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PEDS Exam 2 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

what are the paths of ventilation on children?

A

naso trach, oral trach, and direct trach

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2
Q

where does the direct trach enter the body?

A

Through a stoma created on the lower neck

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3
Q

what infection do you look for when a patient is on a ventilator?

A

ventilator associated penumonia

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4
Q

what can be done to prevent VAP?

A

routine oral care, hand washing, gloves, suctioning, semi fowler positioning, and getting off as soon as they are ready

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5
Q

why must the HOB be elevated in a ventilated patient?

A

doing this helps get rid of secretions in the lungs

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6
Q

what happens to the hospital if a patient gets VAP?

A

insurance will not cover the cost of the hospital acquired infection

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7
Q

what does DOPE mean for ventilated patients?

A

Displacement of the tube
Obstruction…secretions
Pneumothorax
Equipment failure

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8
Q

what medications are ventilated patients on to prevent them from extubating themselves?

A

analgesia, sedation, and paralytic

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9
Q

what are signs someone is ready to come off the vent?

A

improvement of underlying condition, hemodynamic stability, breathing over vent, and LOC is better

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10
Q

is the upper trachea a upper or lower resp infection?

A

upper

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11
Q

is the lower trachea a upper or lower resp infection?

A

lower

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12
Q

why are children under 3 months at low risk of infection?

A

because they still have their mother antibodies

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13
Q

at what age does the risk of infection go up?

A

3-6 months

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14
Q

at what age do the mother antibodies leave the baby?

A

3-6 months

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15
Q

in general who has the greatest risk of infection in kids?

A

younger children

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16
Q

when is whopping cough the most dangerous?

A

in infancy

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17
Q

what does size of the child have to do with infection?

A

then smaller the child the more likely they are to get infectino

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18
Q

why are smaller children more apt to getting infection based on size?

A

smaller children have smaller airways and a smaller distance for the foreign body to go into the respiratory system

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19
Q

what does resistance have to do with etiology of infection in kids?

A

the immunes systems ability to fight off the infection

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20
Q

what does seasonal have to do with etiology of infection in kids?

A

certain times of the year have higher rates of infection

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21
Q

when is the most common time for kids to get resp infections?

A

september to april

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22
Q

what are the symptoms of respiratory infection in kids?

A

same as adults but they can have anorexia from not eating

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23
Q

how do sick kids get anorexia?

A

their body will pick respiratory function over their appetite

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24
Q

what happens to respiratory rate in children sick with a respiratory infection?

A

then childs RR will increase

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25
Q

what happens to the rhythm of a child with a resp infection?

A

it will be irregular

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26
Q

what happens to a childs depth/work of breathing?

A

they will be struggling to breath so they will breath deeper, and also have signs of nasal flaring and retractions

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27
Q

where do retractions typically start?

A

they usually start low and work their way up

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28
Q

what muscles are working with retractions?

A

intercostal muscles

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29
Q

are lower or upper retractions worse?

A

upper

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30
Q

what happens to HR of a child with a resp infection?

A

increases

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31
Q

what happens to pulse ox of a child with a resp infection?

A

drops from their normal

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32
Q

is it okay if a childs pulse ox reads low and they are acting normal?

A

yes

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33
Q

what happens to hydration status of a child with a resp infection?

A

they become dehydrated due to not wanting to drink fluids and vomitting

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34
Q

how can you check hydration status?

A

I/O, skin turgor, color of urine, oral mucosa, tear production, skin turgor

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35
Q

what happens to temp of a child with a resp infection?

A

their temp will increase….if above 100.4 do interventions

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36
Q

what happens to activity level of a child with a resp infection?

A

they will become lethargic

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37
Q

what type of pain might a child with a resp infection have?

A

chest pain

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38
Q

what is a good color for a child to be?

A

pinky

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39
Q

what are bad colors for a child to be?

A

grey or blue

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40
Q

what happens to LOC of a child with a resp infection?

A

it is decreased and often correlated with pulse ox

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41
Q

what does stridor sound like?

A

high pitched

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42
Q

where is stridor auscultated?

A

in the neck

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43
Q

what does stridor indicate?

