Nursing Care of a Child with Respiratory Disorders

Question 1

the exchange of gases from an area of higher pressure to an area of lower pressure.
It occurs at the alveolo-capillary membrane.

Answer 1

Diffusion

Question 2

the availability & movement of blood for transport of gases, nutrients & metabolic waste products.

Answer 2

Perfusion

Question 3

Part of Pons that is responsible for the rhythmic quality of breathing.

Answer 3

Pneumotaxic center

Question 4

responsible for deep, prolonged inspiration

Answer 4

Apneustic center

Question 5

Factors Affecting Respiratory Rate (RR

Answer 5

Exercise
Stress
Environment
Increased Altitude
Medications

Question 6

prolonged deep breaths. CO2 is excessively exhaled (respiratory alkalosis.)

Answer 6

Hyperventilation

Question 7

slow & shallow. CO2 is excessively retained (respiratory acidosis).

Answer 7

Hypoventilation

Question 8

Prolonged inspiratory phase =

Answer 8

upper airway obstruction
Croup (inflammation of the larynx, trachea, and major bronchi) Laryngotracheobronchitis
Foreign body

Question 9

Laboratory Tests in respiratory disorders (labspecimen)

Answer 9

Arterial blood gases
Nasopharyngeal culture
Sputum analysis

Question 10

Diagnostic Tests in Respiratory

Answer 10

Chest x-ray
Sweat chloride Test
MRI
Laryngoscope / bronchoscopy
CT Scan
Pulmonary Function Tests

Question 11

ay be ordered for children with chronic lung disease because this technique can best mark disease progress.

Answer 11

Computed tomography (CT) scans

Question 12

visualization of the bronchi through a bronchoscope

Answer 12

Bronchoscopy

Question 13

measures the forces of innertia, elasticity, and flow resistance

Answer 13

Pulmonary Function Test

Question 14

instilling saline nose drops or using saline nasal sprays can be effective at moistening and loosening dried mucus in the nose

Answer 14

Expectorant Therapy

Question 15

re mechanical devices that provide a stream of moistened air directly into the respiratory tract

Answer 15

Nebulizers

Question 16

most frequent respiratory disorder seen in children and is spread through families easily.

Answer 16

common cold

Question 17

hand-held device that provide that provides a route for medication administration directly to the respiratory tract.

Answer 17

Metered-Dose Inhalers

Question 18

Signs of Severe Respiratory Distress

Answer 18

Nasal flaring and grunting
Severe retractions
Diminished breath sounds
Hypotonia
Decreased oxygen saturations

Question 19

Rhinitis Treatment

Answer 19

Antihistamines
Competitive inhibitors for histamine at the mast cell receptor sites
Benadryl – OTC medication

Question 20

Treatment of Sinusitis

Answer 20

Normal saline nose drops
Warm pack to face
Acetaminophen for pain
Increase oral fluid intake
Antibiotics

Question 21

Treatment for Tonsillitis

Answer 21

Antibiotics X ten days if positive for beta strep
Acetaminophen for pain
Cold fluids
Saline gargles

Question 22

Post operative care: Tonsillectomy

Answer 22

Side lying position
Ice collar
Watch out for frequent swallowing
Cool fluids / soft diet

Question 23

Croup also called?

Answer 23

Laryngotracheobronchitis or Acute spasmotic croup

Question 24

Management of Croup

Answer 24

Home care: 
Cool mist 
Fluids
Hospital care:
Racemic epinephrine inhalant
Mist tent – not used much anymore
Dexamethasone IV over 1 to several minutes

Question 25

``` Agent: Bordetella Pertussis Source: respiratory Transmission: droplet Incubation: 10 days Period of communicability: before onset of paroxysms to 4 weeks after onset ```

Answer 25

Pertussis or Whooping cough

Question 26

Management of Pertussis

Answer 26

Respiratory support as needed Suctioning Oxygen to keep oxygen saturation at > 98 % Nutritional support IV fluids Erythromycin, Zithromax or Biaxin for child & all exposed family members

Question 27

Highly contagious with up to 90% of household contacts developing disease after contact. 3-4 days isolation

Answer 27

Pertussis

Question 28

``` Acute inflammation of supra-glottic structures. Medical emergency Sudden onset High fever Dysphasia and drooling ```

Answer 28

Epilottitis

Question 29

Management of Epiglottitis

Answer 29

Ceftriaxone – third-generation cephalosporin for 7 to 10 days

Question 30

cessation of respiration lasting longer than 20 seconds.

