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Pediatrics > oxygenation: the pediatric patient > Flashcards

oxygenation: the pediatric patient Flashcards

1
Q

PHYSIOLOGICAL DIFFERENCES BETWEEN CHILDREN AND ADULTS

A
  • smaller and shorter airway
  • larger tongue
  • nose breathers
  • belly/diagram breathers
  • increased rate and effort
  • retractions
  • vagal nerve
  • eustation tube
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2
Q

NORMAL RESPIRATORY RATES IN CHILDREN

A

INFANT (<1YR)
30-60

TODDLER(1-3)
24-40

PRESCHOOLER(4-5)
22-34

SCHOOL AGE (6-12)
18-30

ADOLESCENT
12-16

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3
Q

OXYGENATION ASSESSMENT GUIDELINES

A
  • position of comfort
  • vital signs
  • respiratory effort
  • lung auscultation
  • color
  • cough
  • behavior change
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4
Q

RESPIRATORY DISTRESS

A

-any respiratory condition can progress to respiratory distress

  • if not managed can lead to respiratory failure
  • hypoxemia that persists when supplemental oxygen is given is a sign of respiratory failure
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5
Q

CLINICAL MANIFESTATIONS OF RESPIRATORY DISTRESS AND FAILURE

A
  • mild distress/initial signs of failure (compensating )
  • moderate distress/early decompensation
  • severe distress / imminent failure or arrest
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6
Q

GENERAL CARE STANDARDS

A
  • oxygen /O2 sats
  • CPT/PD and suction
  • incentive spirometer
  • saline nose drops
  • antibiotics
  • isolation
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7
Q

GENERAL CARE STANDARDS

A
  • rest
  • reduce fever
  • hydration
  • nutrition
  • cough medications
  • positioning
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8
Q

CATEGORIZATION OF RESPIRATORY TRACT INFECTIONS

A
  • upper respiratory tract
  • croup syndromes
  • lower respiratory tract
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9
Q

UPPER RESPIRATORY TRACT INFECTION (URI)

A
  • tonsillitis:GABHS
  • tonsillitis and adenoidectomy
  • safety education
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10
Q

URI: OTITIS MEDIA

A

-immobile , red or yellow, bulging TM
- symptoms
otalgia
fever
otorrhea
crying
fussy
tendency to pull or rub ear
rolls head from side to side

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11
Q

OTITIS MEDIA

A

therapeutic management

  • high dose amoxicillin
  • myringotomy , tympanoplasty/PE tubes

-teaching and nursing care management

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12
Q

CROUP SYNDROMES

A

general term for a group of symptoms characterized by:

  • barking/brassy or seal like cough
  • inspiratory stridor
  • respiratory distress
  • swelling /obstruction in the region of the larynx

Includes:

  • laryngotracheobronchitits(LTB) : subglottic
  • epiglottis :supraglottic
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13
Q

LARYNGOTRACHEOBRONCHITIS

A
  • obstruction (subglottic)
  • slower onset, URI symptoms lead to cough and hoarseness
  • medical management “steeple sign”
  • nursing management : teaching
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14
Q

EPIGLOTTITIS

A
  • obstruction (supraglottic)
  • cherry red edematous epiglottis
  • usually caused by haemophilus influenza (H.Flu)
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15
Q

EPIGLOTTITIS CLINICAL MANIFESTATIONS

A
  • dysphagia
  • dysphonia
  • stridor aggrevated when supine
  • drooling
  • high fever
  • toxic appearance
  • froglike croaking sound
  • agitated/apprehensive
  • tripod sitting

SAFETY ALERT

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16
Q

EPIGLOTTITIS CONTINUED

A

at risk :

  • 2-4 yrs old
  • teaching vaccination

medical management

  • diagnosis
  • treatment

Nursing teaching

17
Q

RESPIRATORY SYNCYTIAL VIRUS / BRONCHIOLITIS

A
  • inflammation and obstruction of bronchioles
  • Highest risk :
  • less than 2 yrs
  • chronic lung disease
  • congenital lung disease
  • preterm, less than 35 weeks
18
Q

CLINICAL MANIFESTATIONS

A
  • rhinorrhea
  • increased cough and wheezing
  • tachypnea
  • unstable O2 stats

Begins as URI

19
Q

DIAGNOSIS

A
  • rhinorrhea
  • increasing respiratory distress
  • chest x ray
  • positive RSV swab of nasopharyngeal secretions
20
Q

TREATMENT

A

-ribavirin aerosol (controversial)
- RSV immunoglobulin (synagis)
prevention

Nursing care
EBP article
question 1

21
Q

PULMONARY DYSFUNCTIONS NOT CAUSED BY INFECTIOUS AGENTS

A
  • foreign body aspiration
  • asthma
  • cystic fibrosis
22
Q

FOREIGN BODY ASPIRATION

A
  • symptoms
  • Heimlich and back blows
  • bronchoscopy

nursing care
teaching

23
Q

ASTHMA

A

-reactive airway disease
-pathophysiology :
chronic inflammatory disorder of airways

-classification for children 5 years and older

24
Q

ASTHMA CONTINUED

A 
PRIMARY PREVENTION 
who's at risk 
-infants 
-usually starts between 3 and 8 yrs 
-atopy (allegies)
- complex disorder
-genetic predisposition
25
Q

MEDICATION

A

MDI
aerochamber/spacer
nebulizer

26
Q

CYSTIC FIBROSIS

A
  • autosomal recessive trait
  • exocrine gland dysfunction that produces multisystem involvement
  • mutated gene on chromosome 7
27
Q

CF PATHOPYSIOLOGY

A

CFTR: cystic fibrosis transmembrane regulator
- abnormal chloride movement

-increased viscosity of mucus gland secretion

28
Q

CF DIAGNOSIS

A
  • history
  • quantitative sweat chloride test (>60 is diagnostic)
  • chest x ray
  • stool fat and or enzyme analysis
29
Q

CF GOALS

A
  • prevent/ minimize pulmonary complications
  • adequate nutrition for growth
  • assist in adapting to chronic illness
30
Q

AREAS FRO ASSESSMENT IN CF

A

NUTRITION
pancreatic ducts
bile ducts

SEXUALITY

OXYGENATION
lungs

ELIMINATION/NUTRITION
small intestine

coping and adaption

31
Q

COLLABORATIVE CARE

A

-prevent colonization of pathogens and move secreations
-aerosol : bronchodilators, and pulmozyme /DNase
- daily CPT/PD
flutter valve (PEP therapy), vibrating vests

-antibotics

32
Q

NUTRITION

A

pancreatic ducts

  • malabsorption
  • fibrosis eventual CFRD

Bile Ducts

  • decreased bile
  • decreased ADEK
  • portal hypertension
33
Q

TREATMENT FOR CF

A
  • ursodiol/actigall
  • supplemental tube feedings
  • ADEK vitamin
  • increase calories and protein
  • insulin
34
Q

PATIENT CETERED CARE

A
  • therapy at home
  • prognosis
  • lung transplant
  • CF foundation
  • family support
35
Q

COMMON NURSING DIAGNOSIS FOR CHILDREN WITH RESPIRATORY SYMPTOMS

A
  • ineffective airway clearance
  • impaired gas exchange
  • ineffective breathing pattern
  • activity intolerance
  • fluid volume deficeit
  • fear/anxiety
  • risk for spread of infection

Pediatrics (7 decks)

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