A

narrowing of the airway

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44
Q

what is the rock star?

A

head bobbing to breath by using the neck muscles

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45
Q

what is nasal flarring?

A

flarring nose

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46
Q

what should be done during respiratory care management?

A

easing resp effort, promote rest, promote comfort, prevent spread of infection, reduce temp, promote hydration, provide nutrition, family support

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47
Q

what does easing resp effort mean in resp care?

A

sit the patient up and give oxygen

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48
Q

what does reduce temp mean for resp care?

A

look at their clothes, their blankets, and give acetaminophen or ibuprofen depending on age

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49
Q

what medication can you not give before 6 months?

A

ibuprofen

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50
Q

what age group is most at risk for aspiration?

A

toddlers

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51
Q

what are some symptoms of choking?

A

cant speak, cyanotic, coughing, wheezing,

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52
Q

what are some signs of aspiration into the broncioles?

A

coughing, wheezing, dyspnea, asymmetrical breath sounds

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53
Q

do you do back blow or abdominal thrust on a child over a year?

A

abdominal thrust

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54
Q

do you do back blow or abdominal thrust in child under a year?

A

back blow

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55
Q

what should you never do to someone that is choking?

A

finger sweep in the mouth

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56
Q

what is asthma?

A

a chronic inflammatory disease that causes airway to swell and have excessive mucus

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57
Q

what are symptoms of asthma?

A

nonproductive cough, wheezing, restless, tripod, tight chest, and labored breathing

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58
Q

what are the diagnostics for asthma?

A

signs and symptoms, PFT, and peak expiratroy flow rate

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59
Q

what is done during a pft?

A

the patient will do some form of exercise while someone monitors their O2 sat, bp, and HR

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60
Q

what is done during a peak expiratory test?

A

the patient breaths in and then blows as hard as they can into the device

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61
Q

what should you tell a patient to do if they have asthma

A

control physical activity, take medications, prevent exacerbations, limit smoke and know triggers

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62
Q

what are somethings that can cause exacerbations in asthma patients?

A

allergens, smoke, sprays, chemicals, exercise, cold air, changes in temp, colds, infections, animals, meds, emotions, pregnancy, thyroid problems

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63
Q

what age must a patient be before diagnosing with asthma?

A

???

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64
Q

what are the two types of meds used to control asthma?

A

quick acting and long term

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65
Q

what are the quick-acting meds for controlling asthma?

A

albuterol and epi+++++++++

66
Q

when are quick acting meds used?

A

during exacerbations

67
Q

when are long term meds used?

A

used daily to prevent exacerbations

68
Q

what are the long term meds for asthma?

A

dexamethasone, budesonide, fluticasone, salmaterol, Cromolyn, Theophylline,

69
Q

what ages use a breathing chamber for astham?

A

all children

70
Q

how many puffs should the child take out of spacer/breathing chamber?

A

10

71
Q

what is status asthmaticus?

A

this occurs when the patient is not responding to treatment for attack

72
Q

what is respiratory failure?

A

this occurs when the body cannot maintain adeqaute blood oxygenation

73
Q

what can respirtroy faiulure lead to in children besides death?

A

cardiac arrest

74
Q

what are the cardinal signs of resp failure?

A

restless, tachypnea, tachycardia, and diaphoresis

75
Q

what are less obvious signs of resp failrue?

A

mood changes, headaches, altered resp, hypertension, exertional dyspnea, anorexia, CNS, increased CO and Urine output, nasal flarring, retraction, grunt, wheeze

76
Q

what should be done if a child is in resp failure?

A

CPR if needed, O2, suction, high fowlers, cpap, bipap, or vent

77
Q

what is sickle cell anemia?

A

this disease occurs when a genetic mutation effects your RBC production shape.

78
Q

what shape are RBC in a patient with sickle cell?

A

crescent shaped

79
Q

what are symptoms of sickle cell anemia?

A

SOB, fatigue, hand/foot/bone pain, acut chest syndrome, spleen pain, stroke

80
Q

what causes pain in sickle cell patietns?

A

ischemia

81
Q

why is ischemia painful?

