Oxygenation Flashcards
Head Bobbing
The child’s head move forward each time he/she takes a breath. This is caused by the use of neck muscles to assist in breathing.
Grunting
A sound heard on expiration caused by sudden closure of the glottis in an attempt to prevent alveoli from collapsing.
Nasal Flaring
A compensatory symptom that increases upper airway diameter and reduces resistance and work of breathing
Retractions
Sinking in of soft tissues occurs when lung compliance is poor or airway resistance is high. Types of retractions:
- Subcostal - below the ribcage
- Intercostal - between the ribcage
- Substernal - below the sternum
- Suprasternal - above the sternum
- Supraclavicular - above the clavical
Important Associated Observations of Respiratory Depression
- tachypnea
- color changes of the skin (mottling, pallor, and cyanosis of the nailbeds or around the mouth - circumoral)
- chest pain (may be compliant in older children)
- cough
- changes in alertness (low oxygen levels may cause children to act very tired, or decrease awareness)
- changes in behavior (restless, irritable, apprehensive)
Nursing Management of Patient with Oxygenation Issues
- Provide Supportive Care (things you do without a doctor’s order)
- Ensure adequate hydration (infants with RR greater then 60 typically NPO)
- Elevate HOB - keep airway open
- Administer analgesics for pain
- Provide supplemental oxygen
- Suctioning
- Complete respiratory assessments
Nursing Management of Patient with Oxygenation Issues
- Providing Family Education
- stress importance of adhering to prescribed medications
- handwashing
- teach that child may continue to tire easily over the next 1-2 weeks
- infants may continue to need small, frequent feedings
- cough should lessen over time
- pain management
- immunization status
Cough
Serves as a protective mechanism and an indicator of irritation
- Cough medication should not be given to children
- OTC cough medicines should not be given to a child younger than 6
Upper Respiratory Infections: Acute Nasopharyngitis
- The common cold
- Usually caused by rhinoviruses, influenza, parainfluenza, and adenovirus
- Viral particles spread through the air or person-to-person contact
- Occur more frequently in the winter
- Higher incidence among children who attend daycare/school, or exposed to second-hand smoke
- symptoms: fever in younger children, low-grade fever in older children, nasal discharge, nasal congestion, coughing sneezing
- resolves 10-14 days
Therapeutic Management of Nasopharyngitis
- acetaminophen
- elevate head
- saline nose drops
- cool mist humidifier (doesn’t produce as much bacteria/mold)
- What does not work? antibiotics, nasal decongestant, cough medicine, antihistamines
Otitis Media
Behind the eardrum
- inflammation of the middle ear with the presence of fluid
- 6 months to 2 years common age
- causes bulging eardrum
Acute Otitis Media (AOM)
- Rapid onset of signs and symptoms
- Lasts 1 - 3 weeks
- Viral: most common, due to blocked Eustachian tubes from edema or URI and resolves without treatment
- Bacterial causes:
- Clinical manifestations: otalgia (earache), fever, crying, irritability, lethargy, and loss of appetite
Otitis Media with Effusion (OME)
fluid in middle ear space without symptoms of acute infection
- not pus, just fluid (ex: kids with allergies)
Chronic otitis media with effusion: OME lasting longer than 3 months
- can cause hearing damage
Otitis Externa (OE)
Swimmers ear
- infection and inflammation of the skin of the external ear canal
- caused by bacteria (Pseudomonas and staph), or fungi (Aspergillus)
- moisture in the canal contributes to pathogen growth, and changing pH in the ear contributes to inflammation
Therapeutic Management of Ear Infections: AOM
Viral - no antibiotics needed
- acetaminophen may be given to relieve pain and fever
- decision to prescribe antibiotics is up to medical provider
