Nursing Care of a Child with Life-Threatening Conditions - RESPIRATORY DISTRESS SYNDROME

Question 1

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.

Answer 1

Acutely ill/ multi-organ problems/ High acuity
and Emergency Situations (Acute & Chronic)

Question 2

Life-threatening conditions in children include:

Answer 2

1. Respiratory Distress Syndrome
2. Sepsis
3. Meconium Aspiration Syndrome

Question 3

A medical emergency characterized by severe difficulty breathing, which can lead to hypoxemia (low oxygen levels) and eventually, cardiac arrest.

Answer 3

RESPIRATORY DISTRESS SYNDROME

Question 4

RESPIRATORY DISTRESS SYNDROME is A medical emergency characterized by severe difficulty breathing, which can lead to?

Answer 4

hypoxemia (low oxygen levels) and cardiac arrest.

Question 5

Caused by a variety of conditions, including
asthma, bronchiolitis, pneumonia, croup, and
other upper airway obstructions.

Answer 5

RESPIRATORY DISTRESS SYNDROME

Question 6

An incidence of 17.1 cases per 10,000
hospitalizations.

Answer 6

RESPIRATORY DISTRESS SYNDROME

Question 7

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.

Answer 7

32.8 per 1,000 live births.

Question 8

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.)

Answer 8

SUBJECTIVE DATA

Question 9

What questions should be asked for HEALTH HISTORY, During Pregnancy

Answer 9

1. Did the mother have any complications during pregnancy (e.g. gestational diabetes, hypertension)?
2. Did the mother experience preterm labor?
3. Did the mother receive antenatal corticosteroids to help fetal lung maturation?
4. Did the mother have any infections during
   pregnancy?

Question 10

What questions should be asked for HEALTH HISTORY, Labor and Delivery

Answer 10

1. Was the baby born prematurely?
2. Was the baby delivered by cesarean section?
3. Did the baby have a traumatic delivery?

Question 11

What questions should be asked for HEALTH HISTORY, Birth

Answer 11

1. What was the gestational age of the baby at
   birth?
2. What was the birth weight of the baby?
3. What were the baby’s Apgar scores at 1 and 5 minutes?
4. Were any abnormalities noticed during the
   baby check?

Question 12

What questions should be asked for HEALTH HISTORY, Since birth

Answer 12

1. Has the baby experienced any difficulty
   breathing?
2. Has the baby required any respiratory support or oxygen therapy?
3. Has the baby had any infections since birth?
4. Has the baby required any interventions or
   treatment for RDS?

Question 13

What are the 7 OBJECTIVE DATA of RESPIRATORY DISTRESS SYNDROME

Answer 13

1. Tachypnea
2. Dyspnea
3. Decreased breath sounds
4. Deteriorating gas levels
5. Hypoxemia despite high concentration of delivered oxygen
6. Decreased pulmonary compliance
7. Pulmonary infiltrates

Question 14

PHYSICAL ASSESSMENT
Signs of respiratory distress:
Tachypnea – a respiratory rate greater than?

Answer 14

60/min.

Question 15

PHYSICAL ASSESSMENT
Signs of respiratory distress:
Tachycardia - a pulse rate of greater than?

Answer 15

160/min

Question 16

Signs of respiratory distress:
breathing against a closed glottis?

Answer 16

Expiratory grunt

Question 17

Signs of respiratory distress:
breathing against a closed glottis?

Answer 17

Expiratory grunt

Question 18

PHYSICAL ASSESSMENT
Signs of respiratory distress include:

Answer 18

Tachypnea
Tachycardia
Expiratory grunt
Chest retraction or recession.
Flaring of the nostrils.
Cyanosis

Question 19

The (2) Diagnostic and Laboratory Tests

Answer 19

1. Routine laboratory studies
2. Chest radiograph

Question 20

NURSING DIAGNOSIS
PLANNING & IMPLEMENTATION OF CARE - RESPIRATORY DISTRESS SYNDROME

Answer 20

To optimize oxygenation and ventilation while preventing complications like oxygen toxicity and ventilator-acquired pneumonia.

Question 21

5 NURSING INTERVENTIONS - RESPIRATORY DISTRESS SYNDROME

Answer 21

1. Prepare for rapid sequence intubation, if
   necessary.
2. Prevent Ventilator Associated Pneumonia (VAP)
3. 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.
4. Monitor hemodynamics
5. Advocate for lung-protective strategies: low
   tidal volumes, prone positioning, special vent
   settings

Question 22

The Pharmacologic therapy of RESPIRATORY DISTRESS SYNDROME

Answer 22

Surfactant replacement therapy

Question 23

involves administering a synthetic surfactant to help reduce surface tension in the lungs, making it easier for the infant to breathe.

Answer 23

Surfactant replacement therapy

Question 24

Drugs that are commonly used for surfactant replacement therapy in infants with RDS:

Answer 24

1. Survanta (beractant)
2. Curosurf (poractant alfa)
3. Infasurf (calfactant)
4. Exosurf Neonatal (colfosceril palmitate)

Question 25

Define ECMO

Answer 25

Extracorporeal Membrane Oxygenation

Question 26

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.

Answer 26

Extracorporeal Membrane Oxygenation

Question 27

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.

Answer 27

ECMO

Question 28

This is necessary if the baby needs help with
breathing or if the baby is to receive surfactant as a medication.

Answer 28

Endotracheal intubation

Question 29

delivers oxygen concentrations and distending airway pressures via the ventilator without the hazards associated with full endotracheal intubation and mechanical ventilation.

Answer 29

Continuous positive airway pressure (CPAP)

Question 30

can be used to blow or “push” air and/or oxygen into your baby’s lungs while giving
breaths

Answer 30

Ventilator

Question 31

(3) SURGICAL INTERVENTIONS - RESPIRATORY DISTRESS SYNDROME

Answer 31

1. Extracorporeal Membrane Oxygenation
2. Continuous positive airway pressure (CPAP)
3. Ventilator

Question 32

NUTRITION SUPPORT IN ARDS
The primary goal for enteral nutrition in this patient population should be to?

Answer 32

avoid overfeeding

Question 33

(3) Complementary and Alternative Therapies

Answer 33

1. OXYGEN
2. SURFACTANT THERAPY
3. INTRAVENOUS CATHETER TREATMENTS

Question 34

Complementary and Alternative Therapies OXYGEN (3) subtherapies

Answer 34

a. Nasal Cannula
b. Continuous Positive Airway Pressure (CPAP)
c. Ventilator (for severe RDS)