A

due to the tissues not getting oxygenated

82
Q

how long do sickle cell exacerbations last?

A

days to weeks

83
Q

what is used to diagnose sickle cell?

A

electrophoresis

84
Q

what should be done during the treatment of sickle cell?

A

pain meds, oxygen, antibiotics, fluids, immunizations, spleenectomy if needed, heat, MORPHINE, blood

85
Q

why is morphine given to sickle cell patients

A

to help with vasodilation to restore blood flow?

86
Q

what meds are given to sickle cell patients to help with pain?

A

Nsaids, acetaminophen, morphine, and codones

87
Q

what pain med should never be given to sickle cell patients?

A

demmerol/meperidine

88
Q

what education should be given to sick cell patient?

A

get vaccines, take antibiotics, child may bed wet, if signs of infection are present come to the ER

89
Q

what is nasopharyngitis?

A

a common cold caused by a virus

90
Q

what med should be avoided in nasopharyngitis?

A

cough suppressants or diphenhydramine

91
Q

what are symptoms of nasopharyngitis?

A

fever, restless, decreased appetite, sneezing, vomit, diarrhea, anorexia, sore throat

92
Q

what are the interventions for nasopharyngitis?

A

ibuprofen/acetaminophen, fluids, elevate HOB, nasal suction

93
Q

what is the minimum fluid intake every 10 minutes to maintain hydration?

A

5-10ml

94
Q

when should you do nasal suction?

A

at bedtime or right before feeding

95
Q

what are the steps for nasal suciton?

A

saline in the nose and suction with the bulb

96
Q

what is acute streptococcal pharyngitis known as?

A

strep throat

97
Q

is acute streotoccal pharyngitis viral or bacterial?

A

bacterial or viral

98
Q

what is the treatment for acute streptococcal pharyngitis?

A

treated with penicillin, ibuprofen/acetaminophen, and salt water gargle

99
Q

what are the symptoms of acute streptoccoal pharyngitis?

A

sore throat, fever, white exudate, swollen tonsils, headache, vomitting, halitosis

100
Q

what teaching should be given to patient with acute pharyngitis?

A

throw toothbrush away 24 hours after starting antibiotics, kid can back to school 24 hours after starting antibiotics, if unmedicated the child must be 24 hours without fever before returning to school cold or warm compress on neck

101
Q

what is tonsilitis?

A

inflammation of the tonsils due to virus or bacteria

102
Q

what are symptoms of tonsillitis?

A

sore throat, fever, difficulty breathing/swallowing

103
Q

what is the treatment for tonsilitis?

A

same treatments as acute pharyngitis but can also have a tonsilectomy

104
Q

what is a tonsilectomy?

A

removal of tonsils

105
Q

what should be done post op for tonsilectomy?

A

closely monitor airway, position on their side, give ondansetron/scopolamine patch, cool fluids

106
Q

what should not be don post op for tonsilectomy?

A

avoid suction, avoid coughing, avoid blowing nose, avoid flarring throat, no milk, no warm fluids, dont pust fluids until awake, no brown or red foods

107
Q

what should you monitor for in post op tonsilectomy?

A

airway, constant swallowing, hemmorhage, emesis, frequent clearing of throat, increase HR, hypotension

108
Q

what does constant swallowing or throat clearing mean in a tonsillectomy patient?

A

bleeding

109
Q

when is it most common for child to hemmorhage after getting tonsilectomy

A

5-10 days when the scabs come off

110
Q

what pain is normal in tonsilectomy?

A

throat, ear,

111
Q

is minor bad breath normal in tonsilectomy?

A

yes

112
Q

what is RSV

A

infection caused by virus

113
Q

is RSV upper or lower resp tract?

A

lower

114
Q

when does RSV peak?

A

3-5 days

115
Q

how long can RSV last?

A

weeks

116
Q

how is RSV diagnosed?

A

swab test

117
Q

how to prevent RSV?

A

hand hygeine or high risk patients take palivizumab

118
Q

when do high risk patients take palivizumab?

A

during high risk months

119
Q

what can RSV lead to?

A

bronchiolitits

120
Q

what are symptoms of RSV stage 1?

