module 3 Flashcards
Respiratory distress in children arises from
derangement in pulmonary gas exchange and is identified by increased work of breathing, indicating that the child is actively compensating for the disturbance.
Why do Children rely heavily on rate of respiration for compensation?
This is because they are unable to increase respiration depth due to small lung volumes and the flattened diaphragm’s inability to move downward against the abdomen
Over time, increases in the work of breathing significantly increases what?
The metabolic rate and oxygen demand of the child, resulting in respiratory muscle fatigue and decreased respiratory effort as respiratory failure progresses.
o Prolonged inspiration occurs with
upper airway obstruction
o Prolonged expiration occurs with
lower airway obstruction
dyspnoea
distress during breathing
hyperpnoea
increased depth
seesaw (paradoxic) respirations
chest falls on inspiration and rises on expiration
retractions of the upper chest are associated with
with upper airway compromise.
retractions of the lower chest usually suggest
lower airway compromise
head bobbing or extension of the neck on
inspiration is a clinical manifestation of
infants in respiratory distress. Why does it occur
The inability of the underdeveloped sternocleidomastoid muscle to effectively support the effort of breathing results in an infant’s head moving forward and back with each breath
inspiratory stridor is associated with
upper airway disease
expiratory wheeze is associated with
lower airway disease
Why does grunting occur
It is heard at the end of expiration as the body attempts to generate positive-end pressure within the alveoli to prevent collapse.
Tachycardia is a compensatory mechanism that presents in hypoxic states to provide….
If not resolved, prolonged hypoxia can result in bradycardia, which is a signal that the child has
adequate systemic oxygenation.
exhausted all compensatory efforts and an arrest situation is pending.
cause of crackles and sound
Air passing through airways with fluid in them or opening up of collapsed alveoli.
Non-continuous sounds, low-medium pitch.
cause of wheeze and sound
Movement of air through narrowed airways.
High pitched musical sound
cause of pleural rub and sound
Friction caused by inflamed pleura.
Loud, low pitched
pH meaning and normal values
(hydrogen ion concentration)
7.35 - 7.45
pCO2 meaning and normal values
(partial pressure of carbon dioxide)
35 - 45 mm Hg
pO2 meaning and normal values
(partial pressure of oxygen)
80 - 100 mm Hg
HCO3 meaning and normal values
(bicarbonate ion concentration)
22 - 28 mmol/L
. The first heart sound is the lubb sound. What does it signify
it signifies closure of the AV valves (particularly the mitral valve) after ventricular systole. is louder than the second sound
The second heart sound is the dubb sound, it signifies the
closure of the semilunar valves at the beginning of ventricular diastole
The third heart sound: signifies
rapid filling of the ventricles during diastole
is not usually heard
The fourth heart sound is the result of
atrial contraction occurs just before the 1st heart sound
Pallor is usually the first sign of
poor skin or mucous membrane perfusion in infants/young children. It may also be evident in conditions where haemoglobin levels are low.
Mottling is another sign of
poor perfusion commonly seen in the paediatric population and is caused by constriction of the blood vessels to the skin.
Prolonged capillary refill may be an indication of
systemic hypoperfusion as a result of low cardiac output.
what should a Fontanelle be like
Should be firm, flat and pulsatile
Sunken fontanelle: indicates
possible fluid volume deficit
Bulging: indicates
possible fluid volume overload
gcs 13 to 15 =
mild head injury
gcs 9 to 12 =
moderate head injury
gcs Less than 8 =
severe head injury
What is Nociceptive pain
arises from actual or threatened damage to non-neural tissue and is the result of activation of nociceptors in the skin and deep tissues which respond to noxious stimuli.
Nociceptive pain can be divided into somatic (superficial and deep), and visceral
Somatic pain:
o arises from bone, joint, muscle, skin or connective tissue, tends to be localised, constant pain that is usually described as sharp, aching or throbbing
Visceral pain:
o arises from visceral organs such as gastrointestinal tract and pancreas, tends to be vague in distribution, and is usually described as deep, aching, squeezing
Neuralgia:
pain in the distribution of a nerve or nerves
Neuropathic pain:
pain caused by a lesion or disease of the somatosensory nervous system which can be localised to the peripheral or central nervous systems E.G. phantom limb pain,
FLACC
Face Legs Activity Cry Consoloability
Fevers occur because of.. and antipyretic medication is used and works how?
In fever, the production of prostaglandin is increased in response to viral or bacterial pyrogens. This stimulates the hypothalamus to raise the set point of body temperature. Both paracetamol and ibuprofen reduce the production of prostaglandin leading to lowering of the set point and resolution of the fever.
