Paediatric - Conditions Flashcards
1
Q
Asthma
A
- narrowing of small airways (bronchospasm + inflammation + mucous production)
- symptoms in children more severe as they have smaller airways
- caused by triggers - URTI, dust, exercise, seasonal changes, pet hair, pollens
2
Q
Asthma - Symptoms
A
- shortness of breath
- increased WOB
- tachycardia
- tachypnoea
- cough
- ? wheeze (airways can be occluded, no air passing through, no wheeze)
3
Q
Asthma - Management
A
- continual assessment of respiratory status
- bronchodilators, corticosteroids (reduce inflammation), supplemental oxygen therapy, aminophylline
- hydration
- can become acute quickly, need to be in area where visual assessments can be done frequently
4
Q
Bronchiolitis - Definition
A
- acute viral infection of the lower airway (antibiotics are useless), inflammatory obstruction of the bronchioles
- even minor swelling of bronchioles in an infant can produce profound changes in airflow
- common in the cooler months
- source is usually family member with minor respiratory illness
- peak incidence 1-6 months up to 2 years old
- diagnosed on nasal pharyngeal aspirate (NPA)
5
Q
Bronchiolitis - Symptoms
A
- can inhale, can’t exhale
- presentation
- increasing respiratory distress
- tachypnoea
- increasing cough
- irritability
- decreased feeding
- wheeze / apnoea
- develops into respiratory distress, wheezy cough, dyspnoea, irritability
- air becomes trapped in the lungs & interferes with gas exchange
- hypoxaemia
- hypercapnia in severe cases
- collapse of alveoli
- wheezing & rales
6
Q
Bronchiolitis - Management
A
- most critical phase - first 48-72hrs
- cyanosis, pallor, listlessness, sudden diminution or absence of breath sounds indicate impending respiratory failure
- nurse upright
- monitor respiratory status frequently
- antibiotics are ineffective (viral infection)
- treat dehydration if present - ensure adequate hydration
- minimal handling - conservation of energy - comfort
- educate parents
- incubation 2-8 days, nurse in isolation
- strict hand washing, course of illness is 7-10 days
7
Q
Croup - Acute Laryngotracheobronchitis - Definition
A
- acute viral illness, causes inflammation oedema & obstruction of the larynx, trachea & bronchi (inflammation & swelling in upper & lower airway)
- swelling causes narrowing = high pitched stridor and barking cough
- most common in cooler months
- infants & children 6-36 months, up to 7 years
- usually due to parainfluenza (75%)
8
Q
Croup - Acute Laryngotracheobronchitis - Presentation
A
- diagnosis made on presentation & symptoms rather than testing for the virus
- 2-3 days of URTI symptoms
- increasing respiratory distress
- inspiratory stridor
- barking cough
- fever
- all worsening at night
- substernal & intercostal retractions
- child prefers to sit up or be cuddled
9
Q
Croup - Acute Laryngotrachobronchitis - Management
A
- ongoing assessment of respiratory status
- good history
- minimal interventions - if child becomes stressed, increases work of breathing & can lead to respiratory distress
- steroids - get inflammation down
- hydration
- adrenaline (nebulised)
10
Q
Pertussis - Definition
A
- bacterial infection of the respiratory tract
- highly contagious, 70% of unimmunised children will get it, is preventable by vaccination, confirmed cases need to be reported to the health department
- can be fatal
- causes - bordatella pertussis - gram negative bacillus
- diagnosis - with NPA or bloods
- transmission - via respiratory droplets or handling contaminated items
11
Q
Pertussis - Symptoms
A
- incubation of 7-10 days
- URTI symptoms 1-2 weeks
- irritating cough, sneezing, fever, collection of thick secretions
- cough becomes paroxysmal (develops an odd pattern) or spasmodic with little or no effective respiration inbetween
- deep breath after prolonged coughing = characteristic “whoop” or apnoea in babies
12
Q
Pertussis - Management
A
- isolation
- assistance with adequate oxygenation
- support during coughing episodes - positioning, suctioning, oxygen if required
- hydration
- antibiotics - 10-14 days to recude communicability - doesn’t reduce severity or length of illness
13
Q
Chicken Pox - Definition
A
- contagious viral infection
- cause - varicella zoster
- incubation period 12-21 days, infectious 2 days prior to spots appearing until all dried and crusted
- complications - pneumonia, bacterial infection, meningitis, representation as shingles later in life
- doesn’t require hospitalisation unless child is under 12 months old, develops infection of spots or if involves oral mucosa or eyes
14
Q
Chicken Pox - Symptoms
A
- 2-3 days of viral symptoms
- fever
- runny nose
- lethargy
- decreased appetite
- conjunctivitis
- appearance of prodromal rash (pustules) which gradually spread
- spots begin on the trunk
15
Q
Chicken Pox - Management
A
- isolation
- treatment of fever
- adequate diet & fluids
- pinetarsol baths & calamine lotion for itching
