lecture 4 [preschooler + respiratory health problems] Flashcards
what type of disorder is cystic fibrosis?
congenital respiratory
what is cystic fibrosis?
increased production of thick mucus in bronchioles and small intestines, & pancreatic and bile ducts
what is the etiology of CF?
inherited autosomal recessive trait from both parents
what is the role pancreatic enzymes in the body?
they catabolize fats & protein
what is the pathophysiology of CF?
- increased viscosity of secretions
- atelectasis
- clogged pancreatic ducts (–> absent enzymes)
what are the diagnostic tests for CF?
- sweat chloride test
- CXR
- prenatal DNA testing (from amniotic fluid)
- AXR (meconium ileus)
- PFT
- stool analysis (72 hours fecal fat)
how does a child with CF present?
- coughing
- dyspnea
- crackles
- cyanosis
- clubbing
- steatorrhea (frothy, foul smelling)
- low SpO2
how can a nurse care for a child with CF?
- provide high calories & high protein
- administer pancreatic enzymes (w/ meals)
- administer vitamins A, E, D, K (fat soluble)
- increase hydration
why should pulmonary treatments & procedures be avoided after meals?
decrease chances of vomiting
what are the medications for CF?
- mucolytics
- bronchodilators
- ABX
- pancreatic enzymes
- fat-soluble vitamins
proper education for families with a child with CF
- avoid respiratory illness & infection
- chest percussion
- postural drainage
- high calorie & high protein
- physical activity (loosens secretions)
- genetic counseling
acquired respiratory illnesses
- BPD
- asthma
what is BPD?
chronic obstructive pulmonary disease
what can cause BPD?
prolonged oxygen therapy & ventilation
may be genetically predisposed
what is the patho for BPD?
(6)
- high O2 concentrations
- tissue damage from ventilation
- thick alveolar walls
- scarring & fibrosis
- poor airway patency
- poor gas exhange
how can BPD be dianosed?
- CXR
- ABG
what are the ABG results for a child with BPD?
- hypercapnia
- respiratory acidosis
what are the s/s of BPD?
- tachypnea
- tachycardia
- poor feeding
- increased WOB
- retractions
- wheezing
- barrel chest
- pallor
what is the nursing care for a child with BPD?
- ICU
- daily weights
- frequent turning (lay on good side)
- mechanical ventilation
- suction
- maintain O2 sats
- monitor for FVE
what are the medications for BPD?
- bronchodilators
- corticosteroids
- diuretics
- ABX
what is most important for familes to learn for their child with BPD?
- CPR
- trach care
- use of portable O2 equipment
- proper feeding
- appropriate weight gain
what are the characteristics of asthma?
- chronic inflammatory disorder
- narrow airways
- hypersenstivity to stimuli/ irritants
what happens to the lungs among children with asthma?
- bronchial constriction
- alveolar hyperinflation
- air-trapping (unable to exhale properly)
- edema
- increased mucus secretion
what are the diagnostic tests for asthma?
- CXR
- PFT
- PEFR
what does the PEFR measure?
amount of air that can be forcefully expired in 1 second
what are the s/s for asthma?
- expiratory wheezing, crackles, or diminished
- dry cough
- sitting retractions
- prolonged expiration
- restlessness
- fatigue
- tachypnea
- cyanosis
- barrel chest
why do nurses need to avoid giving cold liquids to a pt w/ asthma?
avoid bronchospasms
what is the nursing care for a child w/ asthma?
- administer humidified O2
- high fowler’s
- monitor pulse ox
- maintain IV access (hydration, IV steroids)
what are the medications for asthma?
- steroids
- oxygen
- IV fluids
- bronchodilators (beta agonists & anticholinergics)
what is more important for patient and families to know about regulating asthma?
- check peak flow
- keep rescue inhaler
what are the common infectious respiratory illness among children?
(4)
- acute LTB
- epiglottitis
- pneumonia
- bronchiolitis
what is acute LTB?
a viral infection that causes inflammation, edema, & narrowing in LTB
LTB is usually preceded by an upper respiratory infection
RSV most common
true
what are the common causative agents of LTB?
- RSV
- influenzae A & B
- parainfluenza virus
- mycoplasma pneumonia
what are the s/s of LTB?
- respiratory acidosis
- low-grade fever
- rhinorrhea
- stridor
- retractions
- hypoxia
- pulmonary edema
- increased production of mucus
- airway narrowing
why is diminished or cessation of breathing noise and effort alarming for nurses?
sign of impending respiratory failure
why is drooling a major concern in a patient with LTB?
closed off airways–meaning they are unable to swallow
what should the nurse administer for LTB?
- humidified O2
- corticosteroids
- IV fluids
what is epiglottitis?
swelling of epiglottis
why is epiglottitis considered an emergency?
airway obstruction & tracheal occlusion
what is epiglottitis usually caused by?
Haemophilius influenza
Hib vaccine needed
s/s of epiglottitis
(7)
- dysphonia
- dysphagia
- drooling
- tripoding
- high fever
- pain with swallowing
- edematous epiglottis
how long does it take for the airway to completely obstruct?
2-6 hours
why is throat examination contraindicated with epiglottitis?
could lead to spasm & complete obstruction
what are the diagnostic procedures for epiglottitis?
- portable lateral neck x-ray
- CBC
- blood culture (bacteremia)
why is a child with epiglottitis on NPO?
they are unable to swallow
what are the medications for epiglottitis?
- ABX
- corticosteroids
- antipyretics
what is the ABX regimen for epiglottitis?
IV ABX transitioning to oral for 10 days
parents are worried their child is having epiglottitis for the second time, what does the nurse say?
recurring epiglottitis is common
what is pneumonia?
inflammation of bronchioles and alveolar spaces due to infection