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Pediatric Respiratory Care > NPS Pathology > Flashcards

NPS Pathology Flashcards

1
Q

Four defects involved in Tetralogy of Fallot

A

Ventricular Septal Defect
Overriding Aorta
Right ventricular hypertrophy
Pulmonary Stenosis

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2
Q

Treatment for Tetralogy of Fallot

A

100% O2
Give prostaglandins to keep ductus open
Surgical correction

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3
Q

Boot-shaped heart indicates ___.

Egg-shaped heart indicates ___.

A

Tetralogy of Fallot.

Transposition of Great Vessels.

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4
Q

What are the symptoms of a preductal coarctation?

A

Right to left shunt

Cyanosis will be present.

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5
Q

What are the symptoms of a postductal coarctation?

A

Left to right shunt.
No cyanosis
Pulmonary HTN
Pulmonary edema

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6
Q

(Left to right/right to left) shunts result in hypoxemia.

A

Right to left. (More dangerous than left to right)

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7
Q

(Left to right/right to left) shunts result in pulmonary congestion..

A

Left to right.

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8
Q

If blood pressure in the arms is a lot higher than in the legs, suspect this pathology:

A

Coarctation of aorta.

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9
Q

What is the pathology of a truncus arteriosus? What is the treatment (besides surgery)?

A

Single common vessel for both the aorta and pulmonary artery. Also a septal defect.
Give O2 but not too much because you have to keep PVR high.

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10
Q

What is the pathology of hypoplastic left heart syndrome (x3)?

A

Severely underdeveloped left ventricle.
Stenosis (narrowing) of mitral valve
Small left atrium

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11
Q

What is the treatment for hypoplastic left heart syndrome?

A

Target SpO2 sat 75-85%
Give prostaglandins to keep ductus open.
Surgery.
(If you give too much O2 things will close that you need to stay open)

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12
Q

What is the pathology of Total Anomalous Pulmonary Venous Return?

A

Pulmonary veins don’t return to left atria.

“Snowman” heart shape on CXR.

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13
Q

What is the pathology of an atrial-septal defect?

A

Foramen ovale doesn’t close. L to R shunt.
May require supportive O2.
Not usually critical. Can be fixed at 5-6 years old.

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14
Q

What is the pathology of a ventricular septal defect? How do you treat it small defects? Large defects?

A

An opening between ventricles.
Small defects: O2, digoxin, diuretics.
Large defects: Surgery

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15
Q

How do you treat PDA?

A

High FiO2
Indomethacin.
Give Lasix.
Fluid restrictions.

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16
Q

How can you use PO2 to diagnose PDA or PPHN?

A

Preductal PO2 increased, post-ductal PO2 decreased. Difference must be 15 torr.

17
Q

What is the pathology of Atrial-ventricular canal?

It is common with what syndrome?

A

ASD, VSD, Tricuspid valve defect, and mitral valve defect.

Common in Down syndrome.

18
Q

What is the pathology of PPHN? What’s it caused by?

A

Severe hypoxemia and cyanosis right after birth.
Caused by increased pulmonary vascular resistance.
Similar to PDA.

19
Q

How do you treat PPHN?

A

Hyperoxygenate. (This dilates pulmonary arteries)
Give Tolazoline (Priscoline) (Vasodilator)
Nitric oxide
HFOV
ECMO

20
Q

How do you treat Transient Tachypnea of the Newborn (TTNB)?

A

40-60% FiO2 via hood. May require CPAP.

Usually self limiting.

21
Q

How do you treat MAC?

A

Intubate and suction thoroughly via ET tube.
Percussion and drainage with suctioning x 8 hours
Nitric oxide if PPHN develops.

22
Q

If the patient has CDH, do not ___ until you get a ___.

A

Do not ventilate until you get an NG tube.

23
Q

If an infant shows signs of shock and mother is sick, you should suspect ___.

A

Strep B infection.

24
Q

What is the pathology of Pierre-Robin Syndrome? To treat it, place a ___. Position patient in ___ position. Feed with a ___. And if it’s severe, perform a ___.

A 
Tongue is too big and jaw is too small.
Place a nasal airway. 
Place pt in prone position. 
Feed by NG tube. 
If severe, tracheostomy may be necessary.
25
Q

What is the pathology of Tracheoesophagea fistula?

A

Esophagus is a dead end. A hole goes into the trachea.
Place pt. in reverse trendelenberg.
Put replogle tube to keep esophageal pouch empty.
Clear secretions with a bulb syringe.
Requires surgery.

26
Q

What is the pathology of PIE? CXR will show __ or __. May also show ___ in the hilar area.

A

Air leaking from lungs into interstitial space.
CXR will show pneumothorax or pneumomediastinum.
Bubbles.

27
Q

How do you treat PIE?

A

Keep PIP down.
Give 100% O2 for 10-15 min intervals.
Single-lobe intubation.
HFOV

28
Q

What is the pathology of Necrotizing Entercolitis?

A

Ischemic necrosis to part of the GI tract.

CXR shows distended loops of bowel.

29
Q

How do you treat Necrtoizing Entercolitis?

A 
No oral feeding.
Abdominal decompression via NG tube.
Blood replacement
Antibiotics
Surgical resection of bowel.
30
Q

What are two vaccines for RSV?

What do you use to treat RSV (3 answers)

A

Respigam or Synagis

Treat with Ribavirin with SPAG and scavenger system.

31
Q

A normal sweat chloride test reading is around ___.
CF reading is ___.
If reading is positive, what should you do?

A

28
60
Repeat a second time to confirm.

32
Q

What is the most common infection for a CF patient?

What two drugs treat it?

A

Pseudomonas.

Tobramyacin or aztreonam

33
Q

How do you treat asthma?

If asthma is poorly controlled, give ___ or ___.

A

Always start with O2 (40-60%)
Bronchodilators
Inhaled steroids & mast cell inhibitors if poorly controlled

34
Q

A moderate asthma patient who is 5-11 year old has an FEV1 of ___. Their FEV1/FVC is ___. They use their SABA ___ times a week. And ___ times a week, they wake up in the night.

A

60-80%
75-80%
7 (every day)
Not more than 2 nights per week

35
Q

Yellow zone of asthma action plan:
Peak flow will be ___.
Take ___.
Begin or increase regimen of ___.

A 
50-80%
Take albuterol or SABA.
Begin or increase oral steroids.
Call doctor.
Return to Green when symptoms improve.
36
Q

To remove a foreign body that has been aspirated, use a (flexible or rigid) bronchoscopy.

A

Rigid

37
Q

What is the treatment for croup?

A

Mist tent, 30-40%.
Racemic epinephrine.
Rest
Throat and blood cultures.

38
Q

If croup is severe, treat in the ICU. Severe croup presents with ___ and ___. (Treatment is the same)

A

Inspiratory and expiratory stridor and Retractions

39
Q

What is the treatment for epiglottitis?

A 
Maintain child's position.
Take lateral X ray, look for thumb sign.
Intubate (or tracheostomy in OR only)
Antibiotics
Humidified O2 by T tube or CPAP.

Pediatric Respiratory Care (6 decks)

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