Module 3: Respiratory Health Challenges Flashcards
What does upper respiratory tract consist of
Oronasopharynx (mouth, nose)
Pharynx (back of throat)
Larynx
Upper part of trachea
What does the lower respiratory tract consist of
Lower trachea
Bronchi
Bronchioles
Alveoli
What is croup syndrome
Infections of epiglottis and larynx
What areas does respiratory tract infection involve
Many areas but the effect of 1 area may predominate in any illness
What are most infections caused by
Viruses
What are infections influenced by
age of child, season, living conditions, and pre-existing medical conditions
What is the infection rate in infants 3 months or younger
Lower infection rate due to maternal antibodies
What is the infection rate in children 3 - 6 months
Infection rate increases due to maternal antibodies beginning to disappear
The child is now trying to produce their own antibodies
What is the infection rate in toddlers
Infection rate remains high because the toddler is now more exposed
What is the infection rate in children 5 years old
Viral respiratory infections are less frequent, but infections such as strep throat are more common
What viral agent would produce a mild illness in older children but worse in younger children?
A common cold causes upper respiratory symptoms in older children but in infants it can cause severe respiratory compromise
How is the diameter of the airways in young children?
much smaller based on narrowing and inflammation of the mucus membranes
This makes it more difficult for an infant to secrete
How is the distance between structures in young children?
Much shorter which allows microorganisms to rapidly move down the respiratory tract
What is different in kids regarding their breathing?
tend to be nose breathers, if they’re congested it can cause respiratory compromise
What is different in kids regarding their tongue?
Much larger
What is different in kids regarding their larynx?
It is higher, it is at C3-C4 in children but C6 in older
What does respiratory assessment include?
Inspect colour of skin
Assess respiratory effort and sounds
Assess vital signs
Nursing care management for respiratory infections?
Promote rest/comfort
Prevent spread of infection
Reduce temperature
Promote hydration and nutrition
Provide family support and home care
What is acute epiglottis
Serious obstructive inflammatory process occurring in children 2-8 years old
Considered a medical emergency
What is the onset of acute epiglottis?
usually abrupt and rapidly progresses to severe respiratory stress
What are signs and symptoms of acute epiglottis?
Sore throat, pain, tripod positioning, retractions, fever
Frog like croaking sound
Absence of spontaneous cough, drooling and agitation
What should you not do as a nurse when pt has acute epiglottis
Do not attempt to visualize the epiglottis directly with a tongue depressor or taking a throat culture
Call for assistance
What is bronchitis
AKA Tracheobronchitis
Inflammation of trachea and bronchi
What is bronchitis frequently associated with?
with upper respiratory tract infection and works its way down to the lower respiratory tract
Signs and symptoms of bronchitis?
Dry, hacking, non productive cough
Worsening at night
Becomes productive in 2-3 days
What does RSV effect?
epithelial cells for the respiratory tract
What are signs and symptoms of RSV?
Low grade fever, poor feeding, lethargy, wheezing, retractions
What are therapeutic management for RSV?
Treat symptoms
Airway maintenance
Medications
Adequate fluid intake
Why is pneumonia seen infrequently
Because of early antibiotics and supportive therapy
What are we worried about regarding pneumonia
if they develop a pneumothorax or a tension pneumothorax
When is pleural effusion common with?
when children have pneumococcal pneumonia
What interventions are done with pneumonia
Chest drainage, aspiration of purulent fluid and antibiotics
What is the onset of pneumonia?
quite abrupt generally follows a viral infection
What does a child with bacterial pneumonia look like and where is the pain referred to?
Child will appear ill (high fever, malaise, rapid/shallow respirations, cough, chest pain
Pain will also be referred to the abdomen
Where do older children get treated for pneumonia?
At home, if condition worsens then they will need antibiotic treatment through an IV
Why should a chest x-ray be done for pneumonia
To ensure the lung hasn’t collapsed
Why do we give IV fluid for pneumonia?
To ensure adequate hydration
Nursing management for pneumonia?
Educate family and pt on antibiotic and antipyretic administration
Assess respiratory status
Ensure child is taking fluids
What should we as nurses reassure the parents when their child has pneumonia?
Reassure them that child’s appetite will come back once the acute phase of the illness has passed
What are the 2 types of respiratory insufficiency?
- Increased work of breathing but gas exchange function is almost normal
- When normal blood gas tensions cannot be maintained, hypoxemia and acidosis develop secondary to CO2 retention
What is respiratory failure?
Inability to maintain adequate oxygenation of the blood with or without CO2 retention
Can lead to hypoxia and hypercapnia
Temporary or complete stop of respiration
What kind of failure will children go into first?
respiratory failure
What is apnea?
Temporary or complete stop of breathing for more than 20 seconds or for a shorter period of time associated with hypoxia and bradypnea
What systemic problems can respiratory distress be a sign of?
Sepsis, heart failure, compensation for metabolic acidosis
Signs and symptoms of respiratory distress?
Tachypnea (most common)
Nasal flaring
Retractions
Grunting
See-saw breathing
Head bobbing (late sign)
Interventions for respiratory distress
Supplemental oxygen
Repositioning
Treatment for underlying problem
