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prnu 232 > Lecture 5 Respiratory HEENT > Flashcards

Lecture 5 Respiratory HEENT Flashcards

1
Q

infant respiratory system

A

obligate nose breathers
shorter trachea
immature lungs
immature respiratory muscles = belly breathing

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2
Q

infant trachea

A
  • diameter triples between birth and 3 years
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3
Q

effects of short infant trachea

A
  • less warming and humidifying of air
  • easier for microbes to access lungs
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4
Q

alveoli maturation

A
  • mature around 8-9 years
  • 9x more alveoli in late childhood than at birth
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5
Q

lung maturation

A

lungs are fully mature at 20-25 years

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6
Q

why do children have more respirations per minute than adults?

A
  • children need to breathe more often to meet metabolic demands
  • children have higher proportion of anatomical dead space than adults
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7
Q

infant thorax

A
  • rounder than adults
  • more cartilaginous and pliable
  • faster respiratory rate
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8
Q

optimal positioning for pediatric airway

A

rolled towel under shoulder to counter neck flexion because babies have big heads

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9
Q

physical respiratory exam

A
  • lung auscultation
  • nasal flaring
  • grunting
  • retractions
  • respiratory rate
  • skin assessment
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10
Q

where do retractions occur?

A
  • intercostal
  • suprasternal
  • clavicular
  • subcostal
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11
Q

what vaccines lower risk for respiratory infection?

A
  • Hib
  • Influenza
  • Measles
  • Pertussis
  • Pneumococcus
  • Varicella
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12
Q

how many respiratory infections is normal for child attending daycare?

A

6-8 per year

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13
Q

How common is upper respiratory tract infection for infants?

A

can have 10 per season, may be followed by otitis media

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14
Q

lower airway infections

A

RSV (bronchiolitis)
Pneumonia (Viral or Bacterial)
Aspiration Pneumonia

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15
Q

How should pneumonia be diagnosed?

A

Chest x-ray

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16
Q

Bacterial Pneumonia

A

More severe
Fever
Rapid and shallow breathing
Chest pain
Crackles

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17
Q

Viral pneumonia

A

Follows viral URI
Less severe
Low fever
Malaise
Non-productive cough
wheeze and crackles on auscultation

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18
Q

Croup

A
  • swelling and edema constricting the larynx
  • barking cough
  • inspiratory stridor
  • common for 6mo-3yo
    can be caused by parainfluenza, flu, RSV
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19
Q

Epiglottitis

A
  • Mostly caused by Hib
  • Stridor
  • Dysphagia
  • Drooling
  • High fever
  • Tripod positioning
20
Q

Otitis Media

A
  • after recurrent respiratory infections
  • most often 6 mo - 2 yr
  • eustachian tube more horizontal and difficult to drain
  • pain control and antibiotics
21
Q

pneumothorax

A
  • air in between the pleura
  • traumatic or spontaneous
22
Q

what populations get pneumothorax more often?

A
  • more common in male children
  • more common in tall thin young adults
23
Q

pneumothorax presentation

A
  • chest pain
  • diminished breath sounds on affected side
  • hyper resonant percussion
  • tachypnea
  • cyanosis
24
Q

Pertussis

A

cough lasting 6 - 10 weeks

25
Q

pertussis complications

A
  • vomiting from coughing so hard
  • sleep apnea <6 months
  • contagious for 2 weeks after coughing begins
26
Q

pertussis treatment

A
  • nasopharyngeal swab
  • antibiotics ASAP
  • 50% of infants hospitalized for supportive care
27
Q

catarrhal stage of pertussis

A

7-10 days
rhinitis, low fever, mild cough

28
Q

paroxysmal stage of pertussis

A

1-6 weeks
persistent cough, cyanosis, vomiting, exhaustion

29
Q

convalescent stage of pertussis

A

7-10 days
less persistent cough

30
Q

influenza s/sx

A

high fever
headache
chills
cough
sore throat
muscle pain
fatigue

31
Q

influenza vaccine age

A

6 months and older

32
Q

tamiflu

A

given within 2 days of symptom onset or exposure

33
Q

Preventing spread of RSV

A

droplet and contact precautions
hand washing

34
Q

RSV pathophysiology

A
  • Replicates in nasopharynx
  • infects epithelium of bronchioles and alveoli
35
Q

RSV clinical manifestations

A

fever
cough
tachypnea
retractions
wheezing
crackles

36
Q

RSV treatment

A

oxygen
fluids
ventilation
immunoglobulin

37
Q

what age group gets strep the most?

A

5-15 years

38
Q

strep throat timeline

A

2-5 day incubation
3-5 day duration

39
Q

clinical manifestations of strep throat

A

sudden sore throat
fever and chills
abdominal pain
loss of appetite
headache
N/V
swollen

40
Q

strep throat pathophysiology

A

group a strep colonizes epithelial cells of the throat and skin, cause inflammatory response

41
Q

physical exam strep throat

A

red swollen tonsils
white patches on tonsils
petechiae on palate
swollen lymph nodes

42
Q

strep throat test

A

rapid test - 15 minutes
throat culture - 2 days

43
Q

treatment for strep throat

A
  • penicillin
  • erythromycin for people with penicillin allergies
  • 10 days of antibiotics
  • no longer contagious after 24 hours with treatment
44
Q

patient education for strep throat

A
  • throw away toothbrushes
  • continue antibiotics for full course
45
Q

complications of strep throat

A
  • rheumatic fever
  • scarlet fever
  • abscesses of the tonsils, throat
  • otitis media
  • post strep glomerulonephritis

prnu 232 (7 decks)

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