Answer 30

Apnea

Question 31

Associated with community epidemic | Febrile, URI, achy joints,

Answer 31

Influenza

Question 32

Management: Influenza

Answer 32

``` Acetaminophen for fever Vit. C Fluids Keep away from others Watch for signs of pneumonia ```

Question 33

Bronchioles become narrowed or occluded as a result of inflammatory process, edema, mucus & cellular debris clog alveoli.

Answer 33

Bronchiolitis

Question 34

Management of Bronchiolitis

Answer 34

Oxygen to maintain oxygen saturation >than 95% Pulse oximeter Normal saline nose drops before suctioning Deep suction especially before feeding CPT- (Chest pulmo phy)

Question 35

spread from respiratory secretions through close contact with infected persons or contact with contaminated surfaces or objects.

Answer 35

RSV(Respiratory Syn Virus ) Positive - Isolation

Question 36

nflammatory condition of the lungs in which alveoli fill with fluid or blood resulting in poor oxygenation & air exchange.

Answer 36

Pneumonia

Question 37

Management of Pneumonia

Answer 37

``` Assess for respiratory distress NPO (RR > 60 = high risk for aspiration) IV fluids Oxygen as need to keep oxygen saturation above 95% CPT Deep suctioning Acetaminophen for fever ```

Question 38

hronic, progressive, genetic illness involving the digestive system & lungs.

Answer 38

Cystic Fibrosis

Question 39

``` Meconium ileus at birth Failure to thrive Steatorrhea stools / constipation Voracious appetite with poor weight gain Recurrent respiratory infections Chronic cough ```

Answer 39

Symptoms of Cystic Fibrosis

Question 40

Diagnosis of Cystic Fibrosis

Answer 40

Positive sweat test Genetic marker Life long management

Question 41

Medications for Cystic Fibrosis

Answer 41

Bronchodilators to open airways Vitamin C to improve absorption of other meds Vitamins A,D,E,K

Question 42

chronic, inflammatory lung disease involving recurrent breathing problems.

Answer 42

Asthma

Question 43

Medical Management of Asthma

Answer 43

``` High fowlers position / bed rest Pulse oximetry Nebulized albuterol CPT Methylprednisone / Solu-medrol IV IV fluids Oxygen to keep oxygen sats > 95% ```

Question 44

Home Management of Asthma

Answer 44

Peak flow spirometer Identify triggers Maximize lung function

Question 45

Home Medications for Asthma | Rescue drugs:

Answer 45

short acting albuterol beta 2 agonist – used as a quick-relief agent for acute bronchospas

Question 46

Anti-inflammatory or preventative for Asthma

Answer 46

low-dose inhaled corticosteroid: inhaled or oral prednisone

Question 47

always give with food to decrease GI upset. | medication

Answer 47

Oral Prednisone

Question 48

Anti-inflammatories | Home Medications for Asthma

Answer 48

``` Oral prednisone (Pedia-pred, Prelone, Liquid pred) recommended for short course in moderate or severe exacerbation Inhaled: Pulmicort, AeroBid, Flovent ```

Question 49

occurs in newborns who are born prematurely & or have a variety of pulmonary disorders &

Answer 49

Bronchopulmonary Dysplasia

Question 50

``` Persistent respiratory distress Dependent on supplemental oxygen Failure to thrive Gastro-esophageal reflux Pulmonary hypertension ```

Answer 50

Bronchopulmonary Dysplasia

Question 51

Long Term Management of Bronchopulmonary Dysplasia

Answer 51

``` Supplemental oxygen CPT Bronchodilators Diuretics (pulmonary hypertension) Anti-inflammatory medication Nutritional support: oral formula + NG supplement Gastrostomy tube (GER) Bicarbonate in formula due to chronic state of acidosis ```