S of EIB

Answer 8

• SOB
• wheezing
• cough
• tightness of chest

Question 9

Refractory EIB

Answer 9

repeated bouts of exercise within 2 hours of of the initial episode (EIB) will not exacerbate EIB

Question 10

Cystic Fibrosis

Answer 10

• autosomal recessive, genetically inherited disease
• thick, viscous secretions by excretory glands
• decreased enzymatic production in GI tract
• commonly impacts pulmonary system with obstruction of airways, resulting in hyperinflation, infection, tissue destruction
• child may have concurrent failure to thrive due to GI issues

Question 11

Airways with cystic fibrosis

Answer 11

• thick sticky mucus blocks airway
• dilated airway
• blood in mucus
• bacterial infection

Question 12

PT role with CF

Answer 12

• secretion removal techniques
• education
• aerobic exercise program
• bladder control techniques
• medication, environmental controls, navigating health care system

Question 13

Common thing parent says with CF

Answer 13

“my baby tastes salty”

Question 14

Congenital cardiac defects

Answer 14

• structural anomalies that allow for an alternative route of blood through CVP systems or obstruct usual rote of blood flow
• usually require surgical intervention if they are symptomatic

Question 15

PT role with congenital cardiac defects

Answer 15

• preoperative and post operative care
• positioning
• modifications for exercise activity

Question 16

Neurodevelopmental effects of congential cardiac defects

Answer 16

decreased brain volume
mild motor deficits
language deficits
impacted participation

Question 17

Can you use the borg scale with kids?

Answer 17

YES

Question 18

WeeFIM 2

Answer 18

used for kids with congenital or acquired diseases to measure function

Question 19

Pediatric Pain

Answer 19

Acute (traumatic, burns)
Chronic (disease)
Combo

Question 20

Pain presentation in kids

Answer 20

• verbal
• crying, screaming, grunting
• grabbing body part, limping
• change in pace, energy level, agitation level, movement, facial expression
• change in want for touch/support from others (either increased or decreased)

Question 21

Components of pain to address

Answer 21

behavioral
emotional
functional
physical

Question 22

Faces pain scale

Answer 22

used as a way to determine pain level of a child if they aren’t able to verbally share

Question 23

Pain mgmt action items

Answer 23

• look at communication and alertness
• recognize disparities between children of color
• engage with multiple disciplines, use peds pain programs, use PT/exercise
• pain attention to child’s baseline
• believe the patient

Question 24

Face, Legs, Activity, Cry, Consolability Behavioral Pain Scale

Answer 24

reliable and valid for children with cognitive impairments

Question 25

Pain self-assessment for kids

Answer 25

Wong-Baker FACES for ages 3+

Question 26

Pressure Injuries Prevention

Answer 26

Manage prevent and avoid: immobility shear friction mositure

Question 27

Transfers for kids

Answer 27

* execute safe transfers every time * education for families, caregivers, other providers * includes beds, toilets, stretchers, w/c

Question 28

Stages of pressure injury

Answer 28

* 1: intact skin * 2: partial thickness loss * 3: full thickness loss with visible fat * 4: full thickness loss with visible bone, muscle * Unstageable: full thickness with slough * DTPI: intact or nonintact, deep red or maroon

Question 29

Burns

Answer 29

* 25% of burn injuries in US occur in kids under 15 yrs * can be caused by scalding, fires, electric, matches

Question 30

PT role with burns

Answer 30

* acute care includes assessment, functional mobility, positioning, wound care * rehab includes management of chronic wounds, functional mobility maintenance * outpatient/long term, helping with long term funciton

Question 31

Burn classification

Answer 31

Categorization utilizing thickness, zones, identified locations anatomical proportions change throughout lifespan development, so age matters child's function will be dependent on size and location

Question 32

Abuse and disability

Answer 32

children with a disability have increased likelihood of being abused or neglected AND may have challenges communicating or physically getting away

Question 33

Abuse recognition

Answer 33

* observation of skin * sensitive areas of body * unexplained bruises, burns, scars, other signs of trauma