Nursing Care of a Child with Respiratory Disorders Flashcards
the exchange of gases from an area of higher pressure to an area of lower pressure.
It occurs at the alveolo-capillary membrane.
Diffusion
the availability & movement of blood for transport of gases, nutrients & metabolic waste products.
Perfusion
Part of Pons that is responsible for the rhythmic quality of breathing.
Pneumotaxic center
responsible for deep, prolonged inspiration
Apneustic center
Factors Affecting Respiratory Rate (RR
Exercise Stress Environment Increased Altitude Medications
prolonged deep breaths. CO2 is excessively exhaled (respiratory alkalosis.)
Hyperventilation
slow & shallow. CO2 is excessively retained (respiratory acidosis).
Hypoventilation
Prolonged inspiratory phase =
upper airway obstruction
Croup (inflammation of the larynx, trachea, and major bronchi) Laryngotracheobronchitis
Foreign body
Laboratory Tests in respiratory disorders (labspecimen)
Arterial blood gases
Nasopharyngeal culture
Sputum analysis
Diagnostic Tests in Respiratory
Chest x-ray Sweat chloride Test MRI Laryngoscope / bronchoscopy CT Scan Pulmonary Function Tests
ay be ordered for children with chronic lung disease because this technique can best mark disease progress.
Computed tomography (CT) scans
visualization of the bronchi through a bronchoscope
Bronchoscopy
measures the forces of innertia, elasticity, and flow resistance
Pulmonary Function Test
instilling saline nose drops or using saline nasal sprays can be effective at moistening and loosening dried mucus in the nose
Expectorant Therapy
re mechanical devices that provide a stream of moistened air directly into the respiratory tract
Nebulizers
most frequent respiratory disorder seen in children and is spread through families easily.
common cold
hand-held device that provide that provides a route for medication administration directly to the respiratory tract.
Metered-Dose Inhalers
Signs of Severe Respiratory Distress
Nasal flaring and grunting Severe retractions Diminished breath sounds Hypotonia Decreased oxygen saturations
Rhinitis Treatment
Antihistamines
Competitive inhibitors for histamine at the mast cell receptor sites
Benadryl – OTC medication
Treatment of Sinusitis
Normal saline nose drops Warm pack to face Acetaminophen for pain Increase oral fluid intake Antibiotics
Treatment for Tonsillitis
Antibiotics X ten days if positive for beta strep
Acetaminophen for pain
Cold fluids
Saline gargles
Post operative care: Tonsillectomy
Side lying position
Ice collar
Watch out for frequent swallowing
Cool fluids / soft diet
Croup also called?
Laryngotracheobronchitis or Acute spasmotic croup
Management of Croup
Home care: Cool mist Fluids Hospital care: Racemic epinephrine inhalant Mist tent – not used much anymore Dexamethasone IV over 1 to several minutes
Agent: Bordetella Pertussis Source: respiratory Transmission: droplet Incubation: 10 days Period of communicability: before onset of paroxysms to 4 weeks after onset
Pertussis or Whooping cough
Management of Pertussis
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
Highly contagious with up to 90% of household contacts developing disease after contact.
3-4 days isolation
Pertussis
Acute inflammation of supra-glottic structures. Medical emergency Sudden onset High fever Dysphasia and drooling
Epilottitis
Management of Epiglottitis
Ceftriaxone – third-generation cephalosporin for 7 to 10 days
cessation of respiration lasting longer than 20 seconds.
Apnea
Associated with community epidemic
Febrile, URI, achy joints,
Influenza
Management: Influenza
Acetaminophen for fever Vit. C Fluids Keep away from others Watch for signs of pneumonia
Bronchioles become narrowed or occluded as a result of inflammatory process, edema, mucus & cellular debris clog alveoli.
Bronchiolitis
Management of Bronchiolitis
Oxygen to maintain oxygen saturation >than 95%
Pulse oximeter
Normal saline nose drops before suctioning
Deep suction especially before feeding
CPT- (Chest pulmo phy)
spread from respiratory secretions through close contact with infected persons or contact with contaminated surfaces or objects.
RSV(Respiratory Syn Virus ) Positive - Isolation
nflammatory condition of the lungs
in which alveoli fill with fluid or blood
resulting in poor oxygenation & air
exchange.
Pneumonia
Management of Pneumonia
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
hronic, progressive, genetic illness involving the digestive system & lungs.
Cystic Fibrosis
Meconium ileus at birth Failure to thrive Steatorrhea stools / constipation Voracious appetite with poor weight gain Recurrent respiratory infections Chronic cough
Symptoms of Cystic Fibrosis
Diagnosis of Cystic Fibrosis
Positive sweat test
Genetic marker
Life long management
Medications for Cystic Fibrosis
Bronchodilators to open airways
Vitamin C to improve absorption of other meds
Vitamins A,D,E,K
chronic, inflammatory lung disease involving recurrent breathing problems.
Asthma
Medical Management of Asthma
High fowlers position / bed rest Pulse oximetry Nebulized albuterol CPT Methylprednisone / Solu-medrol IV IV fluids Oxygen to keep oxygen sats > 95%
Home Management of Asthma
Peak flow spirometer
Identify triggers
Maximize lung function
Home Medications for Asthma
Rescue drugs:
short acting albuterol beta 2 agonist – used as a quick-relief agent for acute bronchospas
Anti-inflammatory or preventative for Asthma
low-dose inhaled corticosteroid: inhaled or oral prednisone
always give with food to decrease GI upset.
medication
Oral Prednisone
Anti-inflammatories
Home Medications for Asthma
Oral prednisone (Pedia-pred, Prelone, Liquid pred) recommended for short course in moderate or severe exacerbation Inhaled: Pulmicort, AeroBid, Flovent
occurs in newborns who are born prematurely & or have a variety of pulmonary disorders &
Bronchopulmonary Dysplasia
Persistent respiratory distress Dependent on supplemental oxygen Failure to thrive Gastro-esophageal reflux Pulmonary hypertension
Bronchopulmonary Dysplasia
Long Term Management of Bronchopulmonary Dysplasia
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
