Nursing Care of a Child with Life-Threatening Conditions - RESPIRATORY DISTRESS SYNDROME Flashcards
Life-threatening conditions of children refer to medical emergencies or critical situations in which a child’s health is in immediate danger and requires urgent nursing intervention to prevent further deterioration and stabilize their condition.
Acutely ill/ multi-organ problems/ High acuity
and Emergency Situations (Acute & Chronic)
Life-threatening conditions in children include:
- Respiratory Distress Syndrome
- Sepsis
- Meconium Aspiration Syndrome
A medical emergency characterized by severe difficulty breathing, which can lead to hypoxemia (low oxygen levels) and eventually, cardiac arrest.
RESPIRATORY DISTRESS SYNDROME
RESPIRATORY DISTRESS SYNDROME is A medical emergency characterized by severe difficulty breathing, which can lead to?
hypoxemia (low oxygen levels) and cardiac arrest.
Caused by a variety of conditions, including
asthma, bronchiolitis, pneumonia, croup, and
other upper airway obstructions.
RESPIRATORY DISTRESS SYNDROME
An incidence of 17.1 cases per 10,000
hospitalizations.
RESPIRATORY DISTRESS SYNDROME
According to the Journal of Pediatrics, infants under 1 year of age account for the majority of hospitalizations for respiratory distress, with a rate of _____ per ______ live
births.
32.8 per 1,000 live births.
What is this data called?
Mother’s report of shortness of breath
Mother’s reports signs of weakness
Mother’s report of symptoms of an underlying condition (Sepsis, etc.)
SUBJECTIVE DATA
What questions should be asked for HEALTH HISTORY, During Pregnancy
- Did the mother have any complications during pregnancy (e.g. gestational diabetes, hypertension)?
- Did the mother experience preterm labor?
- Did the mother receive antenatal corticosteroids to help fetal lung maturation?
- Did the mother have any infections during
pregnancy?
What questions should be asked for HEALTH HISTORY, Labor and Delivery
- Was the baby born prematurely?
- Was the baby delivered by cesarean section?
- Did the baby have a traumatic delivery?
What questions should be asked for HEALTH HISTORY, Birth
- What was the gestational age of the baby at
birth? - What was the birth weight of the baby?
- What were the baby’s Apgar scores at 1 and 5 minutes?
- Were any abnormalities noticed during the
baby check?
What questions should be asked for HEALTH HISTORY, Since birth
- Has the baby experienced any difficulty
breathing? - Has the baby required any respiratory support or oxygen therapy?
- Has the baby had any infections since birth?
- Has the baby required any interventions or
treatment for RDS?
What are the 7 OBJECTIVE DATA of RESPIRATORY DISTRESS SYNDROME
- Tachypnea
- Dyspnea
- Decreased breath sounds
- Deteriorating gas levels
- Hypoxemia despite high concentration of delivered oxygen
- Decreased pulmonary compliance
- Pulmonary infiltrates
PHYSICAL ASSESSMENT
Signs of respiratory distress:
Tachypnea – a respiratory rate greater than?
60/min.
PHYSICAL ASSESSMENT
Signs of respiratory distress:
Tachycardia - a pulse rate of greater than?
160/min
Signs of respiratory distress:
breathing against a closed glottis?
Expiratory grunt
Signs of respiratory distress:
breathing against a closed glottis?
Expiratory grunt
PHYSICAL ASSESSMENT
Signs of respiratory distress include:
Tachypnea
Tachycardia
Expiratory grunt
Chest retraction or recession.
Flaring of the nostrils.
Cyanosis
The (2) Diagnostic and Laboratory Tests
- Routine laboratory studies
- Chest radiograph
NURSING DIAGNOSIS
PLANNING & IMPLEMENTATION OF CARE - RESPIRATORY DISTRESS SYNDROME
To optimize oxygenation and ventilation while preventing complications like oxygen toxicity and ventilator-acquired pneumonia.
5 NURSING INTERVENTIONS - RESPIRATORY DISTRESS SYNDROME
- Prepare for rapid sequence intubation, if
necessary. - Prevent Ventilator Associated Pneumonia (VAP)
- Assist to treat the underlying cause. If the patient has pneumonia, administering antibiotics is essential to healing, if the
patient has a PE, administer appropriate blood thinners. - Monitor hemodynamics
- Advocate for lung-protective strategies: low
tidal volumes, prone positioning, special vent
settings
The Pharmacologic therapy of RESPIRATORY DISTRESS SYNDROME
Surfactant replacement therapy
involves administering a synthetic surfactant to help reduce surface tension in the lungs, making it easier for the infant to breathe.
Surfactant replacement therapy
Drugs that are commonly used for surfactant replacement therapy in infants with RDS:
- Survanta (beractant)
- Curosurf (poractant alfa)
- Infasurf (calfactant)
- Exosurf Neonatal (colfosceril palmitate)
Define ECMO
Extracorporeal Membrane Oxygenation
blood is pumped outside of the body to a
membrane that removes carbon dioxide and sends oxygen-filled blood back to tissues in the body.
Extracorporeal Membrane Oxygenation
This method allows the blood to bypass the heart and lungs, enabling these organs to fully rest and heal. This stabilize gas exchange and hemodynamic compromise, consequently preventing further hypoxic organ damage.
ECMO
This is necessary if the baby needs help with
breathing or if the baby is to receive surfactant as a medication.
Endotracheal intubation
delivers oxygen concentrations and distending airway pressures via the ventilator without the hazards associated with full endotracheal intubation and mechanical ventilation.
Continuous positive airway pressure (CPAP)
can be used to blow or “push” air and/or oxygen into your baby’s lungs while giving
breaths
Ventilator
(3) SURGICAL INTERVENTIONS - RESPIRATORY DISTRESS SYNDROME
- Extracorporeal Membrane Oxygenation
- Continuous positive airway pressure (CPAP)
- Ventilator
NUTRITION SUPPORT IN ARDS
The primary goal for enteral nutrition in this patient population should be to?
avoid overfeeding
(3) Complementary and Alternative Therapies
- OXYGEN
- SURFACTANT THERAPY
- INTRAVENOUS CATHETER TREATMENTS
Complementary and Alternative Therapies OXYGEN (3) subtherapies
a. Nasal Cannula
b. Continuous Positive Airway Pressure (CPAP)
c. Ventilator (for severe RDS)