A

rhinorhea, coughing, wheezing

121
Q

what are symptoms of RSV stage 2?

A

worseinging cough/wheeze, fever tachypnea, poor eating ,and increased secretion

122
Q

what are symptoms of RSV stage 3?

A

RR great than 70, listlessness/lethary, and apneic spells

123
Q

what are treatments for RSV?

A

hydration, ribavirin, and bulb syringe

124
Q

when should a child be hospitalized with RSV?

A

continuous pulse ox less than 90

125
Q

what are the treatments for hospitalized RSV patient?

A

humidified o2 in nasal cannula, bulb suction, IV fluids, and bronchodialator

126
Q

what is cystic fibrosis?

A

a gland dysfunction that causes the body to increase mucus production and causes problems digesting food

127
Q

what are symptoms of cysitc fibrosis?

A

thick secretions, anorexia, clubbing fingers, abdominal distention, failure to pass meconium, vomiting, growth failure, weight loss, thin, wheezing and cough

128
Q

how is cystic fibrosis diagnosed?

A

sweat chloride test

129
Q

what are complications associated with cystic fibrosis?

A

meconium illeus, loose frothy stool, hypoxia, and diabetes

130
Q

what vitamins are cystic fibrosis patients deficient in?

A

vitamin A,D,E,K

131
Q

why do CF patients have a wheeze but not a productive cough?

A

their mucus is too thick to get up

132
Q

what is a meconium illeus?

A

blockage of the bowel caused by thick mucus

133
Q

what is steatorrhea

A

fatty poops

134
Q

why do CF patients have steatorrhea?

A

because they cant digest the fats

135
Q

why are cf patients at risk for malnourishment?

A

they have bad absorption

136
Q

what should be given before meals for CF patietns?

A

pancreatic enzymes

137
Q

what is the timing needs for pancreatic enzymes?

A

30 minutes for enteric coats and the open capsule with the meal

138
Q

what are long term effects of the pulmonary system in cf patients?

A

dyspnea, cyanosis, barrel chest, and clubbed fingers

139
Q

what is dornase alpha used for?

A

to thin the mucus in cf patients

140
Q

++++how is ripivirn taken?

A

orally inhaled

141
Q

why are kids with CF at risk for growth failure?

A

bad absorption of calories

142
Q

what kind of diet do CF patietns need?

A

high cal, high protein, high fat

143
Q

what is croup?

A

an umbrella term that involves a barking/brassy cough related to infection

144
Q

what breath sound do croup patietns have?

A

inspiratory stridor

145
Q

what are the symptoms of acute epiglottis?

A

symptoms that occur at night including drooling, high fever, spontaneous cough, agitatoin, retraction, increased breathing effort

146
Q

how bad is acute epiglottis?

A

an urgent emergency

147
Q

what kind of environment is best for acute epiglottis patients?

A

calm anxiety free

148
Q

what should you not do with acute epiglottis patietns?

A

never inspect the throat

149
Q

what should be ready at bedside with acute epiglotis patietns?

A

intubation

150
Q

what age group typically gets acute epiglottis?

A

older kids

151
Q

what is laryngeal bronchitis?

A

a croup disease that is caused by infection

152
Q

what are symptoms of laryngeal bronchitis?

A

stridor, brassy cough, low grade fever, horse,

153
Q

when should you go to the hospital if your child has laryngeal brochitis?

A

xx

154
Q

what helps laryngeal bronchitis?

A

cold air, o2 by face mask, blow by o2

155
Q

what should you monitor for when the child gets better with laryngeal bronchitis

A

rebound of symptoms

156
Q

what is acute spasmodic laryngitis?

A

a croup disease that worsens at night

157
Q

what are symptoms of acute spasmodic laryngitis?

A

stridor, horse, barky, NO FEVER,

158
Q

how quickly does acute spasmodic laryngitis get fixed?

A

few hours

159
Q

what helps spasmodic laryngitis?

A

humidified air, cool air, or warms team

160
Q

what route do you give pain meds in tonsilectomy?

A

IV or rectal

161
Q

what do you not give with spirolactone?

A

no potassium supplement

PEDS Exam 2 (5 decks)

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